1
|
Nguyen AD, White SJ, Tse T, Cartmill JA, Roger P, Hatem S, Willcock SM. Communication during telemedicine consultations in general practice: perspectives from general practitioners and their patients. BMC PRIMARY CARE 2024; 25:324. [PMID: 39232645 PMCID: PMC11373490 DOI: 10.1186/s12875-024-02576-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 08/16/2024] [Indexed: 09/06/2024]
Abstract
BACKGROUND Telemedicine allows delivery of healthcare to occur between parties that are not in the same location. As telemedicine users are not co-present, effective communication methods are crucial to the delivery and reception of information. The aim of this study was to explore perspectives of general practitioners (GPs) and patients on the interactional components of telemedicine consultations. METHODS Semi-structured qualitative interviews were held with telemedicine users; 15 GPs and nine patients self-selected from a larger telemedicine study. Participants were asked about their preparation for telemedicine consultations, conducting telemedicine consultations and post-consultation activities. Deidentified transcripts from the interviews were analysed thematically. RESULTS GPs and patients discussed factors they used to decide whether a consultation would be best conducted by telemedicine or in-person; the condition to be discussed, the existing doctor-patient relationship and whether physical examination was required. Participants also described how they prepared for their telemedicine consultations, gathering relevant documents, and reading previous notes. Participants described strategies they employed to optimise the telemedicine interaction; improving conversational flow and building rapport, as well as difficulties they experienced when trying to provide and receive care via telemedicine. CONCLUSIONS Patient factors including health literacy and familiarity with technology affect the transfer of information shared during telemedicine consultations and consideration of these factors when choosing patients for telemedicine is required. Many GPs and patients have innate communication skills to effectively deliver and receive care through telemedicine. However, they may not be aware of these subconscious techniques to use to optimise telemedicine consultations. Communication training could be delivered to increase conversational flow, build rapport, and establish safety netting.
Collapse
Affiliation(s)
- Amy D Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, 2109, Australia.
- St Vincent's Clinical Campus, UNSW Sydney, Sydney, NSW, Australia.
| | - Sarah J White
- Centre for Social Impact, UNSW Sydney, Kensington, NSW, Australia
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Tim Tse
- Department of Primary Care, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - John A Cartmill
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Peter Roger
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Sarah Hatem
- Department of Primary Care, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Simon M Willcock
- Department of Primary Care, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
2
|
Ritunga I, Claramita M, Widaty S, Soebono H. Challenges and recommendations in the implementation of audiovisual telemedicine communication: a systematic review. KOREAN JOURNAL OF MEDICAL EDUCATION 2024; 36:315-326. [PMID: 39246112 DOI: 10.3946/kjme.2024.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/19/2024] [Indexed: 09/10/2024]
Abstract
This systematic review aims to identify the elements of doctor-patient communication in telemedicine, emerging challenges, and proposed recommendations. Four databases, including Science Direct, PubMed, Cochrane, and ProQuest, were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria consisted of original research papers, availability of free full text, and publications during the past 10 years. A total of 13 articles completed the selection process and satisfied the established criteria. The issues and recommendations of telemedicine communication were categorized into three distinct groups: pre-consultation, during-consultation, and post-consultation. Preparation encompasses the arranging of visual elements, safeguarding patient privacy and confidentiality, and addressing any technical challenges that may arise. The consultation encompasses nonverbal behavior, empathy, the doctor-patient connection, and a physical examination. Post-telemedicine consultations refer to medical appointments that occur after a telemedicine session, typically involving follow-up medical interactions. Telemedicine presents unique challenges in doctor-patient consultations that differ from face-to-face interactions. Therefore, clinicians must acquire communication skills specific to telemedicine to ensure effective consultations and achieve optimal health results.
Collapse
Affiliation(s)
- Imelda Ritunga
- Doctoral Program, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Bioethics and Medical Education, School of Medicine, Universitas Ciputra, Surabaya, Indonesia
| | - Mora Claramita
- Department of Medical Education and Bioethics, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sandra Widaty
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Hardyanto Soebono
- Department of Dermatology and Venereology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
3
|
Ford J, Reuber M. Face-to-face and telephone appointments in the seizure clinic: A comparative analysis based on recorded interactions. PATIENT EDUCATION AND COUNSELING 2024; 123:108171. [PMID: 38368785 DOI: 10.1016/j.pec.2024.108171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/10/2023] [Accepted: 01/21/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVE Telephone appointments are now widely used in seizure treatment, but there is little understanding of how they compare to face-to-face appointments. Studies from other fields suggest that comparisons can be done on three levels: 1) Abstract level: duration of appointment. 2) Structural level: distribution of talk. 3) Detailed level: aspects of communication. This study aims to compare seizure clinic face-to-face and telephone appointments based on their duration, distribution of talk, and the number of questions asked by patients/companions. METHODS Statistical comparison between recordings and transcripts of 34 telephone appointments (recorded in 2021) and 56 face-to-face appointments (recorded in 2013). RESULTS There was no significant difference between the duration of face-to-face (median: 16.5 min) and telephone appointments (median: 16.2 min). There was no significant difference in the ratio of neurologist to patient/companion talk (face-to-face: 55% vs. 45%, telephone: 54% vs. 46%). Patients/companions asked significantly more questions per minute in face-to-face (median: 0.17) than telephone appointments (median: 0.06, p < 0.05). CONCLUSION At a broad level, seizure clinic face-to-face and telephone appointments are similar. Examining the details of the interaction, however, reveals important differences in questioning. PRACTICE IMPLICATIONS Practitioners could take steps to facilitate patient questioning in telephone appointments.
Collapse
Affiliation(s)
- Joseph Ford
- Department of Neuroscience, University of Sheffield, UK.
| | - Markus Reuber
- Department of Neuroscience, University of Sheffield, UK
| |
Collapse
|
4
|
Sobieski M, Grata-Borkowska U, Bujnowska-Fedak MM. Implementing an Early Detection Program for Autism Spectrum Disorders in the Polish Primary Healthcare Setting-Possible Obstacles and Experiences from Online ASD Screening. Brain Sci 2024; 14:388. [PMID: 38672037 PMCID: PMC11047999 DOI: 10.3390/brainsci14040388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
A screening questionnaire for autism symptoms is not yet available in Poland, and there are no recommendations regarding screening for developmental disorders in Polish primary healthcare. The aim of this study was to assess the opinions of parents and physicians on the legitimacy and necessity of screening for autism spectrum disorders, potential barriers to the implementation of the screening program, and the evaluation and presentation of the process of online ASD screening, which was part of the validation program for the Polish version of one of the screening tools. This study involved 418 parents whose children were screened online and 95 primary care physicians who expressed their opinions in prepared surveys. The results indicate that both parents and doctors perceive the need to screen children for ASD in the general population without a clear preference as to the screening method (online or in person). Moreover, online screening is considered by respondents as a satisfactory diagnostic method. Therefore, online screening may prove to be at least a partial method of solving numerous obstacles indicated by participants' systemic difficulties including time constraints, the lack of experienced specialists in the field of developmental disorders and organizational difficulties of healthcare systems.
Collapse
Affiliation(s)
- Mateusz Sobieski
- Department of Family Medicine, Wroclaw Medical University, Syrokomli 1, 51-141 Wroclaw, Poland; (U.G.-B.); (M.M.B.-F.)
| | | | | |
Collapse
|
5
|
Seuren LM, Ilomäki S, Dalmaijer E, Shaw SE, Stommel WJP. Communication in Telehealth: A State-of-the-Art Literature Review of Conversation-Analytic Research. RESEARCH ON LANGUAGE AND SOCIAL INTERACTION 2024; 57:73-90. [PMID: 38741749 PMCID: PMC11090155 DOI: 10.1080/08351813.2024.2305045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
We provide a state-of-the-art review of research on conversation analysis and telehealth. We conducted a systematic review of the literature, focusing on studies that investigate how technology is procedurally consequential for the interaction. We discerned three key topics: the interactional organization, the therapeutic relationship, and the clinical activities of the encounter. The literature on telehealth is highly heterogeneous, with significant differences between text-based care (e.g., via chat or e-mail) and audio(visual) care (e.g., via telephone or video). We discuss the extent to which remote care can be regarded as a demarcated field for study or whether the medium is merely part of the "context," particularly when investigating hybrid and polymedia forms of care involving multiple technological media.
Collapse
Affiliation(s)
- Lucas M. Seuren
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
- Institute for Better Health, Trillium Health Partners, Canada
| | | | - Evi Dalmaijer
- Centre for Language Studies, Radboud University, Netherlands
| | - Sara E. Shaw
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | | |
Collapse
|
6
|
Denvir P, Briceland LL. Exploring the Impact of an Innovative Peer Role-Play Simulation to Cultivate Student Pharmacists' Motivational Interviewing Skills. PHARMACY 2023; 11:122. [PMID: 37624077 PMCID: PMC10458726 DOI: 10.3390/pharmacy11040122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023] Open
Abstract
Effective patient-centered communication is a foundational skill for student pharmacists, with recent decades broadening the scope of professional responsibilities to include an increased emphasis on empathic communication and motivational interviewing (MI) as tools to support patients' therapeutic adherence. Role-play is a potentially effective pedagogical approach to cultivate these skills, although previous research has identified common shortcomings that can hinder its educational value, particularly in peer role-play with relatively inexperienced learners. The purpose of this study is to describe and provide initial assessment data for an innovative approach to peer role-play that incorporates pedagogical principles to address these common shortcomings. Using a mixed-methods study design that includes instructor-graded rubrics and inductive thematic analysis of student reflections, our findings indicate that students successfully demonstrated a range of important competencies through this experience and perceived it to be both challenging and highly beneficial for their personal and professional development. Among the MI principles and techniques practiced, students performed especially well on expressing empathy and frequently reflected on its importance for future patient care and clinical collaborations. Our findings also suggest that peer engagement through team activities and partnered role-play provides a felicitous context to explore empathic communication together.
Collapse
Affiliation(s)
- Paul Denvir
- Department of Population Health Sciences, Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA;
| | - Laurie L. Briceland
- Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, NY 12208, USA
| |
Collapse
|