Abstract

BackgroundUndergraduate medical education was severely impacted by the COVID-19 pandemic. As traditional clinical rotations were suspended, medical students quickly began alternative, novel educational experiences. Third-year medical students at an academic medical center were given the opportunity to join inpatient eConsult teams within the department of medicine. This study describes the development and implementation of this program as well as the experiences of student and faculty participants.MethodsStudent eConsult participation was rapidly developed and implemented within medical subspecialty teams in either infectious diseases (ID) or nephrology. Twelve third-year medical students and 15 subspecialty attendings participated in this program during an eight-week period from April 6 through May 29, 2020. Breadth of student clinical experience was assessed via review of clinical documentation and surveys. Participating students and attending physicians completed surveys to reflect upon their impressions of the program. Surveys were returned by nine students and eight faculty members. Survey responses were summarized with descriptive statistics.ResultsOver an eight-week period, student consultants wrote 126 notes on 100 patients; 74 of these patients (74%) were hospitalized with COVID-19. Student experiences were largely positive with most strongly agreeing that attendings promoted interactive and engaged learning (N = 8 of 8, 100%), that the experience helped to expand their knowledge about consultant roles (N = 6, 75%), and that they would participate in a remote eConsult program again if given the opportunity (N = 6, 75%). Faculty also were largely positive about the experience with most agreeing or strongly agreeing with the importance of teaching medical students about telehealth (N = 7 of 8, 88%) and eConsults (N = 6, 75%). In narrative responses, students and faculty agreed that teaching was a strength of the program whereas lack of in-person contact was a challenge.ConclusionsRapid development of an inpatient eConsult-based educational experience for third-year medical students was feasible and successful. Student-consultants saw a range of pathology including COVID-19 and related complications. Students were satisfied with the program. They were able to develop a strong relationship with attendings while learning about the role of a consultant. Faculty agreed with the importance of teaching students about telehealth and eConsults specifically.

Highlights

  • Undergraduate medical education was severely impacted by the COVID-19 pandemic

  • The purpose of this study is to describe the integration of an eConsult service at an undergraduate medical education program during a pandemic

  • Student characteristics A total of 12 students participated in the inpatient eConsult program

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Summary

Introduction

Undergraduate medical education was severely impacted by the COVID-19 pandemic. As traditional clinical rotations were suspended, medical students quickly began alternative, novel educational experiences. During the COVID-19 pandemic, Montefiore Medical Center, a large academic medical center in the Bronx, NY developed and implemented a novel inpatient eConsult model for subspecialty consultation. Modeled after an ongoing outpatient eConsult program [6], this inpatient eConsult program allowed primary and specialist teams to communicate asynchronously within the electronic medical record (EMR). This allows for inter-provider consultation in situations when limited patient contact is needed for health care provider and public health safety and provides enhanced access to specialty expertise without inperson interaction. During the COVID-19 pandemic, the inpatient eConsult program allowed rapid response from specialty experts while preserving precious personal protective equipment (PPE)

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