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REVIEW ARTICLE
Year : 2021  |  Volume : 48  |  Issue : 3  |  Page : 135-137

Introducing the component of telemedicine in the undergraduate medical education training period


1 Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

Date of Submission04-Apr-2021
Date of Acceptance22-May-2021
Date of Web Publication28-Dec-2021

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jss.jss_29_21

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  Abstract 


The field of telemedicine has shown exponential growth across the last few decades and has opened gateways for people living in distant geographical locations to access health care. The purpose of the current review was to explore the introduction of telemedicine during the medical education training period. An extensive search of all materials related to the topic was carried out in the PubMed search engine and a total of 13 articles were selected based upon the suitability with the current review objectives and analyzed. It is a fact that for the successful implementation of a telemedicine unit, the medical personnel plays a defining role. This calls for an indispensable need to expose the medical students to telemedicine during their training period, so that they are not only aware of the same but even prepared to use it in their future clinical practice. The need of the hour is to systematically introduce the telemedicine-related competencies in a standardized manner without stretching the overall duration of the medical training. In conclusion, telemedicine has emerged as an important aspect of the health-care delivery system, and thus it is quite essential that we expose medical students to telemedicine during their undergraduate period of training. We must remember that a lot of effort is required to ensure that the training of medical students in telemedicine remains meaningful, relevant, and holistic.

Keywords: Medical education, telemedicine, undergraduate


How to cite this article:
Shrivastava SR, Shrivastava PS. Introducing the component of telemedicine in the undergraduate medical education training period. J Sci Soc 2021;48:135-7

How to cite this URL:
Shrivastava SR, Shrivastava PS. Introducing the component of telemedicine in the undergraduate medical education training period. J Sci Soc [serial online] 2021 [cited 2022 Aug 15];48:135-7. Available from: https://www.jscisociety.com/text.asp?2021/48/3/135/333841




  Introduction Top


The field of telemedicine has shown exponential growth across the last few decades and has opened gateways for people living in distant geographical locations to access health care.[1] In fact, the presence of factors such as shortage in the health workforce, weak primary health care, and minimal or no availability of specialists in rural and remote locations have all accounted for the rapid expansion of telemedicine in different settings, especially in low- and middle-income nations. Moreover, the simultaneous rise in the number of people who are having access to smartphones has also been an enabling factor for the applicability of telemedicine in different parts of the world.[1],[2] The purpose of the current review was to explore the introduction of telemedicine during the medical education training period.


  Methods Top


An extensive search of all materials related to the topic was carried out in the PubMed search engine. Relevant research articles focusing on research skills among medical students published in the period 2005–2020 were included in the review. A total of 15 studies similar to current study objectives were identified initially, of which, two were excluded due to the unavailability of the complete version of the articles. Overall, 13 articles were selected based upon the suitability with the current review objectives and analyzed. Keywords used in the search include telemedicine, medical education, and COVID-19 in the title alone only (namely. telemedicine[ti] AND medical education[ti]; telemedicine[ti] AND undergraduate medical education[ti]). The articles published in only the English language were included for the review. The collected information is presented under the following subheadings, namely Telemedicine and Medical Education, Exposing medical students to telemedicine, Telemedicine and Medical Education during COVID-19, Potential limitations and additional considerations, Implications for practice, and Implications for research.


  Telemedicine and Medical Education Top


The scope and utility of telemedicine can be easily understood by the evidence that most of the hospitals and health insurance companies have resorted to telemedicine to come out with feasible solutions to health-care issues.[3] It is quite obvious that a lot of technical assistance is required for the successful implementation of a telemedicine unit, nevertheless the medical personnel involved in telemedicine actually forms the backbone of the entire process.[3],[4] In fact, exposure of the medical student to provide quality-assured, safe, and individualized health care via the channel of telemedicine can significantly minimize the prevailing disparities in utilization of health care.[1],[3] We must note that telemedicine has found immense application even for the sake of continuing medical education and thereby aiding in the process of development of lifelong learners.[5],[6]


  Exposing Medical Students to Telemedicine Top


This calls for an indispensable need to expose the medical students to telemedicine during their training period, so that they are not only aware of the same but even prepared to use it in their future clinical practice.[4],[7],[8] The training in telemedicine plays a remarkable role in the development of core competencies pertaining to the domains of patient care, medical knowledge, and practice-based learning and improvement.[2],[3] The exposure to telemedicine should ideally start from the first professional year in the form of didactic lectures, interactions with standardized patients, or even visit to the telemedicine unit. The same sorts of exposure can be continued across different professional years for a continuous exposure.[3],[4]

Further, the undergraduate medical students can also be posted to a telemedicine unit as a part of the elective postings and learn the involved intricacies. Moreover, we must expose the students to telemedicine during the period of internship by posting them in those departments (namely Psychiatry, neurology, cardiology, and radiology), wherein telemedicine is being widely employed.[7],[8] The tool of telemedicine can also be used for the conduction of assessment (like objective structured clinical examinations) in rural settings.[9]


  Telemedicine and Medical Education during COVID-19 Top


The COVID-19 pandemic has accounted for significant health, social, and financial consequences and made the public health authorities to think about the extent of preparedness. Similar to what was reported across different fields, even the delivery of medical education got impacted in an enormous way.[10],[11],[12] As the infection spreads by close contact, it was decided to close the medical institutions and suddenly the mode of teaching showed a massive shift from the face-to-face classes to the online mode. Although didactic lectures and small group activities continued online, but the same was not the case for clinical postings, considering safety issues (amid shortage of personal protective equipment) and even ethical concerns.[10],[11]

To continue the clinical training, the telemedicine framework was adopted in some of the settings, wherein apart from the medical consultation, students were involved in the COVID-19-related research and to extent mental health support to the patient and their family members.[10] In fact, considering the prolonged nature of the pandemic and the reality that social distancing might become the new normal, specific steps have been taken to integrate telemedicine into the existing medical curriculum. The adoption of such a telemedicine curriculum will not only aid in the smooth training of the current crop of medical students but will also play a big part in developing a framework that can be readily adopted during the future pandemics.[10]

In a medical school in the United States of America, a special pandemic follow-up telemedicine clinic was established to provide medical students with an ample number of learning opportunities toward the aim to continue their education and strengthening of patient care.[11] The clinic was mainly involved in the delivery of follow-up care via telephone calls for those patients who have earlier approached the health-care establishments due to COVID-19. In addition, utilizing the scope of telemedicine, the medical students were also involved in eliciting history, reaching differential diagnosis, management of symptoms, and offering tailormade advice pertaining to the prioritization of their health needs in terms of decision about referral to health-care facilities. The same teleclinic opportunity was utilized for teaching as well through discussion and by encouraging students to reflect upon the interaction with the patients.[11],[12]


  Potential Limitations and Additional Considerations Top


Regardless of the immense scope and utility of telemedicine, there have been concerns pertaining to the quality of care delivered, safeguarding the information of patients, lack of rapport with health-care providers, legal constraints, etc.[2],[3] In addition, as telemedicine is still in nascent stages, a lot of research needs to be done to explore the ways in which undergraduate medical students can be exposed to telemedicine.[1],[4] The need of the hour is to systematically introduce the telemedicine-related competencies in a standardized manner without stretching the overall duration of the medical training. This calls for the need to merge telemedicine within the existing curricular provisions, either merging with the existing clinical postings or as a part of the elective module or earmarked postings.[1],[2],[3],[13]


  Implications for Practice Top


The introduction of telemedicine as a tool to continue the delivery of medical education is a challenging task, especially in those medical institutions that are finding it extremely difficult to extend patient care due to scarcity of logistics.[13] In fact, for decades together, the medical institutions are delivering face-to-face teaching–learning and assessment and expecting them to shift to telemedicine that too for the sake of teaching, essentially will require loads of preparation and planning. The planning has to begin with the identification of the mode or application which the institution will be able to adopt considering the existing status of resources. This consideration will obviously require support from the administration and technical support.

This has to be followed by training of the faculty members about the tool features and the ways in which the tool can serve the purpose of facilitating learning. Simultaneously, students also have to be sensitized about the entire application, the features, and the roles expected from them while they are interacting with the patients. Further, the overall success of the initiative will depend upon the wide reach (especially for the vulnerable population groups) of the application, and this will require the support of the publicity team of the institution. It is always a good practice to evaluate the initiative periodically so that need-based modifications can be made and eventually patients and communities are benefitted.


  Implications for Research Top


Considering the novelty of the telemedicine component in most of the low- and middle-income nations, it gives an ample ground for the researchers to explore the field. The first and foremost research component can be to gain insights into the pros and cons of using telemedicine for the delivery of medical education. This study can be carried out either via a quantitative approach or using a qualitative approach for getting valuable and in-depth information. Another area of research interest will be to compare the extent of learning using the telemedicine approach with other approaches (conventional) for learning. Similarly, research activities can even target patients in terms of obtaining their views about the quality of care delivered via telemedicine and any specific improvements that they desire further in the near future.


  Conclusion Top


Telemedicine has emerged as an important aspect of the health-care delivery system, and thus it is quite essential that we expose medical students to telemedicine during their undergraduate period of training. We must remember that a lot of effort is required to ensure that the training of medical students in telemedicine remains meaningful, relevant, and holistic.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Boyers LN, Schultz A, Baceviciene R, Blaney S, Marvi N, Dellavalle RP, et al. Teledermatology as an educational tool for teaching dermatology to residents and medical students. Telemed J E Health 2015;21:312-4.  Back to cited text no. 1
    
2.
Waseh S, Dicker AP. Telemedicine training in undergraduate medical education: mixed-methods review. JMIR Med Educ 2019;5:e12515.  Back to cited text no. 2
    
3.
O'Shea J, Berger R, Samra C, Van Durme D. Telemedicine in education: Bridging the gap. Educ Health (Abingdon) 2015;28:64-7.  Back to cited text no. 3
    
4.
Yaghobian S, Ohannessian R, Mathieu-Fritz A, Moulin T. National survey of telemedicine education and training in medical schools in France. J Telemed Telecare 2020;26:303-8.  Back to cited text no. 4
    
5.
Praharaj SK, Ameen S. The relevance of telemedicine in continuing medical education. Indian J Psychol Med 2020;42:97S-102.  Back to cited text no. 5
    
6.
Rafiq A, Merrell RC. Telemedicine for access to quality care on medical practice and continuing medical education in a global arena. J Contin Educ Health Prof 2005;25:34-42.  Back to cited text no. 6
    
7.
Lee MS, Nambudiri V. Integrating telemedicine into training: Adding value to graduate medical education through electronic consultations. J Grad Med Educ 2019;11:251-4.  Back to cited text no. 7
    
8.
Randriambelonoro M, Bagayoko CO, Geissbuhler A. Telemedicine as a tool for digital medical education: A 15-year journey inside the RAFT network. Ann N Y Acad Sci 2018;1434:333-41.  Back to cited text no. 8
    
9.
Palmer RT, Biagioli FE, Mujcic J, Schneider BN, Spires L, Dodson LG. The feasibility and acceptability of administering a telemedicine objective structured clinical exam as a solution for providing equivalent education to remote and rural learners. Rural Remote Health 2015;15:3399.  Back to cited text no. 9
    
10.
Jumreornvong O, Yang E, Race J, Appel J. Telemedicine and medical education in the age of COVID-19. Acad Med 2020;95:1838-43.  Back to cited text no. 10
    
11.
Sharma D, Bhaskar S. Addressing the Covid-19 burden on medical education and training: The role of telemedicine and tele-education during and beyond the pandemic. Front Public Health 2020;8:589669.  Back to cited text no. 11
    
12.
Aron JA, Bulteel AJB, Clayman KA, Cornett JA, Filtz K, Heneghan L, et al. A role for telemedicine in medical education during the COVID-19 pandemic. Acad Med 2020;95:e4-5.  Back to cited text no. 12
    
13.
Mahapatra AK, Mishra SK, Kapoor L, Singh IP. Critical issues in medical education and the implications for telemedicine technology. Telemed J E Health 2009;15:592-6.  Back to cited text no. 13
    




 

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