Incorporating Telemedicine in Rheumatology Fellowship Training Programs: Needs Assessment, Curricular Intervention, and Evaluation.

OBJECTIVE: To increase rheumatology fellows' in training (FITs) confidence in delivering virtual care (VC) and prepare them for independent practice, we developed educational materials addressing gaps in their skills.

METHODS: We identified gaps in telemedicine skills based on FIT performance in a virtual rheumatology observed structured clinical examination (vROSCE) station on VC delivery using videoteleconference technology and survey (Survey1) responses. We created educational materials including videos of "mediocre" and "excellent" VC examples, discussion/reflection questions, and a document summarizing key practices. We measured change in FITs' confidence levels for delivering VC with a post-intervention survey (Survey2).

RESULTS: Thirty-seven FITs (19 first-year, 18 second + third-year fellows) from seven rheumatology fellowship training programs participated in a vROSCE and demonstrated gaps in skills mapping to several Rheumatology Telehealth Competency domains. FITs' confidence levels improved significantly from Survey1 to Survey2 for 22 of 34 (65%) questions. All participating FITs found the educational materials helpful for learning and reflecting on their own VC practice; 18 FITs (64%) qualified usefulness as "moderately" or "a lot". Through surveying, 17 FITs (61%) reported implementing skills from the instructional videos into VC visits.

DISCUSSION: Continually assessing our learners' needs and creating educational materials addressing gaps in training is requisite. Using a vROSCE station, needs assessments, and targeted learning with videos and discussion-guidance materials enhanced the confidence level for FITs in VC delivery. It is imperative to incorporate VC delivery into fellowship training program curricula to ensure breadth in skills, attitudes, and knowledge of new entrants into the rheumatology workforce. This article is protected by copyright. All rights reserved.