AB0674 RAPID ADOPTION OF TELEMEDICINE IN RHEUMATOLOGY TRAINING: RESULTS FROM THE COVID-19 GLOBAL RHEUMATOLOGY ALLIANCE TRAINEE SURVEY
Authors: S. A. Yeoh, K. Young, M. Putman, E. Graef, F. Berenbaum, R. Conway, R. Grainger, A. Kilian, M. Konig, J. Liew, P. M. Machado, S. E. Sattui, J. Sparks, P. Sufka, M. Ugarte-Gil, L. Upton, Z. Wallace, J. Yazdany, A. Jayatilleke
Journal: Annals of the Rheumatic Diseases (2021)

Background: The COVID-19 pandemic led to a rapid increase in remote consultations in rheumatology care. Due to the potential impact of this change on rheumatology clinical training, we investigated trainees’ experiences with telemedicine. Objectives: To assess the impact of telemedicine use during the COVID-19 pandemic on rheumatology training, including supervision. Methods: A voluntary, anonymous web-based survey was administered in English, Spanish, or French from 19/08/2020 to 05/10/2020. Adult and paediatric rheumatology trainees worldwide in training in 2020 were invited to participate via social media and email. Using multiple choice questions, Likert scales, and free text answers, we collected data regarding prior and current telemedicine use, training, and supervision. Results: 302 respondents from 33 countries completed the survey, with most (83%, 252/302) in adult rheumatology training. Reported use of telemedicine increased from 13% (39/302) pre-pandemic to 82% (247/302) (Table 1). European trainees predominantly utilised audio-only compared to trainees from the rest of the world (ROW) who predominantly utilised audio-video telemedicine. Most trainees continued to evaluate new patients using telemedicine (65%, 161/247). A larger proportion of trainees were comfortable using telemedicine to evaluate follow-up (69% 170/247) versus new patients (25%, 41/161) (Figure 1). Only 32% (97/302) were trained in telemedicine, with the highest proportion among United States (US) trainees (59%, 69/116); subjects included software, clinical skills, and billing. The majority of trainees found this helpful (92%, 89/97). Supervision was most frequently in the form of verbal discussion after the consultation (Table 1); 24% (59/247) had no telemedicine supervision during the pandemic. In general, trainees found telemedicine negatively impacted their supervision (51%, 123/242) and clinical teaching quality (70%, 171/244); only 9% reported a positive impact on these areas. Conclusion: Adoption of telemedicine during the COVID-19 pandemic has led to areas of concern for rheumatology trainees including inadequate supervision and clinical teaching. Our results suggest a need for education on evaluation of new patients using telemedicine, increasing telemedicine training, and ensuring adequate supervisory arrangements. Table 1. Telemedicine use, supervision, and training by region. Data is presented as n (%). Rest of the world (ROW) data includes Asia (50), Central and South America (23), Canada (12), Australia (8), and Africa (4). Europe n = 89 US n = 116 ROW n = 97 Combined n = 302 Telemedicine use Pre-pandemic 15 (17) 9 (8) 15 (15) 39 (13) During pandemic 64 (72) 112 (97) 71 (73) 247 (82) Telemedicine modality pre-pandemic Audio-only 14 (93) 3 (33) 8 (53) 25 (64) Audio-video 1 (7) 7 (78) 7 (47) 15 (38) Telemedicine modality during pandemic Audio-only 56 (88) 47 (42) 51 (72) 154 (62) Audio-video 7 (11) 100 (89) 29 (41) 136 (55) Supervision pre-pandemic Real-time observation (part of visit) 0 (0) 4 (44) 3 (20) 7 (18) Real-time observation (full visit) 0 (0) 2 (22) 2 (13) 4 (10) Verbal discussion after 8 (53) 3 (33) 7 (47) 18 (46) Written communication after 0 (0) 0 (0) 1 (7) 1 (3) None 7 (47) 2 (22) 5 (33) 14 (36) Supervision during pandemic Real-time observation (part of visit) 2 (3) 54 (48) 15 (21) 71 (29) Real-time observation (full visit) 3 (5) 32 (29) 8 (11) 43 (17) Verbal discussion after 32 (50) 65 (58) 28 (39) 125 (51) Written communication after 7 (11) 15 (13) 9 (13) 31 (13) None 28 (44) 9 (8) 22 (31) 59 (24) Figure 1. Rheumatology trainee comfort levels in using telemedicine during the pandemic. Disclosure of Interests: Su-Ann Yeoh: None declared, Kristen Young: None declared, Michael Putman: None declared, Elizabeth Graef: None declared, Francis Berenbaum: None declared, Richard Conway: None declared, Rebecca Grainger Speakers bureau: Speaker fees from Abbvie, Janssen, Novartis, Pfizer, Cornerstones, all not related to this work, Consultant of: Consultancy fees from Abbvie, Janssen, Novartis, Pfizer, Cornerstones, all not related to this work, Grant/research support from: Travel assistance from Pfizer, not related to this work, Adam Kilian: None declared, Maximilian Konig: None declared, Jean Liew Grant/research support from: Research grant from Pfizer unrelated to this manuscript, Pedro M Machado Speakers bureau: Speaker fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript, Consultant of: Consulting fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript, Sebastian E. Sattui: None declared, Jeffrey Sparks Consultant of: Consultancy for Bristol-Myers Squibb, Gilead, Inova Diagnostics, Optum, and Pfizer unrelated to this manuscript, Grant/research support from: Research support from Bristol-Myers Squibb unrelated to this manuscript, Paul Sufka: None declared, Manuel Ugarte-Gil Grant/research support from: Research grants from Janssen and Pfizer unrelated to this manuscript, Laura Upton: None declared, Zachary Wallace: None declared, Jinoos Yazdany Consultant of: Consultancy for Astra Zeneca, Eli Lilly, and Pfizer, not related to this work, Grant/research support from: Research grants from Gilead and Pfizer, not related to this work, Arundathi Jayatilleke: None declared