Difference in Medical Student Performance in a Standardized Patient Encounter Between Telemedicine and In-person Environments

Introduction: Telemedicine is an increasingly common form of healthcare delivery in the United States. It is unclear how there are differences in clinical performance in early learners between in-person and telemedicine encounters.

Materials & Methods: The authors conducted a single-site retrospective cohort study of 241 second-year medical students to compare performance between in-person and telemedicine standardized patient (SP) encounters. One hundred and twenty medical students in the 2020 academic year participated in a telemedicine encounter, and 121 medical students in the 2022 academic year participated in an in-person encounter. SPs completed a multi-domain performance checklist following the encounter, and the authors performed statistical analyses to compare student performance between groups.

Results: Students who completed in-person encounters had higher mean scores in overall performance (75.2 vs. 69.7,  < 0.001). They had higher scores in physical exam (83.3 vs. 50,  < 0.001) and interpersonal communication domains (95 vs. 85,  < 0.001) and lower scores in obtaining a history (73.3 vs. 80,  = 0.0025). There was no significant difference in assessment and plan scores (50 vs. 50,  = 0.96) or likelihood of appropriately promoting antibiotic stewardship (41.3% vs. 45.8%,  = 0.48).

Conclusion: The authors identified significant differences in clinical performance between in-person and telemedicine SP encounters, indicating that educational needs may differ between clinical environments.