Telehealth requires expansion of physicians’ communication competencies training

Galen, Louise Sandra van; Wang, Cai-Xing; Nanayakkara, Prabath W.B.; Paranjape, Ketan; Kramer, Milton; Car, Josip

doi:10.1080/0142159x.2018.1481284

Cited by 39 publications

(30 citation statements)

References 7 publications

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“…Wijesooriva highlighted the importance of medical education in developing observational skills that need to be rediscovered and honed to establish a diagnosis remotely (12). Delivering telehealth e ciently during a public health threat such as the COVID-19 pandemic requires that professionals be trained and equipped to use the various consultation tools, while also adapting to patients' needs (36,37). However, after the crisis, reserving telehealth use for emergencies would be detrimental to its further advancement and to safe use (2).…”

Section: Role Change Challengesmentioning

confidence: 99%

Telehealth Challenges During COVID-19 As Reported by Primary Healthcare Physicians in Quebec and Massachusetts

Bréton

Sullivan

Deville‐Stoetzel

et al. 2021

Preprint

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Background: The COVID-19 pandemic has driven primary healthcare (PHC) providers to use telehealth as an alternative to traditional face-to-face consultations. Providing telehealth that meets the needs of patients in a pandemic has presented many challenges for PHC providers. The aim of this study was to describe the positive and negative implications of using telehealth in one Canadian (Quebec) and one American (Massachusetts) PHC setting during the COVID-19 pandemic as reported by physicians.Methods: We conducted 42 individual semi-structured video interviews with physicians in Quebec (N = 20) and Massachusetts (N = 22) in 2020. Topics covered included their practice history, changes brought by the COVID-19 pandemic, and the advantages and challenges of telehealth. An inductive and deductive thematic analysis was carried out to identify implications of delivering care via telehealth.Results: Four key themes were identified, each with positive and negative implications: 1) access for patients; 2) efficiency of care delivery; 3) professional impacts; and 4) relational dimensions of care. For patients’ access, positive implications referred to increased availability of services; negative implications involved barriers due to difficulties with access to and use of technologies. Positive implications for efficiency were related to improved follow-up care; negative implications involved difficulties in diagnosing in the absence of direct physical examination and non-verbal cues. For professional impacts, positive implications were related to flexibility (teleworking, more availability for patients) and reimbursement, while negative implications were related to technological limitations experienced by both patients and practitioners. For relational dimensions, positive implications included improved communication, as patients were more at ease at home, and the possibility of gathering information from what could be seen of the patient’s environment; negative implications were related to concerns around maintaining the therapeutic relationship and changes in patients’ engagement and expectations.Conclusion: Ensuring that health services provision meets patients’ needs at all times calls for flexibility in care delivery modalities, role shifting to adapt to virtual care, sustained relationships with patients, and interprofessional collaboration. To succeed, these efforts require guidelines and training, as well as careful attention to technological barriers and interpersonal relationship needs.

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Section: Role Change Challengesmentioning

confidence: 99%

Telehealth Challenges During COVID-19 As Reported by Primary Healthcare Physicians in Quebec and Massachusetts

Bréton

Sullivan

Deville‐Stoetzel

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…We considered it paramount to teach our residents how to communicate and perform remote exams with virtual tools, which require unique communication skills 6 . Residents watched a recording of a simulated encounter prior to their first real encounter (see Appendices).…”

Section: Methodsmentioning

confidence: 99%

Implementing a Telemedicine Curriculum for Internal Medicine Residents during a Pandemic: The Cleveland Clinic Experience

Savage

Gutiérrez

Montanè

et al. 2020

Preprint

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Introduction Telemedicine is an important element of healthcare. However, until the COVID-19 pandemic, training in telemedicine was not a substantial element of most residency programs. Social distancing measures changed this. The Cleveland Clinic Internal Medicine Residency Program (IMRP) is one of the largest programs in the United States, which made the task of developing and adopting an effective, expedited telemedicine curriculum challenging. Our goal was to implement a system for teaching telemedicine care skills and supervising the care provided by residents during virtual visits. Study Design This study was started in April 2020. We developed and implemented a resident-led curriculum and training program for providing telemedicine care in less than five weeks. This entailed creating a formal training program for residents, creating a resource guide for the different video communication tools, and training preceptors to safely supervise care in this new paradigm. We also created an assessment instrument in our education evaluation system that allows residents to receive feedback on their performance during virtual appointments. Results Over 2000 virtual visits were performed by residents in a span of 10 weeks. Of 148 residents, 38% responded to the pre-participation survey. A majority had no prior telemedicine experience and expressed only slight comfort with the modality. Discussion Through collaboration with experienced residents and faculty, we expeditiously developed an enhancement to our ambulatory care curriculum to teach residents how to provide virtual care and help faculty with supervision. We share our insights on this experience for other residency programs to utilize.

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“…Telehealth in the United States in not new and encompasses a wide range of specialties and clinical practice settings( 7), yet its adoption into routine clinical practice has been variable, and less than half of US medical schools incorporate this training into their clerkships (8,9). There have been calls to develop training to ensure graduates are prepared to meet the needs of the increasingly digital clinical care environment where care is being transformed to include video, telephone, and email communication (10). Several medical schools and graduate medical training programs have reported on the successful development of curricula aimed at teaching core telehealth skills, many developed rapidly in response to acute training needs during the pandemic (11)(12)(13).…”

Section: Accepted Articlementioning

confidence: 99%

“…In addition to technologic training, some foundational face-to-face communication skills (i.e., skills used to begin the encounter as well as those used to build rapport and sustain the relationship and flow) were added and adapted in order for students to meet a rudimentary level of success when communicating with a patient via a video conference platform. We were conscious to not conflate the adjustments to the traditional communication curriculum for a telehealth communication curriculum, as the later certainly requires a distinctly modified set of communication competencies to ensure quality and safety (10).…”

Section: Pre-clerkship Preparationmentioning

confidence: 99%

Telehealth: from the abstract to necessity to competency

Adams

Ecker

2021

FASEB BioAdvances

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The COVID‐19 pandemic caused significant disruption in medical education. With disruption comes the opportunity for innovation. Telehealth had been growing rapidly in many fields of medicine prior to the pandemic, however, the necessities of social distancing, scarcity of personal protective equipment, and mandates to prevent unnecessary exposures for healthcare workers and patients alike, brought opportunities for the exponential expansion of telehealth. With expansion of telehealth services came the need to expand curriculum in telehealth to prepare medical students to return to vastly transformed clinical settings as well as prepare them for a future clinical landscape likely to incorporate telehealth to a much greater degree. The University of Colorado School of Medicine (CUSOM) rapidly developed a course in telehealth to prepare students for this changing clinical environment. Simultaneously, a faculty development curriculum was created to support clinical faculty new to telehealth in basic skills and teaching in a virtual environment. Lastly, adaptations were made to the summative Clinical Practice Exam administered to students at the completion of clerkships to incorporate telehealth. Recognizing the importance of achieving competence in telehealth, the CUSOM has taken steps to invest in the development of comprehensive and integrated telehealth curricula. Many creative and innovative solutions have been adopted in the wake of this pandemic to allow medical education to continue despite many hurdles and barriers; many of these will not persist past the pandemic. However, we expect telehealth clinical skills and the curricula developed to support them to remain relevant long past the time when the COVID‐19 pandemic has faded into history.

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Telehealth requires expansion of physicians’ communication competencies training

Cited by 39 publications

References 7 publications

Telehealth Challenges During COVID-19 As Reported by Primary Healthcare Physicians in Quebec and Massachusetts

Telehealth Challenges During COVID-19 As Reported by Primary Healthcare Physicians in Quebec and Massachusetts

Implementing a Telemedicine Curriculum for Internal Medicine Residents during a Pandemic: The Cleveland Clinic Experience

Telehealth: from the abstract to necessity to competency

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