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When third- and fourth-year students were yanked from hospitals last spring, many schools pivoted to telemedicine appointments. (This wasn't unique to medical schools; remote visits surged across the health care system.) After the new academic year started last summer, third-year students at Geisinger spent the first 10 weeks learning how to take patient assessments and develop treatment plans over Zoom. "When clinical care changes, medical-student education follows," says Dr. Alison Whelan, chief medical education officer at the Association of American Medical Colleges (AAMC).
去年春天，当三、四年级的学生被迫离开医院时，许多学校转向了远程医疗预约。(这并不是医学院独有的，远程访问在整个医疗体系中激增。)去年夏天新学年开始后，盖辛格大学的三年级学生在前10周学习如何进行患者评估，并在Zoom上制定治疗计划。美国医学院协会(AAMC)的首席医学教育官艾莉森·惠兰博士说：“当临床护理发生变化时，医学生教育也在随之改变。”
That required teaching students "webside" (as opposed to bedside) manner, to prepare them for a clinical practice likely to be far more virtual than that of their predecessors. "If you're not shaking hands, how do you make that initial connection (with a patient)?" Whelan asks. Students have also been honing the skills needed to perform the behind-the-scenes work that goes into a telemedicine appointment—like how to handle patient privacy when a spouse wanders into the room, or what to do when a patient can't work the web platform, Whelan says.
这就需要在“网站”(而不是床上)对学生进行教学，让他们为可能比前辈们实践的更加虚拟的临床实践做好准备。“如果不握手，那么如何(和病人)建立起最初的联系呢？”惠兰问道。惠兰说，学生们也一直在磨练完成远程医疗预约的幕后工作所需的技能，比如当配偶走进房间时如何处理病人的隐私，或者当病人不能使用网络平台时该怎么办。
Still, you can't take an EKG or draw blood virtually. To continue teaching skills like these when students were sent home, Geisinger built an "e-ICU" that allows students to see what's going on in hospital rooms and remotely do the sort of trainee-doctor work they'd have done in person before the pandemic. Through a webcam, they can ask resident doctors on duty to perform certain exams or tests, as if they were actually at the patient's bedside, and then get immediate feedback from the resident.
而且，你不能做心电图或者虚拟抽血。当学生们被送回家后，为了继续教授这些技能，盖辛格建立了一个“e-ICU”，让学生们可以看到医院病房里发生了什么，并远程完成他们在新冠前亲自做的实习医生工作。通过网络摄像头，他们可以要求值班的住院医生进行某些检查或测试，就好像他们就在病人的床边一样，然后立即得到住院医生的反馈。
The model worked so well that Geisinger plans to continue the e-ICU and the school's broader telemedicine training even as students return to regular clinical work, Jeffries says. Doctors who are digitally literate and comfortable using telemedicine could help expand access to care in the future, he says. Programs like the e-ICU could also help connect doctors in small community clinics with specialists who may not be available locally. "I come from a small town in the middle of nowhere. We don't even have a post office," says Dr. Cass Lippold, a critical- care fellow at Geisinger who oversaw the e-ICU program. "This will be great to help those people who don't have access to a hospital." It could also make it easier for prospective doctors with physical or learning disabilities to participate, as they could tailor their environment to fit their needs.
杰弗瑞斯说这种模式非常有效，盖辛格计划即使在学生们回到常规的临床工作岗位时也继续实施e-ICU和学校更广泛的远程医疗培训。他说，精通数字技术并能熟练使用远程医疗的医生可以在未来帮助扩大医疗服务的覆盖面。像e-ICU这样的项目也可以帮助连接小型社区诊所的医生和当地可能找不到的专家。“我来自一个偏僻的小镇，我们那里甚至连邮局都没有，”卡斯·利波德博士说，他是盖辛格的一位重症护理研究员，负责监督e-ICU项目。“这对帮助那些无法去医院的人来说是件好事。”它还可以让有身体或学习障碍的有潜力的医生更容易参与，因为他们可以调整环境以适应自己的需求。
译文由可可原创，仅供学习交流使用，未经许可请勿转载。
