JMIR Publications

ABSTRACT

Background:

Telemedicine requires clinical, communication, and operational competencies that are not assured by experience with in-person care. Although training initiatives have expanded, evidence on how physician trainees are taught, assessed, and supported in clinical practice remains fragmented.

Objective:

This scoping review aimed to map curricular content, teaching approaches, assessment strategies, and implementation factors in telemedicine education for medical students, residents, and fellows, and examine variation across learner groups, specialties, and geographic settings.

Methods:

The review followed Joanna Briggs Institute guidance and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Education Resources Information Center, Web of Science, and the Cumulative Index to Nursing and Allied Health Literature were searched for English-language publications from January 1, 2015, through January 15, 2026, supplemented by reference-list screening. Two reviewers independently screened records and extracted data using a piloted form. Publication characteristics were summarized descriptively and educational findings narratively. No meta-analysis or formal risk-of-bias appraisal was undertaken.

Results:

The review included 121 publications dated 2015–2025, of which 105 (86.8%) were from North America or Europe. Medical students were the educational population in 67 publications (55.4%), postgraduate physician trainees in 42 (34.7%), and both groups in 12 (9.9%). Curricula combined foundational instruction, simulation, and supervised clinical encounters, addressing communication, remote examination, clinical reasoning, documentation, and safe escalation. Learner self-report instruments were identified in 30 publications (24.8%), sometimes alongside other assessments. Learners commonly reported favorable experiences and increased confidence, but perceived preparedness did not consistently correspond to observed performance. Performance-based assessment was heterogeneous, and evidence of sustained transfer to independent practice and patient outcomes was limited. Implementation was shaped by faculty preparation, supervision, protected teaching time, technological reliability, and patient access.

Conclusions:

The findings highlight priorities for aligning telemedicine learning objectives, performance-based assessment, and supervised practice rather than equating curricular exposure or confidence with clinical readiness. Implementation should account for local resources and patient needs. Longitudinal and comparative evaluations are needed to determine whether educational gains translate into sustained, safe clinical performance. Geographic concentration, heterogeneous reporting, and the absence of formal quality appraisal limit conclusions about effectiveness and transferability. Clinical Trial: Open Science Framework; https://osf.io/jxudv