Pilot Implementation and Evaluation of an Outpatient Teleneurology Curriculum for Medical Students
Melissa Ko1, Heather Moss2, Devin Mackay1, Paul Ko1, Katherine Chartier1, Lindsey Reese1, Paul Wallach1, Bradley Allen1
1Indiana University School of Medicine, 2Spencer Center for Vision Research at Stanford
Objective:
To assess the feasibility and outcomes for a novel teleneurology educational curriculum
Background:
Stemming from the COVID-19 pandemic, medical students rotating on neurology electives were asked to participate in telehealth encounters with limited formal teaching and evaluation on the principles and practice of teleneurology.
Design/Methods:
We developed a 2-week outpatient teleneurology curriculum consisting of virtual asynchronous video modules and virtual synchronous patient interactions designed to address AAMC telehealth competencies. It was delivered as a supplement to an established outpatient neurology elective for 4th year medical students from July 2021-September 2022 at a US medical school. Participation was optional. Assessments included pre and post student self-rated confidence in 6 telehealth competencies on a 4-point scale. Students participated in a summative virtual visit with a neurological patient under direct observation of an attending neurologist well-versed in telehealth. Both the observing neurologist and patient evaluated the student in the telehealth competencies.
Results:
Twenty-six 4th year medical students participated in the pilot. Each student spent 1 hour viewing asynchronous video modules, and had 454 ± 200.5 (mean+/-SD) minutes of virtual patient contact over 15 ± 8.2 virtual visits. After completing the curriculum, students were 92-100% moderately or very confident regarding their capabilities across telehealth competencies, representing an improvement from 12-96% compared to pre-curriculum (average increase 0.56-1.84 on the 4-point scale; p<0.005 for all competencies). Examination and regulatory competencies demonstrated the greatest improvement. Competencies were rated as effective or very effective for 88-100% of students by patients and 92-100% of students by faculty during the summative visit.
Conclusions:
This pilot teleneurology curriculum demonstrated that students not only increased in self-rated confidence in performing telehealth competencies, but also demonstrated meeting these competencies in the opinion of both physician and patient observers. Further research into effective methods for integrating telehealth competencies into the neurology and broader medical school curriculum is warranted.