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Background With the evolving nature of telehealth services being supported across graduate medical programs, understanding changing attitudes among program directors is essential for training future physicians. Objective This 5-year longitudinal survey analysis provides details regarding the knowledge, skills, competency, and confidence levels present among program directors and the ways telehealth training (didactic and experiential) supports resident education. Methods A longitudinal observation survey was sent to 77 program directors (48% completion) from an academic health system. Data were compared from survey responses from 2016 to 2021 with additional information collected about current training processes in 2021. Paired sample t-tests, quantitative data analysis, and qualitative thematic analysis results are reported based on a convenience sampling of all program and fellowship directors. Results Results show that while telehealth knowledge and use increased among program director faculty, systemic concerns about the feasibility of telehealth from a time and cost perspective remain high. In 2016 and 2021, most of those surveyed (28.9% and 37.1%, respectively) were concerned about reimbursement. Directors remain committed to telehealth resident education, with over 60% stating that it is "essential to future practice". The qualitative thematic analysis highlighted the need for additional resources and support to conduct telehealth and the variability within disciplines of the use, therefore modeling, of telehealth in clinical settings. Conclusions The overall utilization of telehealth by graduate medical education programs has increased along with the continued need for training to prepare residents for current and future practice.
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OBJECTIVES: Telesimulation, in which learners and evaluators use technology to connect remotely to simulation-based learning activities, is effective for skills and decision-making review. Historical models in which learners are colocated with the simulation equipment have inherent issues, especially for emergency medical services (EMS) providers. This feasibility study placed the evaluators in the simulation center, whereas the learners were at a distance steering the scenario evolution through telehealth technologies. METHODS: Volunteer EMS providers across South Carolina with varying levels of training and experience completed difficult airway management scenarios focused on clinical decision making. The program consisted of pre- and postexperience examinations, a lecture, and increasingly complicated simulations using high-fidelity mannequins that were facilitated by local trainers under the direction of remote trainees. Audio and video content, including vital signs and cardiac monitoring, were live streamed. Participants worked in two-person teams with lead providers on each scenario clinically assessing and managing cases of anaphylaxis. Data were collected from the simulations using Laerdal software, as well as examination and survey results. RESULTS: A total of 24 participants completed all of the elements of the training. Trends toward improvement in times to bag-mask ventilation and initial epinephrine administration were noted. Average cognitive test scores increased by 9.6%, and learners reported improved comfort with simulation (75%, P ≥ 0.0001) and videoconferencing (83%, P ≥ 0.0001). They also reported high degrees of comfort with intubation (73.3%) following the training. CONCLUSIONS: This method of telesimulation appears to be a viable addition to continuing EMS education and may address access issues for some providers.