Academy Exchange

Any good advice or literature recommendations on how to incorporate medical students (doing HIV elective) into telemedicine visits?

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Gina Simoncini MD MPH FACP AAHIVS
Lewis Katz School of Medicine at Temple University
Philadelphia PA
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I don't know of any literature, but some thoughts:
the teaching largely happens before and after the phone call.  Depending on the trainee's experience, review the history beforehand to extract learning points and to prepare for the call.  For example, "this patient had disseminated MAI on presentation.  How will we know when he can come off treatment?  What questions should we ask about symptoms of MAI?  How should we ask him about adherence and adverse effects? What lab results do we need?  What is IRIS and how will we screen for symptoms of it? How did we choose the meds we put him on?"  Then after the call, debrief -  "what should we have asked him that we didn't?  How did he sound, what did you think of his health literacy, or forthcomingness? How is he doing? how soon should we follow him up and why?"  etc.  This incorporates HIV learning issues, patient interview skills, and helps trainees become more efficient in organizing their thoughts for patient interviews in general!  Once students are more advanced or comfortable, they can start the phone call history (with pt's permission of course), then the preceptor can step in with any followup questions or instructions to the patient.
I'd be curious to hear what others are doing - we may be doing virtual visits for some time - in fact this may be a permanent option in health care!

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Elaine Thomas
University Of New Mexico
Albuquerque NM
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Original Message:
Sent: 05-05-2020 11:15
From: Gina Simoncini
Subject: teaching Med Students/telemed

Any good advice or literature recommendations on how to incorporate medical students (doing HIV elective) into telemedicine visits?

------------------------------
Gina Simoncini MD MPH FACP AAHIVS
Lewis Katz School of Medicine at Temple University
Philadelphia PA
------------------------------

I just started this last week, so some experience & lots of trial and error.

In my HIV clinic, I basically three-way video called my patient & my student (after getting an ok from the patient), once on zoom & once on Doximity. The student had access to the EMR from home, so she was able to review the chart, and then we discussed the patient care/case at the end of the visit.

At my other site where I have residents, and where we've rolled out in-person visits more aggressively, we have been using the opposite technique. We're calling the students on Zoom on an iPad, and bringing the iPad in the room with the patient for the in-person visit. The student can either scribe or interview the patients (depending on clinic flow).

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Jolie LeBlanc, MD
NEW ORLEANS LA
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Original Message:
Sent: 05-07-2020 17:11
From: Elaine Thomas
Subject: teaching Med Students/telemed

I don't know of any literature, but some thoughts:
the teaching largely happens before and after the phone call.  Depending on the trainee's experience, review the history beforehand to extract learning points and to prepare for the call.  For example, "this patient had disseminated MAI on presentation.  How will we know when he can come off treatment?  What questions should we ask about symptoms of MAI?  How should we ask him about adherence and adverse effects? What lab results do we need?  What is IRIS and how will we screen for symptoms of it? How did we choose the meds we put him on?"  Then after the call, debrief -  "what should we have asked him that we didn't?  How did he sound, what did you think of his health literacy, or forthcomingness? How is he doing? how soon should we follow him up and why?"  etc.  This incorporates HIV learning issues, patient interview skills, and helps trainees become more efficient in organizing their thoughts for patient interviews in general!  Once students are more advanced or comfortable, they can start the phone call history (with pt's permission of course), then the preceptor can step in with any followup questions or instructions to the patient.
I'd be curious to hear what others are doing - we may be doing virtual visits for some time - in fact this may be a permanent option in health care!

------------------------------
Elaine Thomas
University Of New Mexico
Albuquerque NM

Original Message:
Sent: 05-05-2020 11:15
From: Gina Simoncini
Subject: teaching Med Students/telemed

Any good advice or literature recommendations on how to incorporate medical students (doing HIV elective) into telemedicine visits?

------------------------------
Gina Simoncini MD MPH FACP AAHIVS
Lewis Katz School of Medicine at Temple University
Philadelphia PA
------------------------------