Finkelstein Julia B, Tremblay Elise S, Van Cain Melissa, Farber-Chen Aaron, Schumann Caitlin, Brown Christina, Shah Ankoor S, Rhodes Erinn T
Department of Urology, Boston Children's Hospital, Boston, MA, United States.
Division of Endocrinology, Boston Children's Hospital, Boston, MA, United States.
JMIR Hum Factors. 2021 Dec 2;8(4):e29941. doi: 10.2196/29941.
Bedside manner describes how clinicians relate to patients in person. Telemedicine allows clinicians to connect virtually with patients using digital tools. Effective virtual communication or webside manner may require modifications to traditional bedside manner.
This study aims to understand the experiences of telemedicine providers with patient-to-provider virtual visits and communication with families at a single large-volume children's hospital to inform program development and training for future clinicians.
A total of 2 focus groups of pediatric clinicians (N=11) performing virtual visits before the COVID-19 pandemic, with a range of experiences and specialties, were engaged to discuss experiential, implementation, and practice-related issues. Focus groups were facilitated using a semistructured guide covering general experience, preparedness, rapport strategies, and suggestions. Sessions were digitally recorded, and the corresponding transcripts were reviewed for data analysis. The transcripts were coded based on the identified main themes and subthemes. On the basis of a higher-level analysis of these codes, the study authors generated a final set of key themes to describe the collected data.
Theme consistency was identified across diverse participants, although individual clinician experiences were influenced by their specialties and practices. A total of 3 key themes emerged regarding the development of best practices, barriers to scalability, and establishing patient rapport. Issues and concerns related to privacy were salient across all themes. Clinicians felt that telemedicine required new skills for patient interaction, and not all were comfortable with their training.
Telemedicine provides benefits as well as challenges to health care delivery. In interprofessional focus groups, pediatric clinicians emphasized the importance of considering safety and privacy to promote rapport and webside manner when conducting virtual visits. The inclusion of webside manner instructions within training curricula is crucial as telemedicine becomes an established modality for providing health care.
临床态度描述了临床医生与患者面对面交流的方式。远程医疗使临床医生能够使用数字工具与患者进行虚拟连接。有效的虚拟沟通或网络态度可能需要对传统临床态度进行调整。
本研究旨在了解一家大型儿童医院的远程医疗服务提供者在患者与提供者之间进行虚拟问诊以及与家属沟通方面的经验，以为未来临床医生的项目开发和培训提供参考。
在2019年冠状病毒病大流行之前，共有2个由儿科临床医生组成的焦点小组（N = 11）参与讨论，这些医生进行过虚拟问诊，经验和专业领域各异。使用涵盖一般经验、准备情况、建立融洽关系策略和建议的半结构化指南来主持焦点小组讨论。会议进行了数字录音，并对相应的文字记录进行审查以进行数据分析。根据确定的主要主题和子主题对文字记录进行编码。在对这些编码进行更高级别的分析的基础上，研究作者生成了一组最终的关键主题来描述所收集的数据。
尽管个体临床医生的经验受其专业和实践的影响，但不同参与者之间存在主题一致性。关于最佳实践的发展、可扩展性障碍以及建立患者融洽关系，共出现了3个关键主题。在所有主题中，与隐私相关的问题和担忧都很突出。临床医生认为远程医疗需要新的患者互动技能，并非所有人都对自己所接受的培训感到满意。
远程医疗为医疗服务带来了好处，也带来了挑战。在跨专业焦点小组中，儿科临床医生强调在进行虚拟问诊时考虑安全和隐私对于促进融洽关系和网络态度的重要性。随着远程医疗成为提供医疗服务的既定模式，在培训课程中纳入网络态度指导至关重要。
