The Effectiveness of Technology-Enhanced Learning in Prosthodontic Education: A Systematic Review.

OBJECTIVE: To compare the effectiveness of technology-enhanced learning (TEL) with traditional learning in prosthodontic education. METHODS: The protocol was registered before commencement [CRD42023390277]. The search was conducted to identify randomized controlled trials (RCTs) focused on comparative assessment of TEL and traditional learning in prosthodontic education up to 6 June 2024. A comprehensive search strategy was formulated, encompassing multiple electronic databases. Screening, data extraction and risk of bias assessment using the Cochrane tool (RoB 2) were performed. Educational outcomes were evaluated by Kirkpatrick's four-level evaluation model. RESULTS: Of 2830 records identified, 14 RCTs were included. All the trials were judged at high risk of bias or had some concerns. The included studies assessed the short-term benefits of various TEL approaches, including e-learning, blended learning, video demonstration specialized self-evaluation software and virtual reality simulation in prosthodontic education for undergraduates. Promising results were found in individual studies, particularly in terms of perceived learning conditions with problem-based learning (PBL) and self-reported understanding and confidence when using video demonstrations. Most studies reported comparable outcomes to traditional learning in practical skills assessments, while the results regarding the acquisition of theoretical knowledge through the incorporation of TEL approaches were contradictory. One study reported promising results in perceived learning conditions with the PBL approach, as well as improved self-reported understanding and confidence with the use of video demonstrations. Furthermore, there was a limited number of studies assessing the effect of TEL approaches on students' behaviour. CONCLUSION: There is a lack of high-quality evidence to support the adoption of TEL approaches in prosthodontics. However, the incorporation of virtual reality simulation has demonstrated promising results, particularly in improving practical clinical skills.

Construction and Surgical Training of Coronary Anastomosis on a Low-Cost Portable Simulator: Experience in a Peruvian Multicenter Study.

INTRODUCTION: The operating room is no longer the ideal place for early surgica training of cardiothoracic surgery residents, forcing the search for simulation-based learning options. The study's aim was the construction and surgicaltraining of coronary anastomosis in a portable, low-cost, homemade simulator. METHODS: This is an observational, analytical, and multicenter study. The simulator was built with common materials and was evaluated with the Objective Structured Assessment ofTechnical Skills (or OSATS) Modified. All junior and senior residents from nine national cardiothoracic surgery centers were considered for 90 days. Operative skill acquisition and time in the creation of side-to-side (S-T-S), end-to-side (E-T-S), and end-to-end (E-T-E) coronary anastomoses were evaluated. All sessions were recorded and evaluated by a single senior cardiothoracic surgeon during two time periods. RESULTS: One hundred and forty residents were assessed in 270 sessions. In junior residents, a significant improvement in final scores was identified in S-T-S (use of Castroviejo needle holder, needle angles, and needle transfer) (P<0.05). In seniors, a significant improvement was identified in S-T-S (graft orientation, appropriate spacing, use of forceps, angles, and needle transfer) anastomoses (P<0.05). A significant improvement in the final anastomosis time of senior residents over junior residents was identified in S-T-S (8.11 vs. 11.22 minutes), E-T-S (7.93 vs. 10.10 minutes), and E-T-E (6.56 vs. 9.68 minutes) (P=0.039). CONCLUSION: Our portable and low-cost coronary anastomosis simulator is effective in improving operative skills in cardiothoracic surgery residents; therefore, skills acquired through simulation-based training transfer have a positive impact on the surgical environment.

Understanding AI in Healthcare: Perspectives of Future Healthcare Professionals.

Introduction The current medical curriculum lacks comprehensive artificial intelligence (AI)-focused training, potentially impacting future healthcare delivery. This study addresses the critical gap in AI training within medical education, particularly in India, by assessing medical students' awareness, perceptions, readiness, confidence, and ethical considerations regarding AI in healthcare. Our findings underscore the necessity of integrating AI competencies into medical education to prepare future healthcare professionals for an AI-driven landscape. Method After obtaining ethics approval, we conducted a cross-sectional study on Bachelor of Medicine and Bachelor of Surgery (MBBS) students from the 2019-2023 batch. An exploratory survey using a validated questionnaire was employed to obtain medical students' current understanding and awareness of artificial intelligence (AI) in healthcare, perceptions, readiness, confidence, and ethical considerations in utilizing AI technologies in clinical practice. Results The survey received 217 responses from 2019-2023 MBBS students. We found a mean percentage of awareness score of 44.74%, a mean percentage perception score of 68.96%, a mean percentage readiness score of 91.32%, a mean percentage confidence score of 58.48%, and a mean percentage ethics importance score of 69.27%. Males had higher awareness, confidence, and readiness scores. Conversely, females scored slightly higher in perception and the importance of ethics consideration, although not statistically significant. Junior batches outperform senior batches in perception, confidence, and readiness scores; in contrast, the awareness and ethics importance scores do not show significant differences between the two groups. Conclusion Our study indicates a generally positive outlook toward AI's potential to enhance healthcare delivery and patient outcomes. The study suggests a strong inclination toward further education and practical training focused on AI in healthcare, considering a solid recognition of the significance of ethical implications related to AI in healthcare. These findings highlight the importance of fostering AI literacy within medical education curricula and underscore the necessity for ongoing evaluation and adaptation to ensure that future healthcare professionals are equipped to navigate the complexities of AI in healthcare delivery while upholding ethical standards.

Introduction and Effectiveness of Early Clinical Exposure Among Dental Students in Pre-clinical Prosthodontics.

BACKGROUND: Lack of patient contact in the pre-clinical prosthodontics curriculum makes it difficult for the students to comprehend and correlate the series of complex steps involved in complete denture fabrication. Early clinical exposure in the second year of the undergraduate program will facilitate a smooth transition of dental students from pre-clinics to clinics, thereby helping to mitigate the lacunae existing in the present curriculum. MATERIALS AND METHODS: A non-randomized prospective educational interventional study was conducted among 50 second-year dental students. Early clinical exposure in the form of clinical demonstration for complete denture steps of border molding and jaw relation was given subsequent to the completion of didactic and laboratory sessions. Pre- and post-multiple-choice question tests were conducted to explore students' knowledge. Student perception towards early clinical exposure was assessed using a self-administered anonymous questionnaire, while faculty perception was gauged with the help of in-depth interviews. RESULTS: A statistically significant difference was observed when pre- and post-multiple-choice question test mean scores were compared, showing an overall improvement in students' knowledge following early clinical exposure. Students and faculty held a positive perception towards the program and found it to be useful in enhancing the overall learning experience of the students. Faculty expressed their concern regarding limited manpower, paucity of time, and difficulty in integrating early clinical exposure into the present timetable. CONCLUSION: Early clinical exposure can be integrated into the traditional pre-clinical prosthodontics curriculum with appropriate time and manpower allocation. Faculty sensitization and training workshops need to be conducted before implementing this program.

Climate change and its impact on health: a global collaborative learning model.

To address the health effects of climate change, leaders in healthcare have called for action to integrate climate adaptation and mitigation into training programs for health professionals. However, current educators may not possess sufficient climate literacy and the expertise to effectively include such content in their respective healthcare curricula. We, an international and interprofessional partnership, collaborated with experts to develop and deploy curriculum to increase health educators' and graduate health profession students' knowledge and competencies on climate change. In a tri-step process, the first phase included recruiting interested faculty members from two institutions and varying health professions. In phase two, faculty members collaborated to develop a faculty symposium on climate change including educational competencies required of health professions, practice standards, guidelines, and profession-specific content. Symposium outcomes included broader faculty member interest and commitment to create an interprofessional climate change course for healthcare graduate students. In phase three, course development resulted from collaboration between faculty members at the two institutions and faculty members from the Global Consortium on Climate and Health Education (GCCHE), with course objectives informed by GCCHE competencies. Climate experts and faculty members delivered the course content over a 10-week period to 30 faculty members and students representing seven health professions, who were surveyed (n = 13) for feedback. This course can serve as an example for international collaborators interested in developing climate change courses for health profession students. Lessons learned in this process include: climate change novice faculty members can develop impactful climate change courses; students and faculty members can be co-learners; diverse representation in course attendees enriches the learning experience; and collaboration is key.

A narrative review of the CEPH-accredited bachelor's public health programs' curricula in the United States.

Background: Undergraduate programs in public health are becoming increasingly popular in the United States (US). The recent pandemic, growing climate instability, and the aging baby boomers have led to higher demands for skilled public health professionals at various levels of the workforce. This study examines the nature of courses being delivered in undergraduate public health programs across the United States. The goal is to assess domains, themes, competencies, and other specialized skills that are currently covered in these academic programs. Methodology: A search was conducted in February 2023 using the online CEPH program database to identify undergraduate public health programs in the US. In total, 86 institutions and 90 CEPH-accredited undergraduate public health programs were identified. Lists of public health courses were retrieved from each program, and a total of 2,259 unduplicated courses were extracted and analyzed. A content analysis of the extracted topics was conducted to generate 38 common themes among the courses offered. Coded course themes were mapped to the public health domains and competencies listed by the ASPPH and CEPH to evaluate the distribution of themes across course offerings. Results: Analysis of course themes found that Foundations of Public Health, Epidemiology, Public Health Management, Policy, and Leadership, Climate and Environmental Health, and Global Health Issues were the most prevalent. When course themes were mapped onto the ASPPH and CEPH domains of critical public health learning, "overview of public health" and "determinants of health" were the most populated domains. Programs had different emphases according to their approach, but overall, about two-thirds of course themes were focused on foundational and theoretical concepts of public health, and one-third were directed toward practical applications of public health concepts. Conclusion: As the demand for skilled public health workers continues to rise, programs will need to watch the skills and competencies required in the current working environment, as well as the ASPPH and CEPH criteria, and adjust their approach accordingly. Given the rapid changes in the public health landscape, schools and programs of public health should evaluate their curricula to ensure that they are meeting the needs of the workforce and the world.

Transforming medical education: the impact of innovations in technology and medical devices.

INTRODUCTION: The rapid advancement of technology and the integration of innovative medical devices are significantly transforming medical education. This review examines the impact of these changes and the importance of adapting educational strategies to leverage these advancements. AREAS COVERED: This narrative review employs a qualitative approach. From an initial pool of 294 articles, researchers conducted independent screenings and identified 134 studies relevant to innovations in technology and their impact on medical education. Following a comprehensive review and consensus, studies deemed to be of low relevance were excluded, resulting in a final selection of 74 articles. An expert panel discussion was held, and the study concludes with a final section that presents the findings and offers brief, clear recommendations. EXPERT OPINION: This study indicates that the utilization of Innovative medical technologies has the potential to enhance learning outcomes. The use of simulations allows students to engage in hands-on practice without risking patient harm. Mobile devices afford students uninterrupted access to educational resources, thereby enabling efficient learning. Artificial intelligence (AI) has the potential to personalize education, enhance diagnostic skills, and foster critical thinking. Further research in this field has the potential to yield significant insights.

Development and applications of graduate outcome-based curriculum for basic medical education.

Introduction: Outcome-based education (OBE) leads to revolutionary change in medical education, but each medical school is acknowledged to develop suited framework based on specific positioning, educational philosophy and expected outcomes. Methods: Based on the graduate outcomes of basic medical education in China released by Working Committee for the Accreditation of Medical Education (WCAME) which officially recognized by World Federation for Medical Education (WFME), Taizhou University re-documented the overall organization of the curriculum and classified the courses as "Crucial, Supporting and Associated (CSA)" categories to connect the graduate outcomes and course objectives. Results: We redefined the standard for graduates in Taizhou University Medical School including 34 items in four domains and redesigned the curriculum with 76 courses classified as CSA. Empirical data reveals a substantial improvement in students' performance on Standardized Competence Test for Clinical Medicine Undergraduates in China (SCTCMU) by implementing the CSA system between 2022 and 2023. Notably, in 2023, Taizhou University's students achieved pass rates more than 20 percentage points higher than the national average, demonstrating a profound and unprecedented impact. Conclusion: The CSA classification system provides a notably clear and structured framework for categorizing courses based on their direct or indirect relevance to educational objectives, which provides clarity to educators and empowers students with a more purposeful approach to their studies.

The transition of patient care: Exploring the outcomes of prehospital to hospital patient handover practices and healthcare provider education.

Introduction: Inadequate patient handover is linked to numerous medical errors and lapses in communication between hospital healthcare providers and prehospital healthcare providers. Undergraduate healthcare curricula may limit programme-specific education on patient handover and shift learning to informal learning opportunities. This study aimed to investigate the outcomes of qualified healthcare provider (HCPs) educational programmes to determine the adequacy of handover practices, the source of their training, and their interprofessional acceptance of these practices. Methods: A multi-method study design was used - a document analysis of HCP programme outcomes and a two-section questionnaire. The questionnaire was sent to HCPs to determine the impact of patient handover practices on current healthcare systems and their opinion on whether the training on handovers is sufficient. Results: HCPs indicated little educational interaction regarding patient handover. Most participants felt handover education relied predominantly on informal training. With their existing knowledge, many HCPs revealed that they were comfortable in handing over a patient. Little interprofessional confidence regarding patient handover information indicates minimal interprofessional collaboration toward standardised approaches for patient handover. Conclusion: This study indicates a lack of standardised handover procedures, which leads to HCP self-interpretations. There is low trust between HCPs regarding information received. The study highlights the need for standardised handover training in healthcare curricula to improve patient safety and interprofessional collaboration.

Development of a Canadian Medical Assistance in Dying Curriculum for Healthcare Providers.

Objectives: Medical Assistance in Dying (MAiD) was legalized in Canada in 2016, necessitating greater education and training in MAiD for physicians and nurse practitioners. To meet this need, the Canadian MAiD Curriculum (CMC) was developed to offer a nationally accredited, comprehensive, bilingual, hybrid (synchronous and asynchronous) educational program to support and enhance the practice of MAiD in Canada. Methods: This work describes the process of developing the CMC, including its guiding principles and framework. The CMC was guided by constructivism and adult learning theory, preliminary literature review, 5 key principles based on a needs assessment survey, as well as consultation with diverse partners. Results: Seven modules were developed: (1) foundations of MAiD in Canada, (2) clinical conversations that includes MAiD, (3) how to do an MAiD assessment, (4) capacity and vulnerability, (5) providing MAiD, (6) navigating complex cases with confidence, and (7) MAiD and mental disorders. An eighth topic on clinician resilience and reflection was woven into each of the 7 modules. Conclusion: This curriculum ensures that consistent information is available to healthcare providers concerning the practice of MAiD in Canada. To ensure sustainability, the CMC will continue to be updated alongside the evolution of MAiD policy and services in Canada.

Contraceptive Counseling Training Experiences and Behaviors Among Obstetrics and Gynecology Residents in California and Florida.

OBJECTIVE: To describe experiences with contraception counseling training and provision of obstetrics and gynecology residents training in California and Florida. STUDY DESIGN: We conducted a mixed-methods study of obstetrics and gynecology residents training across 19 programs (with approximately 428 residents) in California and Florida from September 2022 through February 2023. We asked participants how often they use tiered-effectiveness counseling, their satisfaction with contraception counseling practices, and experiences with witnessing and recognizing contraception coercion. We asked about personal disappointment when patients decline long-acting reversible contraception (LARC) and pressure from faculty to prescribe LARC. To further explore resident contraception counseling education and behaviors, we conducted semi-structured telephone interviews with a subset of 20 survey volunteers. RESULTS: We received survey responses from 155 (36.2%) participants. Most (n=113 [76.4%]) often or always reported using tiered-effectiveness counseling. While few participants (n=17 [11.3%]) reported feeling pressure from faculty to convince a patient to keep a LARC, some (n=34 [22.1%]) reported they often or always feel disappointed when a patient chooses LARC removal, with more Florida participants reporting disappointment (n=19 [37.3%]) compared to California (n=15 [14.6%], p=0.01). We identified two main themes from the telephone interviews. First, residents feel they have limited formal education on how to provide contraceptive counseling and commonly learn these practices by emulating supervising faculty or peer counseling styles. Second, residents are informally taught, through feedback and interactions with supervising faculty and peers, that successful contraception counseling is the ability to convince patients to use highly effective contraception. CONCLUSION: When residents lack formalized contraception counseling education, they adopt counseling behaviors that may not be patient centered. IMPLICATIONS STATEMENT: When obstetrics and gynecology residents lack formalized contraception counseling education, they learn practices that may lead to coercive counseling behaviors during training. Resident education should include recognition and mitigation of contraception coercion and patient-centered counseling both through a formalized curriculum and socialization of trainees during their medical education.

Establishing Microsurgery Skills Laboratories in Low- and Middle-income Countries with Integrated Remote Teaching: A Novel Approach.

Microneurosurgical techniques remain crucial for managing neurosurgical diseases, especially in low- and middle-income countries (LMICs) where other advanced treatment modalities are not available. The global distribution of these techniques is uneven due to disparities in infrastructure, equipment, and training. Medical professionals from LMICs face barriers in reaching training centers in high-income countries, as well as in accessing microsurgical techniques. To address these disparities in microsurgery training, we offer free and accessible microsurgery training model by combining the donations of microsurgery kits with a comprehensive support system that includes live-streamed, offline, and in-person assistance within LMICs.

Understanding of pharmacy students' knowledge of cannabis use disorders in recreational vs non-recreational use states.

INTRODUCTION: Currently, the trend of legalizing recreational cannabis across the United States is experiencing rapid expansion. Cannabis Use Disorder (CUD) is a pattern of cannabis use leading to clinically significant impairment, manifested by at least two of the 11 criteria on DSM-5. The objective of this study is to compare the knowledge of CUD among pharmacy students attending pharmacy schools in recreational cannabis-legalized states to nonlegalized states. METHODS: This was a survey-based study using validated questionnaires distributed among students from ACPE-accredited pharmacy schools in the United States. The survey included a CUD knowledge section followed by section on student characteristics. Individual item knowledge scores for each question were assessed as well as the total knowledge score. Adjusted linear regression model was used to evaluate knowledge scores between legalized and nonlegalized states. RESULTS: A total of 513 students initiated the survey and 408 completed responses with 153 from recreational cannabis legalized states and 255 from nonlegalized states. The mean knowledge score in RC-legalized states was higher than nonlegalized states. After adjusting for covariates, the knowledge of pharmacy students in recreational cannabis legalized states were 40% higher than in nonlegalized states. CONCLUSION: For future patient requirements, it may be necessary for students to receive formal education in pharmacy schools regarding CUD so that they can proficiently assist with their patient needs. Given that pharmacy students might relocate to different states, it is essential to ensure that they possess a comprehensive understanding of the specific regulations CUD across the United States.

Needs Assessment for a Leadership Course in Saudi Medical Schools: The Student Perspective.

Introduction: Leaders in healthcare no longer need to hold formal management positions; instead, leadership is perceived to be the responsibility of all healthcare professionals. Despite changes in curricula and teaching design, however, this review of the content taught in medical colleges in Saudi Arabia reveals a lack of leadership and a failure to equip young graduates to compete on the global stage. Medical students need leadership skills for patient care, cooperation, and navigating the complex healthcare system. Clinical management skills in hospitals require these talents also. The complexity of healthcare and the impact healthcare executives have on people's lives highlight the importance of these skills. Thus, healthcare practitioners must develop non-technical skills like proactivity, motivation, and change management to lead across professional boundaries and negotiate the increasingly complex healthcare landscape. Methods: This cross-sectional study combines a quantitative approach with a self-administered questionnaire-based survey. The sampling procedure is a non-probability convenience technique, adapted for 700 male and female undergraduate medical students from four medical colleges. Results: Of the students, 75.46% had minimal leadership experience and 22.69% had some leadership experience; 3.02% of 464 students considered themselves highly experienced in leadership. Conclusion: As the needs assessment and other relevant factors show, leadership should be introduced as a skilled subject. There will always be a growing demand for competent medical graduates, who are capable of becoming future leaders. Although elementary leadership concepts remain fundamentally the same, curricular development must focus on the needs of society and stakeholders.

The Effects of Implementing Gamification in the Hepatology Curriculum for Medical Students.

Background Gamification, the incorporation of game theory into the curriculum, has been correlated with improved knowledge retention compared to standard didactics. Objective To determine the impact of gamified hepatology modules on medical student knowledge retention and exam performance. Methods We created three web-based, gamified hepatology modules with 15-question pre- and post-tests. Differences in each module's pre- and post-test scores were compared using paired t-tests. Medical school exam scores (total score and hepatology-specific score) in module users versus non-users were compared using independent two-sample t-tests. Results Module completion yielded significant increases in pre- to post-test scores for the jaundice (p=0.002) and anatomy modules (p<0.001). Module users scored 1.2 points higher on the total exam score (p=0.4) and 2 points higher on the hepatology exam score (p=0.31). Post-module survey results revealed higher knowledge retention in hepatology topics, expanded interest in hepatology, and an increased inclination to use web-based learning platforms for future learning experiences. Conclusion Module use led to improved post-test scores in the modules. Module users also had higher hepatology exam and total exam scores, yet, this difference was not statistically significant. Overall, this study suggests that gamification may be beneficial in aiding hepatology knowledge recall.

Medical Students as Teachers: A Student-Led Course in Developing Teaching Skills.

Students as Teachers is a 7-month student-led elective that equips first- and second-year medical students with teaching skills. Pre- and post-course surveys measured participants' knowledge and confidence level in the course's learning objectives such as creating lesson plans, engaging learners, and assessing understanding. Eleven students participated in the course and 10 students completed the pre- and post-course surveys. Upon completion of the course, there was a statistically significant increase in students' self-reported competencies. This series of workshops thus improved learners' confidence with teaching skills and helped identify how they could improve as physician educators.

Early Pre-clinical Exposure Enhances Medical Student Knowledge and Readiness in Caring for Patients with Disabilities.

Physicians receive little dedicated training in caring for patients with disabilities. This study evaluated whether integrating disability-focused content into pre-clinical curricula improved medical student knowledge, readiness, and attitudes in caring for patients with disabilities. Readings, clinical reasoning cases, and patient panels were added to the existing pre-clinical curricula. Students self-reported increased knowledge and readiness in caring for patients with disabilities following implementation. No changes were reported in student attitudes toward patients with disabilities. Integrating disability-related training into the curricula was effective in improving students' self-reported knowledge and readiness to care for patients with disabilities. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-024-02061-5.

Development and Implementation of a Peer-Teaching Curriculum for Student Assistants.

We have developed a peer-teaching program for student assistants involved in medical education. The offer comprises (1) an inventory of potentially relevant courses offered by other institutions at our university and (2) our own peer-teaching curriculum on pedagogy and teaching methodology. We describe a pilot scheme to implement the curriculum.

Pediatric and Adolescent Gynecology Experience in OBGYN Residency Training across the United States.

STUDY OBJECTIVE: The purpose of this study is to better understand the pediatric and adolescent gynecology (PAG) experience from the obstetrics and gynecology (OBGYN) resident perspective and its impact on physician comfort with caring for younger patients. METHODS: This is a cross-sectional survey study of physicians enrolled in OBGYN residency programs in the United States. For each program, an internet search was also performed to identify the closest PAG providers. Chi-square and Fisher's exact tests were performed to compare categorical variables. This study was IRB approved. RESULTS: 74 resident responses from 42 unique OBGYN training programs were included. The majority (62%) of programs offered no PAG clinical experience. Of programs with no PAG clinical experience, 45% had unaffiliated self-identified PAG providers within 30 miles of their institution. Only 26% of residents reported having a dedicated PAG rotation. 68% of residents felt they did not have enough PAG exposure in training. Residents who had a dedicated PAG rotation were more comfortable caring for patients <7 years old (p=0.016) and patients 8-14 years old (p=0.019) than residents without a rotation. The majority (88%) of residents believe that PAG experience will be useful for their future practice. CONCLUSION: Residents with PAG training are more comfortable in caring for patients <14 years than those in programs who lack this training. Residencies without PAG-trained staff physicians could consider partnering with PAG-practicing community physicians with the aim of broadening clinical experience. Improvement in PAG education helps provide graduating obstetrician-gynecologists with the necessary knowledge to provide needed care to younger patients.

Utilization of Telemedicine to Supervise Medical Students in the Post-Acute/Long-Term Care Setting.

OBJECTIVES: Telemedicine has become a widely accepted alternative to face-to-face patient encounters. Although there have been several peer-reviewed journal articles on incorporating telemedicine into the medical school curriculum, particularly during the COVID-19 pandemic, assessments of the effectiveness of remote supervision of medical students have not been reported. This prospective cohort study of student subjects using observational survey data evaluated the efficacy of telemedicine as an educational resource by comparing learning outcomes between osteopathic medical students receiving direct (physically present) supervision with a group who received remote (telemedicine) supervision by clinical faculty within a post-acute/long-term care (PA/LTC) setting. Learning outcomes in the domains of patient rapport, attitudes, knowledge, and behavior were measured using standardized survey instruments. DESIGN: Prospective cohort study of student subjects using observational survey data. SETTING AND PARTICIPANTS: A total of 167 fourth-year osteopathic medical students at a teaching nursing home (TNH). METHODS: A total of 167 fourth-year osteopathic medical students (OMS-4s) were randomly assigned face-to-face PA/LTC patient encounters at the TNH. The encounters were follow-up visits to residents of the TNH that were supervised by faculty geriatricians. Half were accompanied by the physician and the other half were supervised by the physician through telemedicine. Evaluation using validated survey instruments measured patient rapport, verbal communication, and physical examination skills as well as attitudes, knowledge, and behaviors of the student/subjects. RESULTS: A nonparametric statistical analysis of 4 dependent variables measuring patient rapport, attitudes, knowledge and behavior showed no significant difference between the 2 teaching modalities. CONCLUSIONS AND IMPLICATIONS: The results of this prospective cohort study indicate that telemedicine supervision is comparable (noninferior) to direct supervision of medical student trainees in a PA/LTC setting.