Virtual Clinical Teaching in Years 1 & 2 UGME program


 


Virtual clinical teaching can involve the preceptor and student in the same place (clinic) and the patient is in a remote location or all three parties in separate locations, where you are using either a telephone or virtual platform to connect.

The information below is curated from discussions with virtual clinical teaching pioneers, peer-reviewed papers, and physician-led resources as medical schools have worked to provide patient care and medical student education during the COVID-19 pandemic. As experience accumulates and we continue to learn best practices in virtual clinical teaching alongside clinical educators, we will update this website.


Small Group Facilitation


Virtual moderator/presenter/participant guide


Year 1 & 2 Family Practice Preceptor Infographic

(resource developed by VFMP)


Tips and suggestions for optimizing Webside Manner for students


Session Recording for Teaching Year 1 & 2 medical learners in office and virtual settings

If you are a preceptor who is looking for support as you consider teaching in this new virtual environment, please view the recorded session below:


Watch this space for upcoming workshops!

The session will be offered online with a panel presentation and plenty of time for questions and discussion.

 

For specific information on providing virtual patient care, technology considerations and support, and additional virtual clinical teaching resources, please see the annotated bibliography at the bottom of the page.


Providing students with an orientation to your clinic and virtual care practices is more important than ever in this new era of virtual care. Take some time to co-create teaching and learning goals with your student so that you have matched expectations for how you will work together in the virtual environment. Setting shared goals with your learner also makes it easier to provide feedback on the student’s performance in the form of a dialogue of what needs to be learned and accomplished. Iterative check-ins are also important to see if both the student and teacher’s goals are being accomplished and provide an opportunity to plan future ones.

Explore areas in which your students can assist you and take some responsibility. This would depend on the level of the learner but could include initial history taking as they would do typically in an in-person encounter.

Whatever technology and platforms you are already using are likely the best technology to teach with. Don’t overthink it. Students will learn from you (and alongside you) and your patients about providing virtual care regardless of what technology your clinic uses. If you have specific questions about licensing requirements, and what technology platforms are available for virtual care, please visit https://www.doctorsofbc.ca/resource-centre/physicians/doctors-technology-office-dto/health-technology-resources#tab-0-2   [i]

[i] Zoom licenses available free of charge for community providers​. DTO, in partnership with the Provincial Health Services Authority (PHSA), is providing Zoom for Healthcare licenses to community providers (family physicians, nurse practitioners, and specialists). Please follow the above link for more information.

Observation and feedback will vary among preceptor teaching styles and clinical schedules but some suggestions based on others’ experiences involve:

  • Morning check-ins with your students to go over the schedule, what patients you would like them to see and what their goals are for the day.
  • As you provide virtual care, the student along with you and teach in the presence of the patient. Discuss what your role will be and what the student’s role will be. Then you can provide feedback to student in the presence of the patient so that you can correct the student and educate your patient at the same time.
  • End-of-day wrap up with your learner in your clinic or virtually, depending on your situation
  • In order for your feedback to be meaningful and specific, encourage your students to take notes throughout the day as they see patients and jot down any further questions they have and preceptors are also encouraged to take notes on students’ general performance and related to their learning goals.

Telehealth for Teachers and Learners

Introduction to Telehealth platforms (Basics) and a Patient Encounter

See Dr. Arman Abdalkhani, Associate Director, UGME program presenting a 3-way medical student Telehealth teaching video, accompanied by a brief powerpoint.

Skills that you can effectively observe students do virtually include:

  • Communication skills – virtual care often relies on a detailed patient history so you can observe your students listening skills and how effectively the student communicates with the patient.
  • Clinical reasoning skills – since you may not have the breadth or variety of cases that you are providing care virtually for, you can spend time probing students’ depth of knowledge through exploring alternative scenarios.
  • Selectivity skills – how well do students triage which patients need to come into the clinic, despite the current risks associated with in-clinic visits? Would the student’s treatment plan be different if pandemic measures were not in place within clinics? Preceptors can probe deeper thinking on patient-care decisions.
  • Scholar skills – As clinic procedures and processes rapidly change, now is a great time to consider QI or practice improvement projects your student can support.
  • Physical exam skills – while attempting a virtual physical exam is difficult at best and not always possible with certain types exams, some preceptors have found creative solutions to assess students’ ability to preform some physical exams . A summary document on the virtual physical exam oriented along the 12 organ systems is attached.


Do you have experience teaching virtually and would like to share your experience with your peers? Write about something you have learned, a challenge you have experienced and what you did to overcome it, or a virtual clinical teaching success story, enter the details below.


  1. Virtual Care Resources

From: Doctors of BC

About: Find physician-led resources on

  • Zoom videoconferencing software, including licenses, registration, and training videos for healthcare providers.
  • Navigating the new norm, a back to practice guide with tips on how to promote virtual care visit availability and best practices for virtual care exams and proactively connecting with at-risk patients
  • Best practices for conducting group medical visits (GMV)
  • Quick start to virtual care for physicians

  1. Virtual Care Playbook for Canadian Physicians

From: Canadian Medical Association, The College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada

About: This playbook was written to help Canadian physicians introduce virtual patient encounters (aka telemedicine) into their daily practices. It is intended to be virtual care platform and vendor agnostic


  1. Teaching in Turbulent Times

From: UBC Department of Family Practice, Postgraduate program  

About: FAQs on teaching during COVID-19 that offer some ideas to make teaching meaningful and manageable.


  1. The Virtual Resident: Tips and tricks for teaching in virtual care environment Webinar

From: UBC Department of Family Practice, Postgraduate program  

About: Learn from Dr. Krystine Sambor, an early adopter of virtual clinical teaching.


  1. Virtual Visit Guidelines

From: University of Saskatchewan Faculty Development

About: Best practices, guidelines, and tables for what types of patient visits are suitable for virtual care.


  1. Never too busy to learn- pandemic response

From: Royal College of Physicians – United Kingdom

About:  Tips and guidance to support the delivery of vital teaching and learning during the COVID-19 pandemic.


  1. Telemedicine training in undergraduate medical education: mixed-methods review

From: S Waseh, AP Dicker. Originally published in JMIR Medical Education (http://mededu.jmir.org), 08.04.2019.

About: This article discusses how medical schools in the United States implement telemedicine training in undergraduate medical education.