Assessing Medical Student Competency in the Teleneurology Examination

ABSTRACT

Background: The CoVid-19 pandemic prompted U.S. medical schools to increasingly implement telemedicine curriculum in undergraduate medical education. The neurological exam is wellsuited to the virtual doctor's visit, which has been demonstrated by telestroke for many years. However, there are few established protocols for assessing medical students' proficiency at performing a telemedicine exam. Studies show that students view formal telemedicine training as valuable to their medical education. Design/Methods: We recruited voluntary third-year medical students from University of New Mexico School of Medicine. We developed an innovative scorecard to yield a “neurologicalexam-score” (NES). Students were assigned a patient on which both in-person and teleneurological examination was performed yielding a “Student in-person NES” and “Student teleneurology NES”. Students were randomly assigned to perform an in-person exam or the teleneurological exam first. A neurology faculty or resident also performed an in-person examination on the patient yielding a “Faculty/Resident NES,” our “gold standard”. We compared the [Faculty/Resident NES minus Student in-person NES] score to [Faculty/Resident NES minus Student teleneurology NES] score using a one-tailed t-test, where p <.05 is considered statistically significant. Results: Twenty-nine students participated in the study. Ten were excluded for incomplete examinations and/or lack of neurology faculty NES. Comparing students' in-person exam to teleneurological exam, we found no significant difference between students' scores (mean= -0.5, p=.21). In addition, both “student in-person NES” and “student teleneurology NES” significantly differed compared to neurology faculty/resident's NES scores (mean= 2.3, p<.0001 and mean= 1.8, p<.0001 respectively). Conclusions: Students performed similarly on a teleneurological examination compared to inperson neurological examination. The study was limited by low-power and was limited to a single class. Our study shows potential in incorporating a telemedicine curriculum within the third-year clerkships and supports developing a teleneurology curriculum in an objective manner.