Curricular needs for training telemedicine physicians: A scoping review

Abstract

Purpose

The use of telemedicine, a part of ‘Virtual Care’, is rapidly entering mainstream clinical practice. The ideal curriculum for educating physicians to practice in this emerging field has not been established. We examined the literature to evaluate published curricula for quality and comprehensiveness through the lens of Competency-Based Medical Education (CBME).

Methods

We performed a scoping review using CanMEDS as a framework. Peer-reviewed articles describing telemedicine training curricula were identified. Trainee population, curricular points, stage of implementation, evaluation depth, country, and citations (a marker of quality) were examined.

Results

Forty-three curricula from 11 countries were identified, addressing all training levels and covering multiple specialties. Instructional methods included lectures (60.5%), hands-on experiences (76%), directed reading (24%), online modules (21%), reflection (13%), simulation (34%), and group discussions (16%). Hands-on curricula covered all CanMEDS roles more often. Twenty-nine of the implemented curricula were evaluated; 83% were rated positively.

Conclusions

Our scoping review helps inform more comprehensive and efficacious curricula for teaching telemedicine. We suggest centering curricula on a competency-based, outcomes-oriented framework such as CanMEDS with multiple teaching modalities complementing hands-on experiences. This will facilitate rigorous telemedicine training to deliver on the promise of high-quality patient care.

Keywords:

• Telemedicine
• curriculum
• CanMEDS
• education
• physician

Acknowledgments

We would like to acknowledge the support of the HoPingKong Centre for Excellence in Education and Practice (CEEP).

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Telehealth: The delivery of any component of health-care or medical education at a distance.

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Mechael P, Kaonga N, Batavia H, Eskandar H, Dzenowagis J, Perez-Chavolla L, Azad AK, Sovann L, Fraser K, Kupchanko D et al. 2011. mHealth – New horizons for health through mobile technologies. Geneva, Switzerland: World Health Organization.

Knight P, Bonney A, Teuss G, Guppy M, Lafferre D, Mullan J, Barnett S. 2016. Positive Clinical Outcomes Are Synergistic With Positive Educational Outcomes When Using Telehealth Consulting in General Practice: A Mixed-Methods Study. J Med Internet Res. 18(2):e31.

Additional information

Notes on contributors

Rebecca G. Stovel

Rebecca G. Stovel, MD, MScCH (HPTE), FRCPC, is an assistant professor and clinician teacher at the University of Toronto. She practices General Internal Medicine at Women’s College Hospital and has an interest in medical education, ambulatory medicine, and telemedicine.

Nadia Gabarin

Nadia Gabarin, B.Sc, MD, is a core internal medicine resident at the University of Toronto.

Rodrigo B. Cavalcanti

Rodrigo B. Cavalcanti, MD, MSc, FRCPC, is an associate professor and clinician educator at the University of Toronto. He practices General Internal Medicine at Toronto Western Hospital - University Health Network. He is the Director of the HoPingKong Centre for Excellence in Education and Practice (CEEP).

Howard Abrams

Howard Abrams, MD, FRCPC, is an associate professor and clinician innovater at the University of Toronto. He practices General Internal Medicine at Toronto General Hospital – University Health Network. He is the Director of OpenLab.