Neurologists in-training will become proficient in skills needed for an effective teleneurology visit.
Telehealth has improved patient access to clinicians and reduced time/cost burden on patients. Video appointment are now offered in most practices. The AAMC has outlined telehealth domains whereby clinicians must demonstrate proficiency. The Neurology RRC has endorsed support for resident telehealth encounters. We developed a no-cost reproducible telehealth training program to improve resident skills.
Thirteen residents recorded a telehealth counseling session pre-intervention for a patient considering botulinum toxin injections for migraines. (Time 1) Feedback was provided. Residents received a one-hour lesson outlining tele-etiquette, communication and exam skills. Trainees then underwent two 20-minute encounters with faculty trained as standardized patients. (Time 2) A second reviewer also scored the session on video review. Each resident received feedback then completed a third 20-minute clinical encounter at one-year follow-up. (Time 3) Resident confidence in skillset was also measured prior to Time 1 and upon training completion. Statistical analysis was conducted via Wilcoxin Paired t-test
Comparison of pre and post-course resident surveys revealed significant improvement in telehealth comfort in all categories (3.2 ± 0.8 to 4.3 ± SD 0.5 (p <0.005)).
Comparison of initial recording and post-course encounter revealed improvement in tele-communication and “webside” manner ((2.4 ± 0.3, 2.7 ± 0.3), (1.9 ± 0.3, 2.4 ± 0.5) (p <0.05)). Comparison of initial visit and one-year follow up revealed improvement in communication, professionalism and "web-side” manner ((2.4 ± 0.3, 3 ± 0), (2.4 ± 0.7, 3 ± 0), (2.4 ± 0.7, 3 ± 0) (p <0.05)). Additionally, improvement was observed in professionalism between post-course encounter and one year follow up (2.4 ± 0.7, 3 ± 0, (p <0.05)).
A low resource, no cost, telehealth training program can be effectively integrated into resident curriculum and improve tele-related interpersonal skills, communication skills, and professionalism.