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在全科医疗中使用远程医疗咨询时,积极的临床结果与积极的教育结果具有协同作用:一项混合方法研究。

Positive Clinical Outcomes Are Synergistic With Positive Educational Outcomes When Using Telehealth Consulting in General Practice: A Mixed-Methods Study.

作者信息

Knight Patricia, Bonney Andrew, Teuss Grigorijs, Guppy Michelle, Lafferre Danielle, Mullan Judy, Barnett Stephen

机构信息

Graduate School of Medicine, University of Wollongong, Wollongong, Australia.

出版信息

J Med Internet Res. 2016 Feb 8;18(2):e31. doi: 10.2196/jmir.4510.

Abstract

BACKGROUND

The use of telehealth technology to enable real-time consultations between patients and specialist services (to whom travel may be an impediment to the patient's care) has recently been encouraged in Australia through financial incentives. However, the uptake has been both fragmented and inconsistent. The potential benefits for patients include access to a broader range of specialist referral services, cost and time saving, and more rapid access to specialist services and a continuum of care through the triangulation of interaction between patient, primary health care providers (general practitioners and nurses), and specialists. Enhanced broadband connectivity and higher-grade encryption present an opportunity to trial the use of telehealth consulting as an intrinsic element of medical education for both medical students and doctors-in-training within rural practices and Aboriginal Medical Services.

OBJECTIVE

This paper discusses the reported, and varied, benefits of telehealth consulting arising from a multisite trial in New South Wales, Australia. The purpose of this study is to encourage the use of selected telehealth consultations between patients in a primary care setting with a specialist service as an integral aspect of medical education.

METHODS

The trial closely followed the protocol developed for this complex and multiaspect intervention. This paper discusses one aspect of the research protocol--using telehealth consultations for medical education--in detail.

RESULTS

Qualitative and quantitative analyses were conducted. In the quantitative analysis, free-text comments were made on aspects of Telehealth Consulting for the patient, concerning the quality of the interactions, and the time and cost saving, and also on the leaning opportunities. Students commented that their involvement enhanced their learning. All respondents agreed or strongly agreed that that the interpersonal aspects were satisfactory, with some brief comments supporting their views. In the analysis of the qualitative data, five themes emerged from the analyses concerning the educational benefits of Telehealth Consulting for different levels of learners, while three themes were identified concerning clinical benefits.

CONCLUSIONS

The results demonstrated strong synergies between the learning derived from the telehealth consulting and the clinical benefits to the patient and clinicians involved.

摘要

背景

在澳大利亚,近期通过经济激励措施鼓励使用远程医疗技术,以实现患者与专科服务之间的实时咨询(对于患者的治疗而言,出行可能会成为障碍)。然而,其应用既零散又不一致。对患者的潜在益处包括能够获得更广泛的专科转诊服务、节省成本和时间,以及通过患者、初级医疗服务提供者(全科医生和护士)和专科医生之间的三角互动,更快地获得专科服务和持续护理。增强的宽带连接和更高级别的加密为在农村诊所和原住民医疗服务机构中,将远程医疗咨询作为医学生和实习医生医学教育的固有组成部分进行试用提供了机会。

目的

本文讨论了澳大利亚新南威尔士州一项多地点试验中报告的、多样的远程医疗咨询益处。本研究的目的是鼓励在初级保健环境中的患者与专科服务之间进行特定的远程医疗咨询,并将其作为医学教育的一个组成部分。

方法

该试验严格遵循为这一复杂的多方面干预制定的方案。本文详细讨论了研究方案的一个方面——将远程医疗咨询用于医学教育。

结果

进行了定性和定量分析。在定量分析中,针对患者对远程医疗咨询的各个方面,包括互动质量、节省的时间和成本以及学习机会,进行了自由文本评论。学生们表示,他们的参与增强了学习效果。所有受访者都同意或强烈同意人际方面令人满意,并给出了一些简短评论来支持他们的观点。在定性数据分析中,从关于远程医疗咨询对不同层次学习者的教育益处的分析中出现了五个主题,而关于临床益处则确定了三个主题。

结论

结果表明,远程医疗咨询带来的学习与对患者及相关临床医生的临床益处之间存在强大的协同作用。

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