Evaluation of the Education “Clinical Telemedicine/e-Health” in the Curriculum of Medical Students at the University of Zurich

Evaluating perceived technology self-efficacy and telehealth acceptance in optometry students

CLINICAL RELEVANCE

Constant technological improvements require practitioners to be open to adopting technologies such as telehealth for enhanced patient care. Understanding the barriers and facilitators of telehealth adoption will guide stakeholders in making decisions for safe and effective implementation of telehealth.

BACKGROUND

Effective use of telehealth improves patient outcomes. It is unclear if optometry students feel supported in using and/or are accepting of telehealth. This study evaluated telehealth acceptance of optometry students, its association with their technology self-efficacy, and whether telehealth training alters this relationship.

METHODS

Final-year optometry students at the University of Melbourne were invited to participate in a telehealth course. A 22-item online survey adapted from the Technology Proficiency Self-Assessment for twenty-first Century Learning was used to evaluate technology self-efficacy pre- and post-learning. Telehealth acceptance was evaluated using a 34-item survey according to the Unified Theory of Acceptance and Use of Technology-2. A 5-point Likert scale was used for each item, yielding two total scores. Respondent demographics, frequency of usage and number of devices were recorded. Descriptive statistics, ANOVA and Pearson correlation were used to analyse demographic variables and relationship between technology self-efficacy and telehealth acceptance.

RESULTS

58 (68%) and 49 (58%) students participated in the pre- and post-learning surveys. Majority were 20-29-year-old females. Students used between two and four devices for online activities, with 62% being online at least hourly. Technology self-efficacy scores (average ± SD) pre- and post-learning were 83.8% ± 8.2 and 87.8% ± 7.1. Telehealth acceptance scores pre- and post-learning were 66.1% ± 9.6 and 73.98% ± 9.9. There was no association with gender, number of devices and frequency of online use for all scores. Correlation between technology self-efficacy and telehealth acceptance was insignificant pre-learning (p = 0.3) but was significant post-learning (p = 0.04).

CONCLUSION

Optometry students demonstrated high technology self-efficacy compared to telehealth acceptance. Telehealth training resulted in marked improvement in telehealth acceptance.

Opportunities and challenges of integrating digital health into medical education curricula: A scoping review

Background

The global strategy for digital health advocates digital health literacy in formal education and training curricula for all health professionals. However, little is known about the opportunities and challenges of integrating digital health into medical training curricula.

Methods

Guided by Arksey and O'Malley's scoping review methodology, we searched the PubMed, Google Scholar, and ScienceDirect scholarly databases for peer-reviewed articles published between 2014 and 2024. Data extraction was guided by the consolidated framework for implementation research.

Results

Thirty studies met the inclusion criteria and were analyzed. The opportunities identified include the need for healthcare digitalization, reshaping the future daily work of healthcare professionals, decreasing students' doubts about digital health and increasing the quality of patients' care. On the other hand, a lack of infrastructure and educational materials, the dense nature of the existing curriculum, and bureaucratic tendencies were identified as challenges. The provision of consolidated funds and the establishment of dedicated digital health infrastructure, starting with elective and audited modular approaches, raising awareness, and educating stakeholders, emerged as implementation strategies for mitigating these challenges.

Conclusion

Global progress toward integrating digital health literacy in formal medical training curricula remains slow. There is a need for concerted efforts and political commitment to offer guidance and moral and financial support for this integration.

Defining core competencies for telehealth in healthcare higher education: A Delphi study

BACKGROUND

While technology brings many opportunities for optimizing and improving health services, the lack of professionals trained in telehealth poses an important obstacle. Despite the existance of core competency frameworks for some healthcare professions, there is currently no consensus or guidelines on the core competencies that telehealth professionals should possess within the context of a higher education curriculum. This can hinder the potential benefits of healthcare service delivery.

OBJECTIVE

To establish a consensus on the core competencies in telehealth that should be integrated into higher education curricula for healthcare professionals.

METHODS

A three-round international eDelphi study was conducted. The panel comprised of a diverse group of experts in telehealth, clinicians, lectures and professors, administrators, and teaching coordinators. In the first round, an international steering committee developed a list of competencies that were presented to the panel members and they were asked to rate their level of agreement and suggest additional competencies. The consensus was established based on the competencies that achieved a high level of agreement (>75%) by the end of the third round.

RESULTS

We included 100 panellists from 18 different countries. By the end of the third round, we reached a consensus for 47 core competencies in a telehealth curriculum organized into 12 domains: principles of telehealth; care planning and management; assessment, diagnosis, and treatment; adequacy of the environment; professionalism; legal aspects; patient privacy; patient safety; access and equity; patient preference; technology; applicability of telehealth.

CONCLUSION

We identified the core competencies in a telehealth curriculum organized into 12 domains to be used as a foundation for training future health professionals.

The Digital Health Competencies in Medical Education Framework: An International Consensus Statement Based on a Delphi Study

IMPORTANCE

Rapid digitalization of health care and a dearth of digital health education for medical students and junior physicians worldwide means there is an imperative for more training in this dynamic and evolving field.

OBJECTIVE

To develop an evidence-informed, consensus-guided, adaptable digital health competencies framework for the design and development of digital health curricula in medical institutions globally.

EVIDENCE REVIEW

A core group was assembled to oversee the development of the Digital Health Competencies in Medical Education (DECODE) framework. First, an initial list was created based on findings from a scoping review and expert consultations. A multidisciplinary and geographically diverse panel of 211 experts from 79 countries and territories was convened for a 2-round, modified Delphi survey conducted between December 2022 and July 2023, with an a priori consensus level of 70%. The framework structure, wordings, and learning outcomes with marginal percentage of agreement were discussed and determined in a consensus meeting organized on September 8, 2023, and subsequent postmeeting qualitative feedback. In total, 211 experts participated in round 1, 149 participated in round 2, 12 participated in the consensus meeting, and 58 participated in postmeeting feedback.

FINDINGS

The DECODE framework uses 3 main terminologies: domain, competency, and learning outcome. Competencies were grouped into 4 domains: professionalism in digital health, patient and population digital health, health information systems, and health data science. Each competency is accompanied by a set of learning outcomes that are either mandatory or discretionary. The final framework comprises 4 domains, 19 competencies, and 33 mandatory and 145 discretionary learning outcomes, with descriptions for each domain and competency. Six highlighted areas of considerations for medical educators are the variations in nomenclature, the distinctiveness of digital health, the concept of digital health literacy, curriculum space and implementation, the inclusion of discretionary learning outcomes, and socioeconomic inequities in digital health education.

CONCLUSIONS AND RELEVANCE

This evidence-informed and consensus-guided framework will play an important role in enabling medical institutions to better prepare future physicians for the ongoing digital transformation in health care. Medical schools are encouraged to adopt and adapt this framework to align with their needs, resources, and circumstances.

Awareness and Attitudes of Medical Students, Interns, and Residents Toward Telemedicine in Medical Education During the COVID-19 Pandemic: Survey-Based Cross-Sectional Study From Northern Iran

BACKGROUND

Telemedicine is widely used in medical treatment and education systems. Therefore, it is essential to investigate the attitudes and awareness of medical students about it. We aimed to examine the awareness and attitudes of medical students, interns and residents toward telemedicine in medical education during the COVID-19 pandemic.

METHOD

This cross-sectional study was conducted after new educational approaches were implemented due to the COVID-19 pandemic. Two questionnaires were used to assess the new educational methodologies. Participants included residents (R), interns (I), and students (S) from the internal medicine department. A census sampling method was employed, inviting all medical education members who met the entry criteria to participate. The data were analyzed descriptively, and group differences were tested using chi-square, independent samples T-test, Mann-Whitney, and Kruskal-Wallis tests.

RESULT

Out of 278 medical education members eligible to participate, 249 (89.5%) completed the study. The mean score for participants' attitudes was above 3 (M = 3.78, SD = 0.24) indicating a generally favorable view of telemedicine. A significant gap was noted between participants' awareness and attitudes, with residents showing the lowest scores in both areas (P-value = .02). Our assessment revealed that "Satisfaction with the platform and facilities for e-classes" received the highest consensus from residents and interns, rated moderately agreeable by students (R: 64.5%, I: 59.7%, S: 48.8%). Responses to "Using e-learning courses alongside postcrisis face-to-face courses" and "Using e-learning courses alone postcrisis" varied among the groups (R: 58.1% and 54.9%, I: 59% and 58.2%, S: 47.6% and 45.3%).

CONCLUSION

The results of this survey reveal that medical students and interns may demonstrate a favorable awareness and attitude toward telemedicine. Consequently, developing educational programs and enhancing exposure to telemedicine should be considered since these elements could be vital for the future training of medical professionals.

Evaluation of a student telehealth rotation at the Columbia University College of Dental Medicine

OBJECTIVES

This study aimed to assess the impact of a telehealth rotation on the perceived benefits and challenges of telehealth use among third-year dental students at the Columbia University College of Dental Medicine (CDM).

METHODS

A newly implemented weeklong telehealth rotation at CDM engaged all 95 third-year dental students from the 2022 graduating class through assigned readings and virtual interaction with patients. The telehealth rotation involves virtual visits with patients for screening and triage. An ongoing retrospective assessment of the students' post-rotation evaluation was analyzed qualitatively to identify emerging themes and was coded to describe students' attitudes and beliefs about telehealth.

RESULTS

Students reported that the greatest benefit of telehealth is logistical convenience, while the greatest challenge to telehealth is related to the use of technology. After the telehealth rotation, students reported improvement in their clinically relevant skills and knowledge, including patient education, facilitating access to care, and communication skills.

CONCLUSIONS

The skills reported by students as the most important learning takeaway from the telehealth rotation are applicable to many aspects of care delivery, beyond the scope of telehealth. The incorporation of telehealth education into dental curricula allows students to improve essential clinically relevant skills and knowledge beyond the procedural skills emphasized during in-person patient appointments.

The Use of Telemedicine in Medical Education and Patient Care

The COVID-19 pandemic has accelerated and expanded the adoption of telemedicine globally. This allowed telemedicine to engage medical students in patient care and ensured continuity of care for vulnerable patients. In this review, the history of telemedicine and some of its applications in medical education were reviewed. Furthermore, we also shed light on how to incorporate telemedicine into several curricula and the strategies used to include it. The article also explored how to evaluate telemedicine and the major facilitators and barriers any medical and educational institution must address when using telemedicine. At the end of the review, we explored the future promises telemedicine has for medical education.

Digital Transformation in Healthcare: Technology Acceptance and Its Applications

Technological innovation has become an integral aspect of our daily life, such as wearable and information technology, virtual reality and the Internet of Things which have contributed to transforming healthcare business and operations. Patients will now have a broader range and more mindful healthcare choices and experience a new era of healthcare with a patient-centric culture. Digital transformation determines personal and institutional health care. This paper aims to analyse the changes taking place in the field of healthcare due to digital transformation. For this purpose, a systematic bibliographic review is performed, utilising Scopus, Science Direct and PubMed databases from 2008 to 2021. Our methodology is based on the approach by Wester and Watson, which classify the related articles based on a concept-centric method and an ad hoc classification system which identify the categories used to describe areas of literature. The search was made during August 2022 and identified 5847 papers, of which 321 fulfilled the inclusion criteria for further process. Finally, by removing and adding additional studies, we ended with 287 articles grouped into five themes: information technology in health, the educational impact of e-health, the acceptance of e-health, telemedicine and security issues.

The state of the art in telerehabilitation for musculoskeletal conditions

BACKGROUND

Given the rapid advances in communication technology and the need that emerged from the COVID-19 pandemic, telehealth initiatives have been widely used worldwide. This masterclass aims to provide an overview of telerehabilitation for musculoskeletal conditions, synthesizing the different terminologies used to describe telehealth and telerehabilitation, its effectiveness and how to use it in clinical practice, barriers and facilitators for the implementation in health services, and discuss the need of a curriculum education for the near future.

MAIN BODY

Telerehabilitation refers to the use of information and communication technologies provided by any healthcare professionals for rehabilitation services. Telerehabilitation is a safe and effective option in the management of musculoskeletal conditions in different models of delivery. There are many technologies, with different costs and benefits, synchronous and asynchronous, that can be used for telerehabilitation: telephone, email, mobile health, messaging, web-based systems and videoconferences applications. To ensure a better practice of telerehabilitation, the clinician should certify safety and access, and appropriateness of environment, communication, technology, assessment, and therapeutic prescription. Despite the positive effect of telerehabilitation in musculoskeletal disorders, a suboptimal telerehabilitation implementation may have happened due to the COVID-19 pandemic, especially in countries where telehealth was not a reality, and clinicians lacked training and guidance. This emphasizes the need to identify the necessary curriculum content to guide future clinicians in their skills and knowledge for telerehabilitation. There are some challenges and barriers that must be carefully accounted for to contribute to a health service that is inclusive and relevant to health professionals and end users.

CONCLUSIONS

Telerehabilitation can promote patient engagement in health care and plays an important role in improving health outcomes in patients with musculoskeletal conditions. Digital health technologies can also offer new opportunities to educate patients and facilitate the process of behavior change to a healthy lifestyle. Currently, the main needs in telerehabilitation are the inclusion of it in health curriculums in higher education and the development of cost-effectiveness and implementation trials, especially in low- and middle-income countries where access, investments and digital health literacy are limited.

Medical school curriculum in the digital age: perspectives of clinical educators and teachers

BACKGROUND

There is a need to reexamine Singapore's medical school curricula in light of the increasing digitalization of healthcare. Notwithstanding Singapore's digital competitiveness, there is a perceived gap in preparing its medical students for the digital age. Furthermore, limited research has evaluated the extent to which skills in using digital technologies should be taught to medical students in Asian medical schools to prepare them for future clinical practice- a gap that is filled by this study. Using Singapore as a case study, it explores the views of some local clinical educators and teachers towards the need to impart skills in digital technologies to medical students. It also offers recommendations on ways to balance the clinicians' concerns about these technologies with the digital competencies needed for clinical practice.

METHODS

Findings were drawn from individual interviews with 33 clinical educators and teachers from Singapore's public and private healthcare sectors. They were recruited using purposive sampling. Data were interpreted using qualitative thematic analysis.

RESULTS

Participants included vice deans of education from all three local medical schools and senior consultants from a wide variety of disciplines. Overall, they acknowledged two benefits of equipping students with skills in digital technologies including promoting the culture of innovation and improving work efficiency. However, they also highlighted four main concerns of imparting these skills: (i) erosion of basic clinical skills, (ii) neglect of a generalist approach to healthcare characterized by holistic management of patients, inter-professional collaboration, and commitment to breadth of practice within each specialty, (iii) rapid pace of technological advances, and (iv) de-personalisation by technology.

CONCLUSIONS

The findings show that medical students in Singapore would benefit from a curriculum that teaches them to use digital technologies alongside core clinical skills.

A scoping review of the changing landscape of geriatric medicine in undergraduate medical education: curricula, topics and teaching methods

PURPOSE

The world's population is ageing. Therefore, every doctor should receive geriatric medicine training during their undergraduate education. This review aims to summarise recent developments in geriatric medicine that will potentially inform developments and updating of undergraduate medical curricula for geriatric content.

METHODS

We systematically searched the electronic databases Ovid Medline, Ovid Embase and Pubmed, from 1st January 2009 to 18th May 2021. We included studies related to (1) undergraduate medical students and (2) geriatric medicine or ageing or older adults and (3) curriculum or curriculum topics or learning objectives or competencies or teaching methods or students' attitudes and (4) published in a scientific journal. No language restrictions were applied.

RESULTS

We identified 2503 records and assessed the full texts of 393 records for eligibility with 367 records included in the thematic analysis. Six major themes emerged: curriculum, topics, teaching methods, teaching settings, medical students' skills and medical students' attitudes. New curricula focussed on minimum Geriatrics Competencies, Geriatric Psychiatry and Comprehensive Geriatric Assessment; vertical integration of Geriatric Medicine into the curriculum has been advocated. Emerging or evolving topics included delirium, pharmacotherapeutics, healthy ageing and health promotion, and Telemedicine. Teaching methods emphasised interprofessional education, senior mentor programmes and intergenerational contact, student journaling and reflective writing, simulation, clinical placements and e-learning. Nursing homes featured among new teaching settings. Communication skills, empathy and professionalism were highlighted as essential skills for interacting with older adults.

CONCLUSION

We recommend that future undergraduate medical curricula in Geriatric Medicine should take into account recent developments described in this paper. In addition to including newly emerged topics and advances in existing topics, different teaching settings and methods should also be considered. Employing vertical integration throughout the undergraduate course can usefully supplement learning achieved in a dedicated Geriatric Medicine undergraduate course. Interprofessional education can improve understanding of the roles of other professionals and improve team-working skills. A focus on improving communication skills and empathy should particularly enable better interaction with older patients. Embedding expected levels of Geriatric competencies should ensure that medical students have acquired the skills necessary to effectively treat older patients.

Transition to telehealth : Engaging medical students in telemedicine healthcare delivery

In recent years, telemedicine has been increasingly incorporated into medical practice, a process which has now been accelerated by the COVID-19 pandemic. As telemedicine continues to progress, it is necessary for medical institutions to incorporate telemedicine into their curricula, and to provide students with the necessary skills and experience to effectively carry out telemedicine consultations. The purposes of this study are to review the involvement of medical students with telemedicine and to determine both the benefits and the challenges experienced. A literature review on the MEDLINE; CINAHL Plus; APA PsychInfo; Library, Information Science and Technology Abstracts; and Health Business Elite databases was performed on September 7, 2020, yielding 561 results. 33 manuscripts were analysed, with the main benefits and challenges experienced by medical students summarized. In addition to increasing their understanding of the importance of telemedicine and the acquisition of telemedicine-specific skills, students may use telemedicine to act as a valuable workforce during the COVID-19 pandemic. Challenges that students face, such as discomfort with carrying out telemedicine consults and building rapport with patients, may be addressed through the incorporation of telemedicine teaching into the medical curricula through experiential learning. However, other more systemic challenges, such as technical difficulties and cost, need to be examined for the full benefits of telemedicine to be realized. Telemedicine is here to stay and has proven its worth during the COVID-19 pandemic, with medical students embracing its potential in assisting in medical clinics, simulation of clinical placements, and online classrooms.

SERIES: eHealth in primary care. Part 3: eHealth education in primary care

BACKGROUND

Education is essential to the integration of eHealth into primary care, but eHealth is not yet embedded in medical education.

OBJECTIVES

In this opinion article, we aim to support organisers of Continuing Professional Development (CPD) and teachers delivering medical vocational training by providing recommendations for eHealth education. First, we describe what is required to help primary care professionals and trainees learn about eHealth. Second, we elaborate on how eHealth education might be provided.

DISCUSSION

We consider four essential topics. First, an understanding of existing evidence-based eHealth applications and conditions for successful development and implementation. Second, required digital competencies of providers and patients. Third, how eHealth changes patient-provider and provider-provider relationships and finally, understanding the handling of digital data. Educational activities to address these topics include eLearning, blended learning, courses, simulation exercises, real-life practice, supervision and reflection, role modelling and community of practice learning. More specifically, a CanMEDS framework aimed at defining curriculum learning goals can support eHealth education by describing roles and required competencies. Alternatively, Kern's conceptual model can be used to design eHealth training programmes that match the educational needs of the stakeholders using eHealth.

CONCLUSION

Vocational and CPD training in General Practice needs to build on eHealth capabilities now. We strongly advise the incorporation of eHealth education into vocational training and CPD activities, rather than providing it as a separate single module. How learning goals and activities take shape and how competencies are evaluated clearly requires further practice, evaluation and study.

Digital Health Training Programs for Medical Students: Scoping Review

BACKGROUND

Medical schools worldwide are accelerating the introduction of digital health courses into their curricula. The COVID-19 pandemic has contributed to this swift and widespread transition to digital health and education. However, the need for digital health competencies goes beyond the COVID-19 pandemic because they are becoming essential for the delivery of effective, efficient, and safe care.

OBJECTIVE

This review aims to collate and analyze studies evaluating digital health education for medical students to inform the development of future courses and identify areas where curricula may need to be strengthened.

METHODS

We carried out a scoping review by following the guidance of the Joanna Briggs Institute, and the results were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. We searched 6 major bibliographic databases and gray literature sources for articles published between January 2000 and November 2019. Two authors independently screened the retrieved citations and extracted the data from the included studies. Discrepancies were resolved by consensus discussions between the authors. The findings were analyzed using thematic analysis and presented narratively.

RESULTS

A total of 34 studies focusing on different digital courses were included in this review. Most of the studies (22/34, 65%) were published between 2010 and 2019 and originated in the United States (20/34, 59%). The reported digital health courses were mostly elective (20/34, 59%), were integrated into the existing curriculum (24/34, 71%), and focused mainly on medical informatics (17/34, 50%). Most of the courses targeted medical students from the first to third year (17/34, 50%), and the duration of the courses ranged from 1 hour to 3 academic years. Most of the studies (22/34, 65%) reported the use of blended education. A few of the studies (6/34, 18%) delivered courses entirely digitally by using online modules, offline learning, massive open online courses, and virtual patient simulations. The reported courses used various assessment approaches such as paper-based assessments, in-person observations, and online assessments. Most of the studies (30/34, 88%) evaluated courses mostly by using an uncontrolled before-and-after design and generally reported improvements in students' learning outcomes.

CONCLUSIONS

Digital health courses reported in literature are mostly elective, focus on a single area of digital health, and lack robust evaluation. They have diverse delivery, development, and assessment approaches. There is an urgent need for high-quality studies that evaluate digital health education.

Looking at Europe's recent behavioral telehealth practices for children and families impacted by neurodevelopmental disabilities

There is a widespread lack of behavioral professionals available to support children and families affected by neurodevelopmental disabilities. As a result of limited availability, services that can be provided from a distance have developed. Telehealth is a modality that can increase access to services, lessen financial constraints, and support assessments of generalization. Using either synchronous or asynchronous components it can foster evaluation and coaching. Guidelines for usage have surfaced in North America and been integrated into the continent's existing model of behavioral care. However, in Europe where all modalities of behavioral services are fighting to receive funding, frameworks are scarce. Understanding more about telehealth in behavioral care, its various applications throughout Europe, and the local context into which it can be applicable may promote system growth. To support this cause, a scoping review of recent behavioral telehealth practices for children and families impacted by neurodevelopmental disabilities in Europe was undertaken; looking specifically to assess types of studies, their targets and outcomes, telehealth modality components, barriers, and directions for future work. Although few studies surfaced, valuable conclusions can be drawn about the model's empirical validation, creating a groundwork for sustainability, and the need for developing policy and standardized application.

Telemedicine curriculum in undergraduate medical education: a systematic search and review

The number of patient-doctor appointments carried out using telemedicine has surpassed in-person appointments. In spite of this, it is unclear that telemedicine curricula in undergraduate medical education reflect the real importance by means of the effectiveness of these approaches. We aimed to systematically search and review the studies that are on undergraduate telemedicine curricula. We searched the Web of Science, PubMed, and Scopus using the keywords such as telemedicine, medical education, and curriculum. Our search was limited to publication dates between January 1, 2000, and February 1, 2020. We elicited the information of the curricula as to their countries, participants, aims or objectives, teaching methods, and evaluation of effectiveness. We also evaluated the quality of the studies using the Joanna Briggs Institute Qualitative Appraisal and Review Instrument. Out of 461 studies, seven articles were selected based on selection criteria for further review. The studies were mostly from the USA. The participant numbers were between seven and 268. There were several modes of delivery but lectures and patient encounters were used mostly. In four studies, the effectiveness was evaluated only by using satisfaction surveys, and the results were satisfactory. A study reported the acquisition and application of skills as a result. There is no well-established telemedicine curriculum in the undergraduate years. The methods vary but the effectiveness of the educational programs does not have a robust evidence base. It is evident that undergraduate medical education needs a curriculum backed by strong scientific data on its effectiveness.

Understanding Medical Students' Attitudes Toward Learning eHealth: Questionnaire Study

BACKGROUND

Several publications on research into eHealth demonstrate promising results. Prior researchers indicated that the current generation of doctors is not trained to take advantage of eHealth in clinical practice. Therefore, training and education for everyone using eHealth are key factors to its successful implementation. We set out to review whether medical students feel prepared to take advantage of eHealth innovations in medicine.

OBJECTIVE

Our objective was to evaluate whether medical students desire a dedicated eHealth curriculum during their medical studies.

METHODS

A questionnaire assessing current education, the need for education about eHealth topics, and the didactical forms for teaching these topics was developed. Questionnaire items were scored on a scale from 1 (fully disagree with a topic) to 10 (fully agree with a topic). This questionnaire was distributed among 1468 medical students of Maastricht University in the Netherlands. R version 3.5.0 (The R Foundation) was used for all statistical procedures.

RESULTS

A total of 303 students out of 1468, representing a response rate of 20.64%, replied to our questionnaire. The aggregate statement "I feel prepared to take advantage of the technological developments within the medical field" was scored at a mean value of 4.8 out of 10. Mean scores regarding the need for education about eHealth topics ranged from 6.4 to 7.3. Medical students did not favor creating their own health apps or mobile apps; the mean score was 4.9 for this topic. The most popular didactical option, with a mean score 7.2, was to remotely follow a real-life patient under the supervision of a doctor.

CONCLUSIONS

To the best of our knowledge, this is the largest evaluation of students' opinions on eHealth training in a medical undergraduate curriculum. We found that medical students have positives attitudes toward incorporating eHealth into the medical curriculum.

Infectious Diseases Society of America Position Statement on Telehealth and Telemedicine as Applied to the Practice of Infectious Diseases

Over the last 2 decades, telemedicine has effectively demonstrated its ability to increase access to care. This access has the ability to deliver quality clinical care and offer potential savings to the healthcare system. With increasing frequency, physicians, clinics, and medical centers are harnessing modern telecommunications technologies to manage a multitude of acute and chronic conditions, as well as incorporating telehealth into teaching and research. The technologies spanning telehealth, telemedicine, and mobile health (mHealth) are rapidly evolving, and the Infectious Diseases Society of America (IDSA) has prepared this updated position statement to educate its membership on the use of telemedicine and telehealth technologies. IDSA supports the appropriate and evidence-based use of telehealth technologies to provide up-to-date, timely, cost-effective subspecialty care to resource-limited populations.

Medical students' perceptions and expectations regarding digital health education and training: A qualitative study

INTRODUCTION

Digital health - the convergence of digital technologies within health and health care to enhance the efficiency of health-care delivery - is fast becoming an integral part of routine medical practice. The integration of digital health into traditional practice brings significant changes. Logic dictates that for medical practitioners to operate in this new digitally enabled environment, they require specific knowledge, skills and competencies relating to digital health. However, very few medical programmes in Australia and globally include digital health within their regular curriculum. This pilot study aimed to explore medical students' perceptions and expectations of digital health education and training (ET).

METHODS

An online survey and focus groups were used to collect information about medical students' perceptions and expectations relating to digital health and ET relating to this field within the medical programme at the University of Queensland. Sixty-three students took part in the survey, and 17 students were involved in four focus groups.

RESULTS

Most participants had no formal ET in digital health. Most participants (n = 43; 68%) expressed a willingness to learn about digital health as part of their medical programme.

DISCUSSION

Primarily, knowledge- and practice-related factors have motivated students to learn about digital health. The analysis of focus group data identified two superordinate themes: (a) drivers of digital health ET and (b) expectations relating to digital health ET. Students agreed that digital health is a relevant field for their future practice that should be taught as part of their regular curriculum.

Integration of Telehealth Education into the Health Care Provider Curriculum: A Review

Introduction: Telehealth is a rapidly expanding health care delivery modality with increasing utility in the health care community. It is imperative that telehealth education is provided during the training of health care providers to ensure the proper usage and application of this health care delivery system. A comprehensive literature review of telehealth education integrated into the curricula of physician, physician assistant, and advanced practiced registered nurse training programs has not been reported to date. Materials and Methods: An electronic literature search was performed using Scopus^®, PubMed, and 17 of the 35 databases on the EBSCOHost platform. We included studies where telehealth concepts and components were integrated in the curriculum for primary care students. We extracted information pertinent to understanding the scope and sustainability of the curriculum and tabulated the results. Results: After a full-text screening of 164 articles and critically analyzing 34, eight articles were included in this review. Comparison of these articles showed no consistency in how telehealth was integrated into the various health care curricula. Content delivered usually included basic telehealth information, however, the depth and breadth of content varied significantly based on the interventions. Discussion: For the articles included in this review, there were no formal study designs regarding basic telehealth educational integration or competencies. While authors recommended conducting evaluation and determining the effectiveness of the interventions, they did not provide a clear picture as to how these efforts should be conducted. Conclusions: In addition to developing a standardized telehealth curriculum, national competencies need to be created, which will guide the development of standardized curriculum across health care training programs.

Acceptance and Expectations of Medical Experts, Students, and Patients Toward Electronic Mental Health Apps: Cross-Sectional Quantitative and Qualitative Survey Study

BACKGROUND

The acceptability of electronic mental (e-mental) health apps has already been studied. However, the attitudes of medical experts, students, and patients taking into account their knowledge of and previous experiences with e-mental health apps have not been investigated.

OBJECTIVE

The aim of this study was to explore the attitudes, expectations, and concerns of medical experts, including physicians, psychotherapists and nursing staff, students of medicine or psychology, and patients toward e-mental health apps when considering their knowledge of and former experiences with e-mental health apps.

METHODS

This cross-sectional quantitative and qualitative survey was based on a self-developed questionnaire. A total of 269 participants were included (104 experts, 80 students, and 85 patients), and 124 eligible participants answered a paper version and 145 answered an identical online version of the questionnaire. The measures focused on existing knowledge of and experiences with e-mental health apps, followed by a question on whether electronic health development was generally accepted or disliked. Further, we asked about the expectations for an ideal e-mental health app and possible concerns felt by the participants. All items were either presented on a 5-point Likert scale or as multiple-choice questions. Additionally, 4 items were presented as open text fields.

RESULTS

Although 33.7% (35/104) of the experts, 15.0% (12/80) of the students, and 41.2% (35/85) of the patients knew at least one e-mental health app, few had already tried one (9/104 experts [8.7%], 1/80 students [1.3%], 22/85 patients [25.9%]). There were more advocates than skeptics in each group (advocates: 71/104 experts [68.3%], 50/80 students [62.5%], 46/85 patients [54.1%]; skeptics: 31/104 experts [29.8%], 20/80 students [25.0%], 26/85 patients [30.6%]). The experts, in particular, believed, that e-mental health apps will gain importance in the future (mean 1.08, SD 0.68; 95% CI 0.94-1.21). When asked about potential risks, all groups reported slight concerns regarding data security (mean 0.85, SD 1.09; 95% CI 0.72-0.98). Patient age was associated with several attitudes toward e-mental health apps (future expectations: r=-0.31, P=.005; total risk score: r=0.22, P=.05). Attitudes toward e-mental health apps correlated negatively with the professional experience of the experts (r_s(94)=-0.23, P=.03).

CONCLUSIONS

As opposed to patients, medical experts and students lack knowledge of and experience with e-mental health apps. If present, the experiences were assessed positively. However, experts show a more open-minded attitude with less fear of risks. Although some risks were perceived regarding data security, the attitudes and expectations of all groups were rather positive. Older patients and medical experts with long professional experience tend to express more skepticism.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00013095; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00013095.

SERIES: eHealth in primary care. Part 1: Concepts, conditions and challenges

Primary care is challenged to provide high quality, accessible and affordable care for an increasingly ageing, complex, and multimorbid population. To counter these challenges, primary care professionals need to take up new and innovative practices, including eHealth. eHealth applications hold the promise to overcome some difficulties encountered in the care of people with complex medical and social needs in primary care. However, many unanswered questions regarding (cost) effectiveness, integration with healthcare, and acceptability to patients, caregivers, and professionals remain to be elucidated. What conditions need to be met? What challenges need to be overcome? What downsides must be dealt with? This first paper in a series on eHealth in primary care introduces basic concepts and examines opportunities for the uptake of eHealth in primary care. We illustrate that although the potential of eHealth in primary care is high, several conditions need to be met to ensure that safe and high-quality eHealth is developed for and implemented in primary care. eHealth research needs to be optimized; ensuring evidence-based eHealth is available. Blended care, i.e. combining face-to-face care with remote options, personalized to the individual patient should be considered. Stakeholders need to be involved in the development and implementation of eHealth via co-creation processes, and design should be mindful of vulnerable groups and eHealth illiteracy. Furthermore, a global perspective on eHealth should be adopted, and eHealth ethics, patients’ safety and privacy considered.

National survey of telemedicine education and training in medical schools in France

INTRODUCTION

Telemedicine is a remote medical practice using information communication technology (ICT), and has been increasing in France since 2009. With all new forms of medical practice, education and training (ET) is required for quality and safety. To date, implementation of telemedicine ET has not been assessed in France. The objective of this study was to describe the implementation of telemedicine ET and evaluate the knowledge, attitudes and practices (KAP) of deans and associate deans from all medical schools in France.

METHODS

A cross-sectional non-mandatory, descriptive online survey with a self-administered questionnaire was performed from 15 November to 6 December, 2017. Respondents were accessed through the 'Conférence des doyens des Facultés de médecine'.

RESULTS

There were 48 respondents with a 47.4% response rate among deans. Telemedicine ET was limited in France; 10.4% in 1st year medicine (PACES); 4% in the final 3 years of medical school (D.F.A.S.M.) and 18.8% in medical residency. Emergency medicine, dermatology, radiology, neurology and geriatrics were specialties with implemented telemedicine training during residency. Of all respondents, 90% expressed a need to increase telemedicine ET, among which 75% accepted external support. A highly positive attitude towards telemedicine practice was reflected by 60.4% of respondents, and 56.2% practiced telemedicine at least once.

DISCUSSION

This study was the first to assess national telemedicine ET implementation in France. Telemedicine was integrated into initial medical education; however, telemedicine ET remains limited despite the positive attitudes of deans and associate deans. Further research would need to be conducted on telemedicine ET implementation and KAP of medical students and residents.