Parsons Jo, Salman Bilal, Leach Helen, Watson Eleanor, Atherton Helen
Unit of Academic Primary Care, Warwick Medical School, Coventry, UK
Unit of Academic Primary Care, Warwick Medical School, Coventry, UK.
BJGP Open. 2023 Dec 19;7(4). doi: 10.3399/BJGPO.2023.0110. Print 2023 Dec.
Remote consultation is widely used in primary care, and its use has increased greatly since the onset of the COVID-19 pandemic. Despite this, primary care clinicians lack formal training in delivering remote consultation. There is a need to understand how training might best be delivered, and what evidence there is to support this.
To summarise existing published literature about training primary care staff in conducting primary care consultation remotely, to outline which models of training may be effective, and to identify unanswered questions for future research.
DESIGN & SETTING: Systematic review of English language studies in primary care included in Medline (Ovid), Cochrane Database, PubMed, Embase (Ovid), Web of Science, and CINAHL from 2010-2021; and in Google results from 2010-2022.
Databases were searched using a predefined search strategy. Title, abstract, and full-text screening was conducted to identify eligible studies for inclusion in the review. The quality of included studies was assessed, and findings were synthesised to answer the research questions.
We included 10 studies. Seven examined training on remote consultation with trainee GPs or residents, and three examined training on remote consultation with qualified primary care clinicians. Training described led to positive change overall, including increased confidence and self-efficacy in delivering remote consultations. Furthermore, trainees reported increased use of remote consultation, increased efficiency, and increased engagement from patients. Studies where training involved workshops or didactic learning alongside experiential learning resulted in more positive feelings and more confidence about how technology could aid consultations.
There is limited evidence on training primary care staff in conducting remote consultation. Available evidence indicates that training has a positive impact on the ability of clinicians and staff to deliver remote consultation.
远程会诊在基层医疗中被广泛使用，自新冠疫情爆发以来其使用量大幅增加。尽管如此，基层医疗临床医生在提供远程会诊方面缺乏正规培训。有必要了解如何才能最好地开展培训，以及支持这一点的证据有哪些。
总结现有的已发表文献，内容涉及培训基层医疗人员进行远程基层医疗会诊，概述哪些培训模式可能有效，并确定未来研究中尚未解决的问题。
对2010年至2021年期间收录在Medline（Ovid）、Cochrane数据库、PubMed、Embase（Ovid）、科学引文索引和护理学与健康领域数据库中的基层医疗英语研究进行系统综述；以及2010年至2022年期间谷歌搜索结果中的相关研究。
使用预定义的搜索策略对数据库进行搜索。进行标题、摘要和全文筛选，以确定符合纳入综述条件的研究。评估纳入研究的质量，并综合研究结果以回答研究问题。
我们纳入了10项研究。7项研究考察了对全科医生实习生或住院医师进行远程会诊培训的情况，3项研究考察了对合格的基层医疗临床医生进行远程会诊培训的情况。所描述的培训总体上带来了积极变化，包括在进行远程会诊时信心增强和自我效能提高。此外，学员报告称远程会诊的使用增加、效率提高以及患者参与度提高。培训涉及研讨会或理论学习以及体验式学习的研究，使学员对技术如何辅助会诊产生了更积极的感受和更大的信心。
关于培训基层医疗人员进行远程会诊的证据有限。现有证据表明，培训对临床医生和工作人员进行远程会诊的能力有积极影响。
