To provide a structured inpatient neurology experience for 3rd year medical students through telemedicine at a rural clinical campus.
In 2021, Neurology became a required 3rd year clerkship for Geisinger Commonwealth School of Medicine (GCSOM) students. Eleven third year medical students per year, since 2022, rotate at Geisinger Lewistown Hospital (GLH), a 133-bed, rural, primary stroke center. This campus has no access to in-house inpatient neurology attendings. The hospital is staffed 24/7 by teleneurology, including telestroke in the emergency department. By exposing medical students to teleneurology both locally at GLH and throughout our telemedicine network, we aim to provide a meaningful educational experience.
Students are oriented to telemedicine and given access to our full list of televideo endpoints and provider software. They are also trained in the operation and storage locations of the local GLH televideo equipment. During their rotation they are accountable for responding to all local stroke alerts and neurology consults. They transport the local televideo equipment into the patient room and are observed by a teleneurology attending throughout the encounter. The students practice the neurological history and exam under direct supervision and with remote teaching at bedside. The student is also able participate, through multipresence software, in remote consults and stroke alerts with the same attending, at other campuses.
Since the inception of this novel rotation, subjective feedback from both students and teleneurology attendings has been positive. All students who rotated through this campus in 2022-2023 passed the National Board of Medical Examiners end-of-clerkship exam on the first attempt; six students received scores of Honors. In 2023, three students from the inaugural GLH clinical campus rotation applied for neurology residency.
Teleneurology, both local site and remote site, is a valuable educational experience for 3rd year medical students and fosters interest in neurology as a career choice.