Telemedicine in Anesthesiology: Utilizing Simulation to Teach Remote Pre-operative Assessment

Background: The move toward telemedicine has markedly accelerated with the COVID-19 pandemic. As faculty learn the skills necessary to provide anesthesia services on a virtual platform, the specialty must ensure residents are instructed effectively. We therefore created a pilot curriculum for postgraduate year-2 (PGY2) anesthesiology residents focusing on telemedicine instruction. Methods: Our pilot curriculum consisted of a virtual didactic teaching session and a simulated encounter with a standardized patient (SP) on a telemedicine platform. Formative feedback was provided from both a faculty member and the patient using a checklist based on the American Medical Association Telehealth Visit Etiquette Checklist and the American Board of Anesthesiology Applied Examination Objective Structured Clinical Examination content outline. Residents completed surveys assessing their perceptions of the effectiveness and helpfulness of the didactic session and simulated encounter, as well as the mental workload of the encounter. Results: Twelve PGY2 anesthesiology residents participated in this study. All considered the didactic session to be effective for teaching virtual pre-operative assessment and conveying best practices. They indicated that the SP encounter was of greater value (more effective and helpful) than the didactic session. In assessing mental workload, residents perceived the encounter as demanding, but they felt successful in accomplishing the encounter and did not feel rushed. Faculty and the SP indicated that the checklist guided them in providing clear and useful formative feedback. Conclusion: Training programs must embrace telemedicine and train residents on best practices when utilizing this tool. Standardized patient encounters can enhance training by safely facilitating practice.