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Release: March 15, 1999

UI physician assistant students gaining valuable telemedicine experience

IOWA CITY, Iowa -- Telemedicine will be a valuable tool for tomorrow's health care providers, including physician assistants (PAs), according to the director of the University of Iowa's Physician Assistant Program.

In July 1998 the PA program at the UI received a three-year training grant from the U.S. Department of Health and Human Services to provide PA students with telemedicine technology.

To begin educating PA students on telemedicine, a three-session introductory course was offered at the beginning of the 1999 spring semester. The PA program developed the curriculum in collaboration with Susan Zollo, director of the UI Telemedicine Resource Center. This was the first time that a telemedicine curriculum of this kind has been systematically presented to PA students at the UI.

"I anticipate telemedicine to be used routinely in the medical field in the next four to five years. Consequently, we need to prepare our students to enter practice settings that they are most likely to be working in, and telemedicine is going to be part of those settings," said David Asprey, director of the PA program at the UI.

Telemedicine, in general terms, is the transmission of medical information and services using telecommunications technology. This can include the use of two-way interactive video, data and audio communications systems. In Iowa, this connection typically involves the statewide fiber optic system known as the Iowa Communications Network (ICN). However, telemedicine also can be carried out using a standard personal computer and modem.

Telemedicine can be particularly valuable to patients who live in rural areas which are typically hours away from cities where medical specialists are usually located. Often patients cannot afford to take time off of work to visit a specialist. With telemedicine, patients travel to their closest telecommunications link, which is typically at a hospital, and interact directly with the specialist. Because PAs generally work in these rural areas, it is important that they learn about telemedicine, Asprey noted.

Physician assistants are health professionals licensed to practice medicine with the supervision of a physician. Within the PA/physician relationship, PAs exercise autonomy in decision-making. They obtain medical histories, perform physical exams and provide a wide range of diagnostic and therapeutic services.

In the introductory telemedicine course, the PA students received a broad overview of telemedicine technology, observed demonstrations of video conferencing and discussed some of the legal and ethical issues surrounding its use. This included the question of which state medicine is being practiced when using telemedicine and whether or not the consulting physician is responsible for providing care for the patient. In addition, the students were taken to the UI Hospitals and Clinics where they witnessed an interaction between a patient and a doctor who were separated by more than 100 miles.

"This kind of demonstration gives the student a more concrete idea of what telemedicine is and how it is used," Asprey said.

At the end of the course the students were asked to evaluate what they had learned. Perhaps not surprisingly, the evaluations showed that prior to the course many of the students had minimal to no knowledge of telemedicine. However, after the course nearly half of all of the students claimed a moderate to great increase in knowledge, and many said that they were much more likely to seek out telemedicine opportunities in the future.

More hands-on telemedicine opportunities for the PA students who completed the introductory sessions are planned in June. This will decrease any intimidation students may feel toward telemedicine and will educate them on how to run through their transmissions and how the technology functions.

"Ultimately, we hope that they will catch a vision of the way telemedicine can augment their practice in rural and remote sites," Asprey said.

The PA program at the UI is considered to be one of the best in the country, averaging a 99 percent graduation rate since its first class graduated in 1974. Telemedicine can only strengthen the program further, Asprey said.

"This kind of training is important to PAs because telemedicine is clearly here to stay and is only going to expand," he said.