JMIR Publications

ABSTRACT

Background:

Introduction Distance remains a significant access barrier to equitable healthcare services in rural communities. COVID-19 forced healthcare providers to deliver services via telehealth with minimal training. It is imperative that new providers know how to leverage telehealth and artificial intelligence (AI) to enhance access and continuity of care. Yet the extent to which clinical health professions programs are thoughtfully and consistently preparing the next generation of healthcare providers in these areas is unknown. While some gains in didactics and clinical experiences have been realized in telehealth curricula post-pandemic [1-3], the adequacy and systematic integration of telehealth content remains a pervasive concern across training programs [2,4-6]. Calls for more comprehensive, interactive, and standardized telehealth coursework [7-8] have been met with incremental progress at best. It is also unclear to what extent institutions and accreditation bodies are assessing competency and addressing barriers.

Objective:

This study used survey data to assess the current level of telehealth training provided at Idaho State University (ISU). The results are intended to help ISU identify factors that limit or enhance implementation of discipline-specific best practices in telehealth. Methods

Methods:

Ethical Considerations Approval was obtained from the institutional review board at the authors’ home institution (FY2026-221). Participation was voluntary, responses were anonymous, and no compensation or incentive was provided. Survey Overview Thirty program directors and chairs involved in clinical training were invited via email to participate in a Qualtrics survey about how telehealth and AI are incorporated into their programs in Spring/Summer 2026. The survey instrument is provided in the Multimedia Appendix. Administrators provided information about accreditation expectations and total hours of telehealth instruction, and indicated whether each of ten telehealth topics was required, optional, or not included in their curricula. They also responded to questions about method of delivery and formal assessment of telehealth-related knowledge or skills. Graduate preparedness was rated on a five-point scale, and barriers were identified from a list of options. The use of telehealth for meeting the needs of rural or underserved populations and how well programs prepare students for those settings were assessed. Administrators were also given the opportunity to describe gaps, provide feedback, and share other insights.

Results:

Results Of the 30 program directors and chairs invited, 17 (57%) responded to part or all of the survey and 14 (47%) completed it; denominators therefore vary by item (Table 1). Despite all programs having specialized accreditation, only 6 of 17 (35%) reported specific accreditor telehealth training standards, and 9 of 14 (64%) devoted 5 or fewer hours to telehealth coverage in their entire curricula. A majority of programs (64%) addressed telehealth as a tool for serving rural and underserved populations, yet most (72%) reported preparing students only “slightly” or “not at all” to use it in those settings. By comparison, less than half (43%) agreed that their graduates are adequately prepared to use telehealth in clinical practice generally. Required coverage of telehealth topics followed a predictable gradient (Figure 1) from compliance-oriented basics, primarily ethics/privacy and data security/HIPAA (required by 9 programs each), followed by legal/regulatory issues (8 programs). Following these were communication (6 programs), telehealth technologies (4), coverage of telehealth in rural and underserved settings (4), and reimbursement/policy (3). Content on clinical application was rarely required: adapting clinical assessment (3) and adapting interventions (2). Only one program required coverage of AI in telehealth. Programs reported delivering telehealth content via lecture (71%), clinical placements/experiential training (64%), case-based learning (43%), and online modules (21%). Only 4 of 14 (29%) reported formally assessing telehealth-related competencies. When asked about barriers, administrators most often cited limited time in the curriculum (93%), followed by limited access to clinical telehealth experiences and lack of accreditation requirements (50% each). Lack of institutional support was the least frequently cited barrier (14%). Table 1. Accreditation, curricular time, delivery, assessment, barriers, and preparedness reported by health professions program administrators at Idaho State University. Item Response n/N (%) Accreditation and curricular time Accrediting body includes expectations related to telehealth education Yes 6/17 (35) No 10/17 (59) Not sure 1/17 (6) Total hours of telehealth education in the program 0–5 hours 9/14 (64) 6–10 hours 2/14 (14) More than 40 hours 1/14 (7) Not sure 2/14 (14) Delivery and assessment Delivery methods (select all that apply) Lecture 10/14 (71) Clinical placement or experiential training 9/14 (64) Case-based learning 6/14 (43) Online modules 3/14 (21) Students formally assessed on telehealth knowledge or skills Yes 4/14 (29) No 8/14 (57) Not sure 2/14 (14) Barriers (select all that apply) Barriers limiting inclusion or expansion of telehealth education Limited time in the curriculum 13/14 (93) Lack of accreditation requirements 7/14 (50) Limited access to clinical telehealth experiences 7/14 (50) Limited space or equipment 5/14 (36) Limited faculty expertise 4/14 (29) Lack of institutional support 2/14 (14) Other 4/14 (29) Preparedness “Our graduates are adequately prepared to use telehealth in clinical practice” Agree or strongly agree 6/14 (43) Neutral 4/14 (29) Disagree or strongly disagree 4/14 (29) Program addresses telehealth as a tool for rural or underserved populations Yes 9/14 (64) No 4/14 (29) Not sure 1/14 (7) How well the program prepares students to use telehealth in rural or underserved settings Not at all 4/14 (29) Slightly 6/14 (43) Moderately 2/14 (14) Well 2/14 (14) Note: Percentages use item-specific denominators. Select-all-that-apply items sum to more than 100%. Two “other” responses to the delivery item (“none,” “N/A”) indicated no delivery and are not shown. Figure 1: Coverage of telehealth topics in health professions program curricula at Idaho State University. Topics are ordered by number of programs requiring them; denominators (n) vary because of item nonresponse.

Conclusions:

Discussion This study found that clinical health professions programs at ISU recognize the opportunities that quality telehealth training offers when serving rural and underserved communities. Despite reliance on telehealth during the pandemic, telehealth training remains limited in hours, is rarely assessed formally, and is focused mostly on privacy and security, with little required content on adapting clinical care for telehealth. Efforts to further develop and integrate technology, including telehealth and AI, into curriculum are constrained chiefly by limited curriculum time and the absence of telehealth-specific accreditation expectations. As a result, the next generation of health care providers may not be prepared to fully leverage technology to enhance access and continuity of care for patients. In 2004, Cunningham and Stamm [9] pioneered efforts to use distance-delivered health professions education as a means to increase the healthcare workforce and improve access in Idaho. To develop empirically-based best practices requires investments in research, shared expectations, and genuine collaboration. It also requires ongoing assessment and accountability, which are currently lacking. This is especially true as advancements in telehealth curriculum since 2004 have brought new educational processes and approaches, such as telehealth etiquette to improve communication in virtual care [10]. This pilot study has limitations. It reflects a single institution, and findings may not generalize to other settings. Data were self-reported by program administrators, who may over-or underestimate content delivered by faculty or preceptors. The sample was small and programs with a greater interest in telehealth may have been more likely to respond. With this in mind, we recommend that states and communities come together to assess the current state of telehealth care and methods for successfully integrating healthcare technology, especially for rural areas. We encourage collaboration across institutions and communities, as well as accrediting bodies, to develop an action plan with measurable outcomes in delivering comprehensive, interactive, and standardized telehealth coursework. A method for adopting emerging technologies, such as AI, to better serve those at risk should similarly be considered. Otherwise, opportunities to leverage emerging technologies and innovative practices will continue to be missed to the detriment of those we serve.