1
|
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
|
2
|
Rettinger L, Putz P, Aichinger L, Javorszky SM, Widhalm K, Ertelt-Bach V, Huber A, Sargis S, Maul L, Radinger O, Werner F, Kuhn S. Telehealth Education in Allied Health Care and Nursing: Web-Based Cross-Sectional Survey of Students' Perceived Knowledge, Skills, Attitudes, and Experience. JMIR MEDICAL EDUCATION 2024; 10:e51112. [PMID: 38512310 PMCID: PMC10995793 DOI: 10.2196/51112] [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: 07/21/2023] [Revised: 12/04/2023] [Accepted: 02/13/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the growing relevance of telehealth in health care. Assessing health care and nursing students' telehealth competencies is crucial for its successful integration into education and practice. OBJECTIVE We aimed to assess students' perceived telehealth knowledge, skills, attitudes, and experiences. In addition, we aimed to examine students' preferences for telehealth content and teaching methods within their curricula. METHODS We conducted a cross-sectional web-based study in May 2022. A project-specific questionnaire, developed and refined through iterative feedback and face-validity testing, addressed topics such as demographics, personal perceptions, and professional experience with telehealth and solicited input on potential telehealth course content. Statistical analyses were conducted on surveys with at least a 50% completion rate, including descriptive statistics of categorical variables, graphical representation of results, and Kruskal Wallis tests for central tendencies in subgroup analyses. RESULTS A total of 261 students from 7 bachelor's and 4 master's health care and nursing programs participated in the study. Most students expressed interest in telehealth (180/261, 69% very or rather interested) and recognized its importance in their education (215/261, 82.4% very or rather important). However, most participants reported limited knowledge of telehealth applications concerning their profession (only 7/261, 2.7% stated profound knowledge) and limited active telehealth experience with various telehealth applications (between 18/261, 6.9% and 63/261, 24.1%). Statistically significant differences were found between study programs regarding telehealth interest (P=.005), knowledge (P<.001), perceived importance in education (P<.001), and perceived relevance after the pandemic (P=.004). Practical training with devices, software, and apps and telehealth case examples with various patient groups were perceived as most important for integration in future curricula. Most students preferred both interdisciplinary and program-specific courses. CONCLUSIONS This study emphasizes the need to integrate telehealth into health care education curricula, as students state positive telehealth attitudes but seem to be not adequately prepared for its implementation. To optimally prepare future health professionals for the increasing role of telehealth in practice, the results of this study can be considered when designing telehealth curricula.
Collapse
Affiliation(s)
- Lena Rettinger
- Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria
- Institute of Digital Medicine, Philipps-University & University Hospital of Giessen and Marburg, Marburg, Germany
| | - Peter Putz
- Competence Center INDICATION, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Lea Aichinger
- Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Susanne Maria Javorszky
- Logopedics - Phoniatrics - Audiology, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Klaus Widhalm
- Physiotherapy, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Veronika Ertelt-Bach
- Occupational Therapy, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Andreas Huber
- Orthoptics, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Sevan Sargis
- Midwifery, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Lukas Maul
- Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Oliver Radinger
- Competence Center Nursing Sciences, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Franz Werner
- Health Assisting Engineering, FH Campus Wien, University of Applied Sciences, Vienna, Austria
| | - Sebastian Kuhn
- Institute of Digital Medicine, Philipps-University & University Hospital of Giessen and Marburg, Marburg, Germany
| |
Collapse
|
3
|
Särchen F, Springborn S, Mortsiefer A, Ehlers J. Digital learning about patients: An online survey of German medical students investigating learning strategies for family medical video consultations. Digit Health 2024; 10:20552076241230070. [PMID: 38323240 PMCID: PMC10846016 DOI: 10.1177/20552076241230070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
Objective Training in video consultations is seldom included in the curriculum for future physicians. Exploration of preferred teaching methods and learning objectives in this context among medical students remains limited. This study addresses this research gap by conducting a survey among medical students in Germany to assess their educational requirements concerning video consultations and patient-centred distance learning. Methods This quantitative study employed an online questionnaire designed for German medical students, following the guidelines of the International Association for Health Professions Education. The study primarily focused on discerning the didactic preferences related to patient-centred digital teaching regarding family medical video consultations. We provided a detailed explanation of a concrete learning concept, a family medical synchronous distance learning seminar. Subsequently, we surveyed students to gauge their needs, expectations, and evaluations of this concept. The collected data were subjected to descriptive analysis. Results The analysis revealed that students aspire to offer video consulting services to their patients in the future (sample size (n) = 369, median (med) = 68 of 101 Likert scale points, interquartile range (IQR) = 53.75), despite having limited knowledge in this area (n = 353, med = 21, IQR = 33.25). To acquire expertise in telehealth, students favor blended learning models (n = 331, med = 76, IQR = 50). They also recognize the benefits of distance learning, particularly for students with family responsibilities or those who must travel long distances to their learning institutions,. The presented distance seminar concept resonated with them (n = 278, med = 72.5, IQR = 50.5), surpassing five other digital learning models in preference. Furthermore, they expressed a desire for its continued implementation beyond the Coronavirus SARS-CoV-2 pandemic (n = 188, med = 77.5, IQR = 44.75). Conclusions The deficiency in medical school education regarding video consultations requires attention. This issue could be resolved by integrating one of the five distance learning concepts outlined in this article.
Collapse
Affiliation(s)
- Franziska Särchen
- Didactics and Education Research in the Health Sector, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | | | - Achim Mortsiefer
- General Practice II and Patient-Centeredness in Primary Care, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Jan Ehlers
- Didactics and Education Research in the Health Sector, Faculty of Health, Witten/Herdecke University, Witten, Germany
| |
Collapse
|
4
|
Cardoso Pinto AM, Patel SB, Stephens M, Guha P, Baptista A, Smith S. Developing as health professionals through community volunteering: exploring the value of a partnership between medical students and primary schools online compared to in-person. BMC MEDICAL EDUCATION 2023; 23:56. [PMID: 36694256 PMCID: PMC9873211 DOI: 10.1186/s12909-023-04032-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/16/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Imperial College Teddy Bear Hospital (ICSM-TBH) is a student-led volunteering group, which uses interactive, play-based teaching to educate school pupils aged 5-7 years about healthy lifestyles and healthcare. During the COVID-19 pandemic, volunteering sessions shifted online. The aim of this study was to compare the value of online and in-person ICSM-TBH volunteering for volunteers and school pupils. METHODS Undergraduate university students at Imperial College London (medicine can be taken as a first degree in the UK) who volunteered with ICSM-TBH between 2019 and 22 were invited to complete an anonymous online questionnaire evaluating their experiences of volunteering online and in-person through Likert-scale questions. Those who completed the questionnaire were also invited to an interview. Teachers who hosted online ICSM-TBH sessions were also invited to an in-person interview, exploring their view of their pupils' experiences with these sessions. Questionnaire results were analysed through descriptive statistics. Interviews were analysed through inductive thematic analysis. RESULTS Thirty-two university students completed the questionnaire. Of these, 9 experienced both in-person and online volunteering, all of whom preferred in-person volunteering. For those who only volunteered in-person, 92% reported that ICSM-TBH sessions were a positive experience, compared to 100% who volunteered online; 92% in person volunteers agreed or strongly agreed that ICSM-TBH volunteering in person improved their mood, compared to 89% online; and 100% agreed or strongly agreed that ICSM-TBH volunteering in person helped them feel part of a community, compared to 84% online. A total of 12 volunteers and 4 teachers were interviewed, from whom five themes emerged: interaction and engagement (interaction and engagement between pupils and volunteers was more readily achieved in-person); personal and professional development (both online and in-person sessions enabled volunteers to gain valuable skills); community and social (greater sense of community was established in-person); emotional wellbeing and enjoyment (both modalities were enjoyed by volunteers and pupils); and workload (online sessions were more convenient for volunteers but with risk of screen fatigue). CONCLUSION Overall, both in-person and online volunteering were of substantial benefit to volunteers and school pupils. However, most teachers and volunteers preferred in-person volunteering.
Collapse
Affiliation(s)
| | - Sajan B Patel
- School of Medicine, Imperial College London, London, UK
| | | | - Payal Guha
- School of Medicine, Imperial College London, London, UK
| | - Ana Baptista
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
| | - Susan Smith
- Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
5
|
Shepherd L, McConnell A, Watling C. Good for patients but not learners? Exploring faculty and learner virtual care integration. MEDICAL EDUCATION 2022; 56:1174-1183. [PMID: 35732194 DOI: 10.1111/medu.14861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The pandemic catapulted the adoption of virtual care far ahead of its anticipated maturation date, forcing faculty to role model and teach learners with barely enough time to master it themselves. With a scant body of prepandemic literature now accompanied by experience gained under extraordinary circumstances, we can benefit from understanding ad hoc strategies implemented by those on the front lines and from listening to learners about what is working and what is not. The purpose of this study was to explore the experience of learner integration into virtual care from both the faculty and learner perspectives. METHODS Using a constructivist grounded theory methodology and sociomateriality as a sensitising concept, we recruited participants using purposeful and theoretical sampling from a Canadian University with limited prepandemic virtual care provision. We interviewed 16 faculty and 5 learners spanning a breadth of specialties and years of practice/education to probe their experience of teaching and learning virtual care. Data collection and analysis were conducted iteratively with themes identified through constant comparative analysis. RESULTS Integrating learners into virtual care proved challenging initially because of a lack of familiarity with the process and later because of disrupted workflow, triggered by the structure and logistics of the virtual care clinic. Both faculty and learners identified learning deficiencies in the virtual care experience when compared with in-person clinics, but several unique and valuable learning affordances were noted. All faculty expressed a desire to keep virtual care as part of their future clinic practice, but paradoxically most felt that they were unlikely to include learners. CONCLUSIONS Training learners in virtual care is an educational challenge that will not disappear with COVID-19, even if our participants wished it could. The perceived value for patients but not learners begs a reconsideration of the sociomaterial contribution to this pandemic paradox.
Collapse
Affiliation(s)
- Lisa Shepherd
- Centre for Education Research & Innovation, Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Allison McConnell
- Division of Emergency Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Christopher Watling
- Department of Oncology and Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| |
Collapse
|
6
|
Telemedicine to Expand Access to Critical Care Around the World. Crit Care Clin 2022; 38:809-826. [PMID: 36162912 DOI: 10.1016/j.ccc.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This multiauthored communication gives a state-of-the-art global perspective on the increasing adoption of tele-critical care. Exponentially increasing sophistication in the deployment of Computers, Information, and Communication Technology has ensured extending the reach of limited intensivists virtually and reaching the unreached. Natural disasters, COVID-19 pandemic, and wars have made tele-intensive care a reality. Concerns and regulatory issues are being sorted out, cross-border cost-effective tele-critical care is steadily increasing Components to set up a tele-intensive care unit, and overcoming barriers is discussed. Importance of developing best practice guidelines and retraining is emphasized.
Collapse
|
7
|
Bouamra B, Chakroun K, Medeiros De Bustos E, Dobson J, Rouge JA, Moulin T. Simulation-Based Teaching of Telemedicine for Future Users of Teleconsultation and Tele-Expertise: Feasibility Study. JMIR MEDICAL EDUCATION 2021; 7:e30440. [PMID: 34941553 PMCID: PMC8734919 DOI: 10.2196/30440] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Health care professionals worldwide are increasingly using telemedicine in their daily clinical practice. However, there is still a lack of dedicated education and training even though it is needed to improve the quality of the diverse range of telemedicine activities. Simulation-based training may be a useful tool in telemedicine education and training delivery. OBJECTIVE This study aims to assess the feasibility and acceptability of simulation-based telemedicine training. METHODS We assessed five telemedicine training sessions conducted in a simulation laboratory. The training was focused on video teleconsultations between a patient and a health care professional. The assessment included the participants' satisfaction and attitudes toward the training. RESULTS We included 29 participants in total. Participant satisfaction was high (mean score 4.9 of 5), and those that took part stated the high applicability of the simulation-based training to their telemedicine practices (mean score 4.6 of 5). They also stated that they intended to use telemedicine in the future (mean score 4.5 of 5). CONCLUSIONS Simulation-based training of telemedicine dedicated to video teleconsultation was feasible and showed high satisfaction from participants. However, it remains difficult to scale for a high number of health care professionals.
Collapse
Affiliation(s)
- Benjamin Bouamra
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Karim Chakroun
- Department of Neurology, Besançon University Hospital, Besançon, France
| | | | - Jennifer Dobson
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Jeanne-Antide Rouge
- Faculty of Medicine, University of Franche-Comté MedSim Laboratory, Besançon, France
| | - Thierry Moulin
- Department of Neurology, Besançon University Hospital, Besançon, France
| |
Collapse
|