Internal Medicine Inpatient Telehealth Elective Design

During the COVID-19 pandemic, all internal medicine clerkship rotations and sub-internships at Yale School of Medicine were abruptly cancelled. Concurrently, patient volume and demands on the hospital and house staff increased at an exponential rate. Thus, a group of furloughed medicine sub-interns, in collaboration with the Internal Medicine Chief Residents, designed a curriculum with the primary goal of remotely utilizing senior medical students to help relieve the workload on house staff and support patients with COVID-19. Secondary goals included teaching medical students about COVID-19, ICU-level care, and how to handle difficult discussions around COVID-19 care with patients and their families. Based on these goals, a curriculum for this inpatient Internal Medicine Telehealth was designed. To implement this, medical student coordinators worked with chief residents in the Department of Internal Medicine to ensure that students and residents were aware of this novel curriculum and attendant students’ roles and responsibilities. An orientation session was hosted among students including a module led by our Department of Palliative Care. Palliative care faculty taught students how to communicate with COVID patients and the best way to appropriately address these patients’ questions and concerns. During the elective, students had the opportunity to remotely interact with their team, communicate with families, and participate directly in individual patient care by data gathering, note writing, and suggesting next steps for management. They also had the opportunity to attend virtual educational sessions. Further details about students’ roles and responsibilities are included in the document entitled “Yale Inpatient Telehealth Clinical Elective Description.” Other available resources include a detailed description of our process of curricular development according to Kern’s 6-step model, the letter we sent to all residents explaining the roles/responsibilities of virtual medical students, and slides from our palliative orientation module.