Learning to Assess and Care via Telehealth

Clinical internships and experience change, COVID-19 Students in the master’s of athletic training program faced another kind of challenge this spring in response to COVID-19: moving from hands-on, face-to-face clinical experiences with patients and oversight with local preceptors to virtual simulations and mentoring, all done online.

For the first two weeks after spring break, Tricia Schrage, coordinator of clinical education, connected with preceptors at clinical sites to see if they remained able to mentor students--virtually via telehealth with actual patients, or in a mentoring role remotely. She also was confirming accreditation requirements, all to ensure an acceptable level of clinical experience.

On April 6, clinical experiences went virtual. Schrage explained how it worked with a key partner, Athletico Physical Therapy: “Students participated in virtual clinical experiences at least once per week for four weeks with one to four preceptors.The sessions emulated face-to-face experience in some capacity, as there were rich discussions centered around various injury assessments and rehabilitation strategies,” .

Students actively engaged in patient care by viewing video of patients captured by preceptors. Preceptors also acted as patients, allowing students to perform injury assessments and develop a care plan, all using a telemedicine--or telerehabilitation--approach.

Preceptors and students adapt

Schrage noted this was uncharted territory for everyone. “The four preceptors involved did an incredible job engaging and mentoring students, all while navigating unfamiliar territory with their own patients,” she says. Among the preceptors working with students were alumni Kayla Hutton, (‘13, B.A.), Taylor Vaske (‘16, B.A.) Stephanie Bradley-Diehl (‘06, B.A.) and Hannah Rinken, who is completing her master’s research project.

“We often lecture on the importance of effective communication in athletic training, but the use of telemedicine and telerehabilitation brings effective communication to a whole new level. Students quickly learned that they must be intentional and strategic in describing each and every movement they want their patients to perform as they conduct either an assessment or rehabilitation exercises,” she says.

A similar scenario played out for students in the professional undergraduate athletic training program. Using Zoom, students experienced intake, assessment and care planning virtually when they were no longer able to continue at a local free medical clinic. Students worked with a simulated patient (husband of a faculty member) while being observed and mentored by Schrage and program coordinator Kelli Snyder.

Schrage says telehealth, telemedicine and tele-rehabilitation are here to stay. She recalls the first time she walked students through a virtual shoulder assessment in a Therapeutics Intervention class after spring break: “I chuckle as I think about the debriefing session following that exercise. With hands on their heads, the students appeared dumbfounded; they were mentally exhausted. It was certainly a powerful learning tool.”

By end of semester, she says, “It was fascinating to observe how our students have embraced telemedicine. Our program plans to integrate these topics into our courses. This will allow students to be educated on current evidence, best practice guidelines, state practice acts, and national/local laws centered around these topics.”

All in all, everyone adjusted as best as they could while meeting the standards required. As summer began, students in these and other areas were moving into internships, some which were starting remotely, others which were beginning to shift on-site. Master’s of athletic training student Alex Crum, was typical: having secured an internship with the Indianapolis Colts, he found himself “on hold” instead of heading to summer training camp in May. In early June, he received the word he can pack his bags and head east.