- Elizabeth Painter, PsyD, MSCP, Clinical Instructor, Case Western Reserve University School of Medicine and Associate Director of Psychology for the Center of Outpatient Education at the VA Northeast Ohio Healthcare System, Cleveland, OH
- Megan McNamara, Professor of Medicine, Case Western Reserve University School of Medicine and Director of the Center of Outpatient Education at the VA Northeast Ohio Healthcare System, Cleveland, OH
The Center of Outpatient Education (COE) in an interprofessional teaching program that was developed to train future health care professionals to work successfully in teams. Trainees within the COE include residents and students from the following fields: Medicine, Nurse Practitioner, Nursing, Pharmacy, Psychology and Social Work. At the onset of the COVID-19 pandemic, the entirety of these learners’ clinics, didactics, and supervision had to be transitioned to virtual modalities.
Thankfully, our faculty team was able to successfully convert our didactics to a virtual platform, while still maintaining interactivity and learner engagement. However, we realized that our existing curriculum did not adequately address the knowledge and skills necessary for successful virtual medicine encounters, including rapport building, attending to verbal and non-verbal cues, and tolerance of clinical ambiguity. Additionally, we felt that it was essential to highlight the unique challenges of clinical decision-making in the absence of physical exam findings or “standard” resources (i.e., radiology, lab work, social services, etc.).
As such, we developed a new case-based virtual medicine curriculum, which leverages digital learning platforms and small-group work to teach learners the essential skills necessary for our evolving outpatient practices. The approach we took is consistent with adult learning theory, the ICAP model of cognitive engagement proposed by Chi and Glaser, and research on fostering independent learning. Our focus was on achieving high levels of cognitive engagement by maximizing interactions among learners as well as learner independence and accountability.
This curriculum was created to provide essential clinical skills for virtual medicine, with an emphasis on teamwork, leadership, and effective communication. Conducted in three parts, the sessions focused on 1) The Fundamentals, 2) Advanced Skills in Virtual Medicine, and 3) Chronic Disease Management and Virtual Medicine through the utilization of didactic components, “unfolding cases”, and small and large group work. To date, this curriculum has been well-received by learners, who report satisfaction with the content as well as the small group activities. In the future, we plan to investigate how patient outcomes may be influenced by participation in this course.
Teaching virtual medicine through virtual platforms requires clear goals, creativity, and dedicated faculty. While practicing virtually is not always easy or preferred, utilizing a developmental case-based curriculum can help learners recognize the most beneficial components of virtual practice. And ideally, by providing not only content/clinical skills, but fostering and reinforcing skills in teamwork, leadership, and effective communication, virtual learning empowers trainees to optimize their experiences with this modality of practice.
- Identify the impact of COVID-19 on clinical care modalities and the current role of virtual visits in outpatient medicine.
- Describe the creation and implementation of an innovative virtual medicine curriculum for interdisciplinary learners, focusing on needed clinical skills with an emphasis on teamwork, leadership, and effective communication.
- Summarize satisfaction/effectiveness data for the implementation of a novel virtual medicine curriculum and discuss future directions of the project.