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Newcomb AB, Duval M, Bachman SL, Mohess D, Dort J, Kapadia MR. Building Rapport and Earning the Surgical Patient's Trust in the Era of Social Distancing: Teaching Patient-Centered Communication During Video Conference Encounters to Medical Students. JOURNAL OF SURGICAL EDUCATION 2021; 78:336-341. [PMID: 32709566 PMCID: PMC7373024 DOI: 10.1016/j.jsurg.2020.06.018] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/29/2020] [Accepted: 06/20/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Effective physician communication improves care, and many medical schools and residency programs have adopted communication focused curricula. The COVID-19 pandemic has shifted the doctor-patient communication paradigm with the rapid adoption of video-based medical appointments by the majority of the medical community. The pandemic has also necessitated a sweeping move to online learning, including teaching and facilitating the practice of communication skills remotely. We aimed to identify effective techniques for surgeons to build relationships during a video consult, and to design and pilot a class that increased student skill in communicating during a video consult. METHODS Fourth-year medical students matched into a surgical internship attended a 2-hour class virtually. The class provided suggestions for building rapport and earning trust with patients and families by video, role play sessions with a simulated patient, and group debriefing and feedback. A group debriefing generated lessons learned and best practices for telemedicine communication in surgery. RESULTS Students felt the class introduced new skills and reinforced current ones; most reported higher self-confidence in target communication skills following the module. Students were particularly appreciative of opportunity for direct observation of skills and immediate faculty feedback, noting that the intimate setting was unique and valuable. Several elements of virtual communications required increased focus to communicate empathy and concern. Proper lighting and positioning relative to the camera were particularly important and body movement required "narration" to minimize misinterpretation. A patient's distress was more difficult to interpret; asking direct questions was recommended to understand the patient's emotional state. CONCLUSIONS There is a need to teach video-conference communication skills to enable surgical teams to build rapport in this distinct form of consultation. Our training plan appears effective at engaging learners and improving skills and confidence, and identifies areas of focus when teaching virtual communication skills.
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Affiliation(s)
- Anna B Newcomb
- Inova Fairfax Medical Campus, Division of Trauma Acute Care Surgery, Falls Church, Virginia.
| | - Margaret Duval
- George Washington School of Medicine and Health Sciences, Washington, District of Columbia
| | - Sharon L Bachman
- Inova Fairfax Medical Campus, Department of Surgery, Falls Church, Virginia
| | - Denise Mohess
- Inova Fairfax Medical Campus, Department of Medicine, Falls Church, Virginia
| | - Jonathan Dort
- Inova Fairfax Medical Campus, Department of Surgery, Falls Church, Virginia
| | - Muneera R Kapadia
- University of North Carolina at Chapel Hill, Department of Surgery, Chapel Hill, North Carolina
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Richardson L, Reid C, Dziurawiec S. “Going the Extra Mile”: Satisfaction and Alliance Findings from an Evaluation of Videoconferencing Telepsychology in Rural Western Australia. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12126] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Lisa Richardson
- School of Psychology and Exercise Science, Murdoch University,
| | - Corinne Reid
- School of Psychology and Exercise Science, Murdoch University,
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Mobile Tele-Mental Health: Increasing Applications and a Move to Hybrid Models of Care. Healthcare (Basel) 2014; 2:220-33. [PMID: 27429272 PMCID: PMC4934468 DOI: 10.3390/healthcare2020220] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 03/22/2014] [Accepted: 04/17/2014] [Indexed: 11/17/2022] Open
Abstract
Mobile telemental health is defined as the use of mobile phones and other wireless devices as applied to psychiatric and mental health practice. Applications of such include treatment monitoring and adherence, health promotion, ecological momentary assessment, and decision support systems. Advantages of mobile telemental health are underscored by its interactivity, just-in-time interventions, and low resource requirements and portability. Challenges in realizing this potential of mobile telemental health include the low penetration rates of health applications on mobile devices in part due to health literacy, the delay in current published research in evaluating newer technologies, and outdated research methodologies. Despite such challenges, one immediate opportunity for mobile telemental health is utilizing mobile devices as videoconferencing mediums for psychotherapy and psychosocial interventions enhanced by novel sensor based monitoring and behavior-prediction algorithms. This paper provides an overview of mobile telemental health and its current trends, as well as future opportunities as applied to patient care in both academic research and commercial ventures.
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Thompson AE, Voyer D. Sex differences in the ability to recognise non-verbal displays of emotion: a meta-analysis. Cogn Emot 2014; 28:1164-95. [PMID: 24400860 DOI: 10.1080/02699931.2013.875889] [Citation(s) in RCA: 220] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The present study aimed to quantify the magnitude of sex differences in humans' ability to accurately recognise non-verbal emotional displays. Studies of relevance were those that required explicit labelling of discrete emotions presented in the visual and/or auditory modality. A final set of 551 effect sizes from 215 samples was included in a multilevel meta-analysis. The results showed a small overall advantage in favour of females on emotion recognition tasks (d=0.19). However, the magnitude of that sex difference was moderated by several factors, namely specific emotion, emotion type (negative, positive), sex of the actor, sensory modality (visual, audio, audio-visual) and age of the participants. Method of presentation (computer, slides, print, etc.), type of measurement (response time, accuracy) and year of publication did not significantly contribute to variance in effect sizes. These findings are discussed in the context of social and biological explanations of sex differences in emotion recognition.
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Affiliation(s)
- Ashley E Thompson
- a Department of Psychology , University of New Brunswick , Fredericton , NB , Canada
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Krupinski EA, Weinstein RS. Telemedicine in an Academic Center—The Arizona Telemedicine Program. Telemed J E Health 2013; 19:349-56. [DOI: 10.1089/tmj.2012.0285] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
BACKGROUND The use of telemedicine for the care of mental health problems has developed significantly over the last decade thanks to the emergence of a number of stable telepsychiatry programs in many countries. Parallel to this development, this care modality has also targeted specific populations with higher difficulty in gaining access to mental health services such as the elderly. Telepsychogeriatrics is expected to have an increasing role in providing care to geographically isolated rural communities, with a particular focus on long-term care facilities, in light of the high prevalence of psychiatric disorders in these centers and the lack of available specialized care. METHODS A thorough search of the literature was conducted using Medline, Web of Science, and PsychINFO databases in order to gather available evidence on the applicability of telepsychiatry, specifically the use of videoconferencing for remote consultation, in the elderly population with mental disorders. A succinct description of the selected studies is given along with a general reflection on the state-of-the-art in the field of psychogeriatric clinical practice and research. RESULTS Research on the use of telemedicine in this age group has taken into account their special characteristics, and has focused on demonstrating its applicability, the acceptance and satisfaction of elderly users and their healthcare providers, the possibility of carrying out cognitive and diagnostic assessments, and the efficiency of these programs. CONCLUSIONS Despite limited experience, telepsychogeriatrics appears to be a viable option, well accepted by patients, including those having dementia. More systematized studies are needed in this new field based on larger sample sizes, including comparison with traditional consultations and assessment of the clinical outcomes.
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Bashshur R, Shannon G, Krupinski E, Grigsby J. The Taxonomy of Telemedicine. Telemed J E Health 2011; 17:484-94. [DOI: 10.1089/tmj.2011.0103] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - Jim Grigsby
- University of Colorado at Denver, Denver, Colorado
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Feng C, Rozenblit JW, Hamilton AJ. A computerized assessment to compare the impact of standard, stereoscopic, and high-definition laparoscopic monitor displays on surgical technique. Surg Endosc 2010; 24:2743-8. [PMID: 20361211 DOI: 10.1007/s00464-010-1038-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 03/11/2010] [Indexed: 01/12/2023]
Abstract
BACKGROUND Surgeons performing laparoscopic surgery have strong biases regarding the quality and nature of the laparoscopic video monitor display. In a comparative study, we used a unique computerized sensing and analysis system to evaluate the various types of monitors employed in laparoscopic surgery. METHODS We compared the impact of different types of monitor displays on an individual's performance of a laparoscopic training task which required the subject to move the instrument to a set of targets. Participants (varying from no laparoscopic experience to board-certified surgeons) were asked to perform the assigned task while using all three display systems, which were randomly assigned: a conventional laparoscopic monitor system (2D), a high-definition monitor system (HD), and a stereoscopic display (3D). The effects of monitor system on various performance parameters (total time consumed to finish the task, average speed, and movement economy) were analyzed by computer. Each of the subjects filled out a subjective questionnaire at the end of their training session. RESULTS A total of 27 participants completed our study. Performance with the HD monitor was significantly slower than with either the 3D or 2D monitor (p < 0.0001). Movement economy with the HD monitor was significantly reduced compared with the 3D (p < 0.0004) or 2D (p < 0.0001) monitor. In terms of average time required to complete the task, performance with the 3D monitor was significantly faster than with the HD (p < 0.0001) or 2D (p < 0.0086) monitor. However, the HD system was the overwhelming favorite according to subjective evaluation. CONCLUSION Computerized sensing and analysis is capable of quantitatively assessing the seemingly minor effect of monitor display on surgical training performance. The study demonstrates that, while users expressed a decided preference for HD systems, actual quantitative analysis indicates that HD monitors offer no statistically significant advantage and may even worsen performance compared with standard 2D or 3D laparoscopic monitors.
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Affiliation(s)
- Chuan Feng
- Department of Electrical and Computer Engineering and Arizona Simulation Technology and Education Center, University of Arizona, Tucson, AZ 85721, USA.
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Richardson LK, Frueh BC, Grubaugh AL, Egede L, Elhai JD. Current Directions in Videoconferencing Tele-Mental Health Research. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2009; 16:323-338. [PMID: 20161010 PMCID: PMC2758653 DOI: 10.1111/j.1468-2850.2009.01170.x] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The provision of mental health services via videoconferencing tele-mental health has become an increasingly routine component of mental health service delivery throughout the world. Emphasizing the research literature since 2003, we examine: 1) the extent to which the field of tele-mental health has advanced the research agenda previously suggested; and 2) implications for tele-mental health care delivery for special clinical populations. Previous findings have demonstrated that tele-mental health services are satisfactory to patients, improve outcomes, and are probably cost effective. In the very small number of randomized controlled studies that have been conducted to date, tele-mental health has demonstrated equivalent efficacy compared to face-to-face care in a variety of clinical settings and with specific patient populations. However, methodologically flawed or limited research studies are the norm, and thus the research agenda for tele-mental health has not been fully maximized. Implications for future research and practice are discussed.
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Affiliation(s)
| | | | - Anouk L. Grubaugh
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
| | - Leonard Egede
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
- Medical University of South Carolina, Charleston, SC, USA
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Richardson LK, Frueh BC, Grubaugh AL, Egede L, Elhai JD. Current Directions in Videoconferencing Tele-Mental Health Research. CLINICAL PSYCHOLOGY : A PUBLICATION OF THE DIVISION OF CLINICAL PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION 2009. [PMID: 20161010 DOI: 10.1111/j.1468‐2850.2009.01170.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The provision of mental health services via videoconferencing tele-mental health has become an increasingly routine component of mental health service delivery throughout the world. Emphasizing the research literature since 2003, we examine: 1) the extent to which the field of tele-mental health has advanced the research agenda previously suggested; and 2) implications for tele-mental health care delivery for special clinical populations. Previous findings have demonstrated that tele-mental health services are satisfactory to patients, improve outcomes, and are probably cost effective. In the very small number of randomized controlled studies that have been conducted to date, tele-mental health has demonstrated equivalent efficacy compared to face-to-face care in a variety of clinical settings and with specific patient populations. However, methodologically flawed or limited research studies are the norm, and thus the research agenda for tele-mental health has not been fully maximized. Implications for future research and practice are discussed.
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Rabinowitz T, Brennan DM, Chumbler NR, Kobb R, Yellowlees P. New Directions for Telemental Health Research. Telemed J E Health 2008; 14:972-6. [DOI: 10.1089/tmj.2008.0119] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Terry Rabinowitz
- Departments of Psychiatry and Family Medicine, University of Vermont College of Medicine and Fletcher Allen Health Care, Northeast Telehealth Resource Center, Burlington, Vermont
| | - David M. Brennan
- Center for Applied Biomechanics and Rehabilitation Research, National Rehabilitation Hospital, Washington, DC
| | - Neale R. Chumbler
- Department of Veterans Affairs (VA) Health Services Research & Development (HSR&D) Center of Excellence on Implementing Evidence-Based Practice, Roudebush VAMC, Indianapolis, Indiana. Department of Sociology, Indiana University School of Liberal Arts, Indiana University–Purdue University Indianapolis, Indianapolis, Indiana
| | - Rita Kobb
- Department of Veterans Affairs (VA) Office of Care Coordination Services, North Florida/South Georgia Veterans Health System, Lake City, Florida
| | - Peter Yellowlees
- Department of Psychiatry, University of California–Davis, Sacramento, California
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Thara R, John S, Rao K. Telepsychiatry in Chennai, India: the SCARF experience. BEHAVIORAL SCIENCES & THE LAW 2008; 26:315-322. [PMID: 18548517 DOI: 10.1002/bsl.816] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
India, with its huge population and limited mental health resources, must find alternative ways of delivering its mental healthcare services. Telepsychiatry seems to be a promising option even with no regulatory authority in place or specific laws in India that deal with telemedicine practice, there has been a mushrooming of telemedicine services in India. Healthy cooperation between government organizations such as the Indian Space Research Organization (ISRO) and institutions in the non-government and private sectors is another key feature in India. The experience of the Schizophrenia Research Foundation (SCARF), at Chennai, in South India, in running and establishing a telepsychiatry network is presented in this article. We identified the following tasks as essential to ensure an efficient intervention using telemedicine: identifying a suitable technology, a suitable location, and a local collaborator; providing training and creating awareness; establishing peripheral telepsychiatry centers and ensuring case documentation; and accountability.
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Affiliation(s)
- Rangaswamy Thara
- Schizophrenia Research Foundation, R/7A, North Main Road, West Anna Nagar Extension, Chennai 600 101, India.
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Nelson EL, Palsbo S. Challenges in telemedicine equivalence studies. EVALUATION AND PROGRAM PLANNING 2006; 29:419-425. [PMID: 17950871 DOI: 10.1016/j.evalprogplan.2006.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2004] [Revised: 04/01/2005] [Accepted: 02/01/2006] [Indexed: 05/25/2023]
Abstract
As the number of telemedicine programs continues to grow, the accuracy of diagnosis over interactive televideo is a central concern. Although investigators have begun to address diagnostic equivalency in telehealth clinics, few published studies reflect strong research design. The two presented telehealth programs completed randomized controlled trials in real-world clinical settings that addressed some of the methodologic shortcomings of prior studies. Diagnostic equivalency studies were completed across five telehealth specialty clinics: physical therapy, speech therapy, ambulatory pediatrics, child psychiatry, and developmental disabilities services. The two research teams encountered similar decision points in designing and implementing the equivalency protocols. This article addresses methodologic issues in choosing design, participants, technology, and evaluation measures. Although the paper focuses on interactive televideo, the issues raised are pertinent across telehealth technologies.
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Affiliation(s)
- Eve-Lynn Nelson
- Kansas University Medical Center, 2012 Wahl Annex, MS 1048, 3901 Rainbow Blvd. Kansas City, KS 66160, USA
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