To the Editor:
The COVID-19 pandemic has challenged health care workers in innumerable ways. One of the practical challenges has been converting from seeing patients in the office to having virtual visits. A modality that was hardly used in years prior, telehealth has become the mainstay for many primary care physicians. From troubleshooting new software to compensating for the lack of a physical exam to navigating difficult conversations with only oral or pixellated visual cues, the telehealth switch has been a monumental change from the way many physicians practiced only a few months ago.
With more and more health systems scrambling to offer virtual visits to patients, it is reasonable to expect that telehealth will remain in place even after COVID-19 is no longer wreaking havoc across the world. If true, medical educators will have to develop a comprehensive curriculum to prepare medical students for virtual visits.
Many medical schools already have courses teaching students the “soft skills” of being a physician, such as motivational interviewing, the proper way to do physical exam maneuvers, and delivering bad news, among many others. Similarly, medical students will need education on telehealth etiquette and expectations, tricks of the trade for effectively taking a virtual history, and possible ways to instruct patients to do modified physical exam maneuvers. Medical students need to be prepared for seeing patients on the screen instead of in person.
Even though this care modality is still early in its inception, several medical schools have already offered educational opportunities in telehealth. Unfortunately, these opportunities are still few and far between.1 Medical schools will need to develop a robust curriculum that engages students throughout their education. There are a number of ways to incentivize the development of this curriculum from offering grants to modifying either accreditation requirements or national testing. I recommend that, if the United States Medical Licensing Exam Step 2 Clinical Skills is offered again, it become entirely virtual. While grants and standards can cause educational committees to reexamine curriculum, changes in testing drive medical schools to reevaluate and revolutionize curriculum. COVID-19 is the tragic catalyst medical schools need to make virtual health education a reality.
1. Waseh S, Dicker AP. Telemedicine training in undergraduate medical education: Mixed-methods review. JMIR Med Educ. 2019;5:e12515