A Student-Led Telephone-Based Clinical Learning Program for Outreach to Older Adults

Abstract Background: Early clinical experiences expose students to patient-centered care. However, early incorporation of telehealth communication skills remains limited in health professions education. In this study, we aimed to design and evaluate a telephone-based clinical learning program for students to promote the development of patient-centered communication skills while addressing healthcare disparities experienced by older adults during the COVID-19 pandemic.Methods: We utilized workplace learning principles in designing a telephone-based clinical learning pilot program for health professions students at an academic geriatrics primary care clinic. Students conducted three types of telephone calls to patients that 1) assessed for unmet needs (e.g. food, medication, medical supplies, caregiving, social support, and/or access to medical care) (screening call), 2) addressed social isolation (social call), and 3) helped patients set up videoconferencing software to prepare for telehealth appointments (telehealth-training call). We tracked telephone call completion and outcomes via weekly student reports and the electronic health record. To evaluate program efficacy and learning outcomes, students completed an anonymous post-program survey that assessed pre- and post-program knowledge and skills acquisition. Data was analyzed using descriptive statistics and Wilcoxon rank-sum tests.Results: Five medical student liaisons led 23 medical and nurse practitioner students in calling 335 patients over 13 weeks. Students successfully reached 247 patients (74%), assisted 25 patients in setting up videoconferencing software, and engaged 30 patients in weekly social calls. Of 21 students who completed the post-program survey, 18 (86%) believed this program provided meaningful clinical exposure. After participation, all students felt comfortable interacting with patients by telephone and 20 (95%) felt confident in relationship-centered communication. Students reported increased knowledge about vulnerabilities in the geriatric population (p = 0.002).Conclusion: This telephone-based program allowed health professions students to support a vulnerable population and gain patient-centered communication skills. This program could be adapted for implementation in multiple contexts as an effective telehealth clinical learning experience, especially for pre-clerkship health professions students who could gain early exposure to telehealth and practice communication and health coaching skills with patients.