Telehealth Care and its Role in Undergraduate Medical Education in the COVID-19 era.

Program Goals On March 17, 2020, the American Association of Medical Colleges issued a statement which“strongly supports medical schools pausing all student clinical rotations, effective immediately, until at leastMarch 31 ” The University of Texas Rio Grande Valley School of Medicine immediately withdrew third- andfourth-year students from clinical rotation sites, and developed alternative, online-based clerkship curricula tocomplete for the remainder of the academic year The COVID-19 pandemic has brought about manychallenges to Undergraduate Medical Education, and has deprived upper-level students of foundational, in-person, clinical experiences The UTRGV School of Medicine Department of Neurology is among the rstprograms in the country to offer an exclusively online, telehealth-focused, Pediatric Neurology Clerkship TheUTRGV Pediatric Neurology clerkship curriculum was implemented between March 30-April 24, 2020 Duringthis time, students were not allowed to work in-person at clinical sites, and the entire clerkship was conductedentirely online Faculty and residents brought computers into the examination room, and students were able to take a patient history, present ndings to the attending physician, and observe the physical examinationusing Zoom software and submit History & Physical notes Students also participated in Telehealth Care visitsin which patients used Zoom to communicate with the clinic from home Other responsibilities includedsimulated neurology cases, online didactic sessions, and readings from texts and clinical journals designed toprepare students for the National Board of Medical Examiners Clinical Neurology Subject Examination Evaluation Students interviewed 2-3 patients a day via Zoom Technical difficulties over Zoom were common,which complicated history taking and viewing the physical examination for students and frustrated severalpatients Given the low patient volume due to the COVID-19 pandemic, students were provided more time toprepare for the NBME Clinical Neurology Subject Examination and time to discuss cases and interpretradiographs with the attending physician Students communicated with faculty daily over email, phone call,and text messaging, who provided immediate feedback and evaluation Discussion The COVID-19 pandemicbrings unique challenges to Undergraduate Medical Education While Telehealth Care visits do providemedical students with opportunities to develop interviewing, presentation, and documentation skills,exposure and familiarity with physical examination techniques remains limited Audio, visual, and internetconnectivity difficulties from patients, faculty, and students complicated many Telehealth Care visits However,the low patient volume and close correspondence between students and faculty provided uniqueopportunities to discuss clinical cases in greater detail when compared to a traditional clinical clerkship Thisalternative clerkship curriculum was created out of necessity to continue clinical medical education and is notintended to replace traditional clinical experiences Further study may investigate how online clerkshipcurricula affect student prociency in physical examination skills, as well as performance on NBME clinical examinations