By Dr. Lance Fuchs

Maria is a young adult who moved to the U.S. a few years ago with her extended family. She just started a new job and is happy to have, for the first time, health insurance. Maria is a non-native English speaker who is unfamiliar with the U.S. health care system and lacks internet access.

Using Maria’s situation as a case study in teaching telemedicine to health care providers helps bring common challenges in the health care setting to life. Adapting the case study method of teaching medicine to apply to telehealth visits, not just to an exam room, has some challenges and nuances. Doing so, though, is important. Better-trained telehealth physicians means better health outcomes.

Clinical case studies are a common and integral part of medical education and training. Real-life scenarios depicting patient symptoms, lab results and vital signs provide learners valuable experience that can be easily applied to real patient care.

With the exponential growth in telehealth care in recent years, utilizing case studies to train already licensed physicians on telemedicine best practices is an effective way to ensure patients are receiving the best possible care during phone and video visits.

The Benefits of Case Studies in Medical Training

Case studies generally provide learners with the following:

• A decision that needs to be made involving a question or problem to be solved
• Some context and descriptions of the situation
• Supporting information, which can include anything from data and test results to news articles and videos

Teaching with case studies is, simply, more engaging. I’ve seen firsthand how learners are more connected to the lesson when they have both a “story” and are tasked with actively solving a problem. I’m not alone in this observation: In the Journal of College Science Teaching’s 2007 report on “Teaching Science with Case Studies,” 95% of the college faculty that participated in the survey agreed that students are more active in the learning process when the faculty used case studies.

In addition to improving focus and attention, case studies enable learners to develop new skills. Problem solving, quantitative and qualitive analytical tools and decision-making during complex, ambiguous, stressful and high-stakes situations are some of the abilities learners build through case studies.

Case Studies in Telehealth Training

What can a telehealth physician learn from Maria’s case study?

Maria’s situation serves as a lesson in providing culturally sensitive care. Telehealth can improve accessibility by expanding physicians’ reach beyond geographic and demographic boundaries. Telehealth providers are virtually treating patients from ethnically diverse, low-income and rural communities. Physicians learn about cultural humility — approaching each patient as a unique individual. But when we take that lesson outside the brick-and-mortar clinic’s walls, the situation can create unique challenges.

Learning how to navigate these challenges to provide equitable care, addressing the patient’s unique challenges and needs, is key to being an effective telehealth physician. Maria’s case study demonstrates to physicians the importance of evaluating a patient’s ability to access the tools and resources they need for a successful telehealth encounter prior to scheduling an appointment. It teaches the value of adapting to the patient’s ability and preferences and accommodating them appropriately.

Certain specific populations have unique needs that require additional attention during telehealth visits.Patients who are hard of hearing, are children, have dementia, are suffering from mental health conditions like depression or are transgender require sensitivity in any setting. Using case studies to learn and practice the best approaches to optimizing a telehealth visit ensures physicians are prepared — and patients are treated respectfully and effectively.

Knowing about, understanding and implementing the technology that supports telehealth is best learned through case studies that demonstrate real-life applications. For instance, there are some telehealth platforms that allow for individuals in more than two locations to join. This can be important when incorporating a translator, another caregiver or a family member. There are best practices when incorporating such technologies so that patient care isn’t compromised. In a situation where an interpreter is needed, physicians should be trained to direct their attention directly to the patient, to speak in short questions and statements and to make other accommodations, such as written materials in the patient’s preferred language.

Since telehealth visits have become a prevalent type of doctor-patient visit, physicians can best serve their patients by learning the unique skills to optimize this care. Telehealth trainings that incorporate case studies nurture deep learning through context that allows physicians to incorporate their experience and knowledge for great patient outcomes.

Dr. Lance Fuchs developed and retains oversight of PRR’s Telemedicine module. He is the residency program director for the Kaiser Permanente San Diego Residency Program and co-director for Graduate Medical Education for Kaiser Permanente in San Diego. He served on the Society of Teachers of Family Medicine National Telemedicine Task Force from 2020 to 2022, creating a national on-line telehealth curriculum for physicians.