PC1264: Telemedicine in Pediatric Training: A National Needs Assessment of the Current State of Telemedicine Education in Pediatric Training

Background: Prior to the COVID-19 pandemic, telemedicine use was gaining momentum in clinics nationwide and in the wake of COVID-19, numerous institutions rapidly adopted this care modality. As a result, graduate medical education (GME) programs increased trainee utilization of telemedicine. Given this increased use it is imperative that pediatric GME programs provide adequate training in the responsible use of telemedicine. This study sought to describe the current state of telemedicine within pediatric training programs, and to inform development of a national telemedicine training curriculum for pediatric trainees.

Methods: We conducted an anonymous cross-sectional survey of pediatric residency (Fall 2020) and fellowship program directors (Spring 2021) on their current telemedicine practices in pediatric post-graduate training. We used descriptive statistics to quantify telemedicine use and settings, both prior to and since the COVID-19 pandemic, as well as to discern provider perceptions of important aspects of and limitations to implementing a telemedicine curriculum.

Results: Forty-eight U.S. pediatric residency programs (n=48/198, 24%) and 422 fellowship programs completed the survey (n=422/872, 48%); combined response rate 44% (n=470/1,070). Pre-COVID-19, 12% (n=57/470) of programs surveyed reported using telemedicine in their training program, but during the pandemic 71% (n=334/470) reported telemedicine use with trainees. Over 71% (n=334/470) agreed that a formalized curriculum is important, yet 69% (n=262/380) of programs reporting telemedicine use either did not have a curriculum or were unsure if one existed at their program. Respondents who were unsure/not likely to add a telemedicine curriculum and/or indicated that a telemedicine curriculum would not be important (52% n=243/470), cited “time” (55%, n=136/243) most frequently as a barrier.

Conclusion: Our needs assessment indicates significant increase in the use of telemedicine by pediatric GME programs with less than half the respondents having a formalized training curriculum. Telemedicine presents a unique opportunity to expand care as a complement to in person care, and most agreed that a curriculum is important to facilitate this expanded access. Therefore, it is imperative that pediatric trainees are educated and trained on the unique challenges and appropriate use of telemedicine. While some programs reported lack of interest in a pediatric telemedicine curriculum, the barriers reported (time, cost, and logistics) can be overcome by a national, open-source pediatric telemedicine curriculum, such as the Telemedicine in Pediatric Training program (TIPT), which was piloted in January 2021.