Virtual Clinical Shadowing for Pre-Clinical Medical Students in an Emergency Medicine-Based Leadership Course.

Purpose: The COVID-19 pandemic limited pre-clinical medical students from participating in traditional clinical in-person shadowing. Rather than eliminating clinical shadowing from an established leadership course, we describe the experience of six pre-clinical medical students shadowing physician preceptors remotely through virtual platforms. Methods: Six pre-clinical medical students enrolled in 2020's Weill Cornell Medicine's Healthcare Leadership and Management Scholars Program were prepared with training materials for on-camera patient care. Students shadowed emergency medicine (EM) physicians providing clinical care in one of our New York Presbyterian emergency departments (EDs) and through telemedicine. Pre- and postsurveys were provided to these students. Results: From three different U.S. time zones, students were safely able to shadow EM physicians. The educational fidelity was maintained in physician-student relationships, but revealed opportunities for improvement in students' clinical learning, in ED clinical care, and in telemedicine visits. Conclusions: Virtual clinical shadowing is a viable option for pre-clinical students, when in-person options are not available. With logistical adjustments, this medium may be a long-term educational option especially for telemedicine.

Curricular response to COVID-19: real-time interactive telehealth experience (RITE) program.

Introduction. The COVID-19 pandemic placed an unprecedented strain on academic healthcare systems necessitating a pause in medical student teaching in clinical care settings, including at Weill Cornell Medicine (WCM). WCM had a preexisting telemedicine curriculum, but limited opportunities for students to apply knowledge and skills related to direct virtual patient care. The authors describe the rapid implementation of real-time interactive telehealth experience (RITE) courses for clerkship students to allow for meaningful engagement in remote patient care and continuation of academic progress during the pause.Methods of Course Development. Medical school administration disseminated a request for proposals for RITE courses conforming to the WCM electives format with rapid turnaround time of 1 week or less. Requirements included remote care activities, goals and objectives, general logistics, supervision methods and standards of achievement. RITE courses were developed in outpatient medicine, inpatient medicine, psychiatry and women's health. A lottery process was developed to register students for the approved courses.Course Implementation and Evaluation. Using the technical platform and standard course registration process, students were assigned to 74 of 76 available RITE course slots. Students participated in supervised remote direct patient care and also provided critical support for frontline healthcare workers by performing remote clinical tasks. Online teaching and reflection sessions were incorporated into each RITE curricular offering. Student feedback was overall positive ranging from 3.33-4.57 out of 5.Discussion. The COVID-19 pandemic created a need to rapidly incorporate telehealth models in order to continue to deliver patient care and an opportunity to develop innovative remote educational experiences. We developed a framework for structured real-time interactive telehealth experiences to address COVID-19 related curricular needs that will be continued post-COVID-19. This expanded telehealth curriculum for our students will provide standardized training in telehealth logistics, communication techniques, and care delivery now essential for graduating medical students.

Utilizing Telemedicine in a Novel Approach to COVID-19 Management and Patient Experience in the Emergency Department.

Background: The COVID-19 crisis has highlighted telemedicine as a care delivery tool uniquely suited for a disaster pandemic. Introduction: With support from emergency department (ED) leadership, our institution rapidly deployed telemedicine in a novel approach to large-scale ED infectious disease management at NewYork-Presbyterian/Weill Cornell Medical Center (NYP/WCMC) and NewYork-Presbyterian/Lower Manhattan Hospital (NYP/LMH). Materials and Methods: Nineteen telemedicine carts were placed in COVID-19 isolation rooms to conserve personal protective equipment (PPE) and mitigate infectious risk for patients and providers by decreasing in-person exposures. Results: The teleisolation carts were used for 261 COVID-19 patient interactions from March to May 2020, with 79% of overall use in March. Our urban academic site (NYP/WCMC) had 173 of these cases, and the urban community hospital (NYP/LMH) had 88. This initiative increased provider/patient communication and attention to staff safety, improved palliative care and patient support services, lowered PPE consumption, and streamlined clinical workflows. The carts also increased patient comfort and reduced the psychological toll of isolation. Discussion: Deploying customized placement strategies in these two EDs maximized cart availability for isolation patients and demonstrates the utility of telemedicine in various ED settings. Conclusions: The successful introduction of this program in both academic and urban community hospitals suggests that widespread adoption of similar initiatives could improve safe ED evaluation of potentially infectious patients. In the longer term, our experience underscores the critical role of telemedicine in disaster preparedness planning, as building these capabilities in advance allows for the agile scaling needed to manage unforeseen catastrophic scenarios.