ABSTRACT
Telehealth offers a healthcare solution when functional, social, or geographic barriers arise;however, many clinical education curricula are ill-equipped to prepare learners for effective, multidisciplinary telehealth consultations. The COVID-19 pandemic drastically expanded reliance on telehealth in clinical practice and highlighted the urgent need to educate students across health professions in telehealth delivery. To address this educational gap, student and faculty collaborators from Duke University and the University of North Carolina at Chapel Hill utilized a developmental evaluation approach to rapidly design and pilot a compact, five-session, virtual curriculum to train students from a broad range of health professions in telehealth delivery. Through focused readings, large group didactics, and small group discussion, the curriculum provided a general overview of telehealth, addressed specific issues in health equity and access in virtual care both locally and nationally, introduced skills for conducting telehealth visits, and employed a patient simulation for students to practice their newly learned skills. The curriculum was delivered virtually over eight weeks to 36 students from ten health professions programs (occupational therapy, social work, pharmacy, audiology, speech-language pathology, dentistry, medicine, nursing, physical therapy, and physician assistants) across two universities. End-of-course feedback surveys identified that students most valued the opportunity to work with learners from different professions, practical instruction for telehealth, and a standardized patient experience. On post-course surveys students reported high self-efficacy in their telehealth competencies and indicated very positive attitudes toward interprofessional education. Overall, the compact nature of this curriculum facilitates adaptability to other student-led groups. © 2023 Elsevier Inc.
ABSTRACT
As both the largest integrated health system and largest provider of telehealth in the country, the Veterans Health Administration (VHA) has a particular interest in understanding how best to implement and utilize virtual care. VHA has long embraced virtual care as part of its mission to "serve all who have served" regardless of their socioeconomic and geographic circumstances. Having begun conducting "virtual care" in the 1960s when doctors first communicated with patient's via TV screens,1 VHA has since provided over 2.6 million episodes of care to more than 900,000 Veterans in 20192 and has distributed over 50,000 data- and video-enabled iPads for Veterans throughout the country.3 Virtual care within VHA includes services such as MyHealtheVet secure messaging, the Home Telehealth program that combines case management principles with remote monitoring to improve access and coordinate care, and the VA Video Connect (VVC) video platform for synchronous visits within both specialty and primary care.4 Increasing Veteran access to care via virtual care has been an integral part of VHA's strategy for improving chronic disease management for a population that is on average older and sicker than their civilian counterparts.5,6 Given the importance that virtual care has for Veteran care even beyond the COVID-19 pandemic, understanding the strengths and limitations associated with synchronous virtual care will be critical in shaping how VHA utilizes virtual care going forward.