Teachers’ perspectives on communication in the context of supervising learners during telehealth encounters

Authors

  • Kelly Skelly University of Iowa, USA
  • Joshua A. Thompson University of Minnesota, USA
  • Kristin Chu University of Minnesota, USA
  • Caroline Carlin University of Minnesota, USA
  • Sherri Fong University of Minnesota, USA
  • David Power University of Minnesota, USA
  • Marcy Rosenbaum University of Iowa, USA

DOI:

https://doi.org/10.7146/qhc.v2i1.132129

Keywords:

Clinical teaching and learning, communication skills, clinical skills, telehealth teaching

Abstract

Background: The COVID-19 pandemic has led to increased use of telehealth for healthcare visits. Telehealth visits have created new communication challenges for clinician-patient encounters and for interactions between health professional learners and clinical teachers, known as preceptors. Little research has explored how teachers can effectively supervise and explicitly emphasize communication skills during telehealth visits. Aim: This study’s purpose was to explore clinical preceptors’ perspectives on effective approaches in precepting telehealth visits with medical residents and students. Methods: An online survey elicited comments from clinical preceptors from two United States medical schools on effective telehealth teaching practices. Thematic analysis identified salient perspectives and overall guidance on precepting telehealth encounters. Results: Survey participants reported varying levels of experience with precepting telehealth visits. Main areas identified as important for effectively supervising telehealth encounters and facilitating effective communication included explicit preparation for preceptors, learners and patients and using educational opportunities, especially observation, during the telehealth encounter. Discussion: This study identifies strategies for maximizing effective communication between preceptors, learners, and patients during supervised telehealth visits. Participants identified potential educational advantages of supervising telehealth visits. Conclusions: Clinical teachers can reinforce effective telehealth communication skills with learner led telehealth patient encounters.

References

Bombeke, K., Symons, L., Debaene, L., De Winter, B., Schol, S., & Van Royen, P. (2010). Help, I'm losing patient-centredness! Experiences of medical students and their teachers. Med Education, 44. https://doi.org/ 10.1111/j.1365-2923.2010.03627.x

Callaghan, T., McCord, C., Washburn, D., Goidel, K., Schmit, C., Nuzhath, T., Spiegelman, A., & Scobee, J. (2022). The Changing Nature of Telehealth Use by Primary Care Physicians in the United States. Journal of Primary Care & Community Health. https://doi.org/10.1177/21501319221110418

Cameron, M. P. L., Ray, R., & Sabesan, S. (2014). Physicians’ perceptions of clinical supervision and educational support via videoconference: a systematic review. Journal of Telemedicine and Telecare, 20(5), 272-281. https://doi.org/10.1177/1357633X14537776

Crabtree, B. F., & Miller, W. L. (1992). Doing Qualitative Research. Newbury Park, California: Sage Publications.

Dzara, K., Sarver, J., Bennett, J. I., & Basnet, P. (2013). Resident and medical student viewpoints on their participation in a telepsychiatry rotation. Acad Psychiatry, 37(3), 214-216. https://doi.org/10.1176/appi.ap.12050101

Elliott, T., Matsui, E. C., Cahill, A., Smith, L., & Leibner, L. (2022). Conducting a Professional Telemedicine Visit Using High-Quality Webside Manner. Current allergy and asthma reports, 22(2), 7–12. https://doi.org/10.1007/s11882-022-01029-y

Ferrel, M. N., & Ryan, J. J. (2020). The Impact of COVID-19 on Medical Education. Cureus, 12(3), e7492. https://doi.org/10.7759/cureus.7492

Fleming, D. A., Riley, S. L., Boren, S., Hoffman, K. G., Edison, K. E., & Brooks, C. S. (2009). Incorporating telehealth into primary care resident outpatient training. Telemed J E Health, 15(3), 277-282. https://doi.org/10.1089/tmj.2008.0113

Gill, S. D., Stella, J., Blazeska, M., & Bartley, B. (2020). Distant supervision of trainee emergency physicians undertaking a remote placement: A preliminary evaluation. Emerg Med Australas, 32(3), 446-456. https://doi.org/10.1111/1742-6723.13440

Hanson, J. L., Balmer, B. F., & Angelo, P. (2011). Qualitative Research Methods for Medical Educators, Academic Pediatrics, 11, 375–386. https://doi.org/10.1016/j.acap.2011.05.001

Hauer, K. E., Holmboe, E. S., & Kogan, J. R. (2011). Twelve tips for implementing tools for direct observation of medical trainees' clinical skills during patient encounters. Med Teach, 33(1), 27-33. https://doi.org/10.3109/0142159x.2010.507710

Heidenreich, C., Lye, P., Simpson, D., & Lourich, M. (2000). The Search for Effective and Efficient Ambulatory Teaching Methods Through the Literature. Pediatrics, 105(2), 231-237. Retrieved from https://pediatrics.aappublications.org/content/pediatrics/105/Supplement_2/231.full.pdf

Henry, B. W., Block, D. E., Ciesla, J. R., McGowan, B. A., & Vozenilek, J. A. (2017). Clinician behaviors in telehealth care delivery: a systematic review. Advances in health sciences education : theory and practice, 22(4), 869–888. https://doi.org/10.1007/s10459-016-9717-2

Holstead, R. G., & Robinson, A. G. (2020). Discussing Serious News Remotely: Navigating Difficult Conversations During a Pandemic. JCO oncology practice, 16(7), 363–368. https://doi.org/10.1200/OP.20.00269

Hovaguimian, A., Joshi, A., Onorato, S., Schwartz, A. W., & Frankl, S. (2021). Twelve tips for clinical teaching with telemedicine visits. Med Teach, 1-7.

https://doi.org/10.1080/0142159X.2021.1880558

Iancu, A. M., Kemp, M. T., Gribbin, W., Liesman, D. R., Nevarez, J., Pinsky, A., . . . Schiller, J. H. (2020). Twelve tips for the integration of medical students into telemedicine visits. Med Teach, 1-7. https://doi.org/10.1080/0142159X.2020.1844877

Kogan, J. R., Holmboe, E. S., & Hauer, K. E. (2009). Tools for direct observation and assessment of clinical skills of medical trainees: a systematic review. JAMA, 302(12), 1316-1326. https://doi.org/10.1001/jama.2009.1365

Lawrence, K., Hanley, K., Adams, J., Sartori, D. J., Greene, R., & Zabar, S. (2020). Building Telemedicine Capacity for Trainees During the Novel Coronavirus Outbreak: a Case Study and Lessons Learned. J Gen Intern Med, 35(9), 2675-2679. https://doi.org/10.1007/s11606-020-05979-9

Madson, L., Rosenbaum, M., Kreiter, C., Lynch, A., & Witt, A. (2014). A randomized controlled trial assessing the feasibility of examination room versus conference room teaching in a psychiatric setting. Teach Learn Med, 26(1), 40-48. https://doi.org/10.1080/10401334.2013.857336

Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358, 483-488. https://doi.org/10.1016/S0140-6736(01)05627-6

McNair, R., Griffiths, L., Reid, K., & Sloan, H. (2016). Medical students developing confidence and patient centredness in diverse clinical settings: a longitudinal survey study. BMC medical education, 16, 176. https://doi.org/10.1186/s12909-016-0689-y

Nemetz, E., Urbach, D. R., & Devon, K. M. (2020). The Art of Surgery: Balancing Compassionate With Virtual Care. Journal of medical Internet research, 22(8), e22417. https://doi.org/10.2196/22417

Nowell, L. S., Norris, J. M., White, D. E., Moules, N. J. (2017). Thematic Analysis: Striving to Meet the Trustworthiness Criteria. International Journal of Qualitative Methods, 16, 1–13. https://doi.org/10.1177/1609406917733847

Petersen, K., Rosenbaum, M. E., Kreiter, C. D., Thomas, A., Vogelgesang, S. A., & Lawry, G. V. (2008). A randomized controlled study comparing educational outcomes of examination room versus conference room staffing. Teach Learn Med, 20(3), 218-224. https://doi.org/10.1080/10401330802199484

Power, D. V., Rosenbaum, M. E., Hanson, L., Reynolds, I. R., Brink, D., Prasad, S., & Kreiter, C. D. (2017). Precepting Medical Students in the Patient's Presence: An Educational Randomized Trial in Family Medicine Clinic. Fam Med, 49(2), 97-105.

Rodriquez, J. A., Betancourt, J. R., Sequist, T. D., Ganguli, I. (2021). Differences in the Use of Telephone and Video Telemedicine Visits During the COVID-19 Pandemic. The American journal of managed care, 27(1), 21-26. Retrieved from https://doi.org/10.37765/ajmc.2021.88573

Rosenbaum, M. E. (2017). Dis-integration of communication in healthcare education: Workplace learning challenges and opportunities. Patient Educ Couns, 100(11), 2054-2061. https://doi.org/10.1016/j.pec.2017.05.035

Sakumoto, M., & Khanna, R. (2022). Using Technology to Enhance Communication. The Medical clinics of North America, 106(4), 705–714. https://doi.org/10.1016/j.mcna.2022.01.010

Schopper, H., Rosenbaum, M., & Axelson, R. (2016). ‘I wish someone watched me interview:’ medical student insight into observation and feedback as a method for teaching communication skills during the clinical years. BMC Med Educ, 16(1), 286. https://doi.org/10.1186/s12909-016-0813-z

Schrading, W. A., Pigott, D., & Thompson, L. (2020). Virtual Remote Attending Supervision in an Academic Emergency Department During the COVID-19 Pandemic. AEM Education and Training, 4(3), 266-269. https://doi.org/10.1002/aet2.10460

Skelly, K., Rosenbaum, M., Barlow, P., & Priebe, G. (2019). Comparing resident-patient encounters and case presentations in a family medicine clinic. Med Educ, 53(7), 677-686. https://doi.org/10.1111/medu.13806

Smith, T.M. (2020), 4 tips for incorporating telemedicine into clinical training. American Medical Association [Internet]. Retrieved from https://www.ama-assn.org/practice-management/digital/4-tips-incorporating-telemedicine-clinical-training.

Szeftel, R., Hakak, R., Meyer, S., Naqvi, S., Sulman-Smith, H., Delrahim, K., & Rapaport, M. (2008). Training psychiatric residents and fellows in a telepsychiatry clinic: a supervision model. Acad Psychiatry, 32(5), 393-399. https://doi.org/10.1176/appi.ap.32.5.393TM.

Tuckson, R.V., Edmunds, M., Hodgkins, M. L. (2017). Telehealth. N Engl J Med. 377, 1585–1592. https://doi.org/10.1056/NEJMsr1503323

Valdes, D., Alqazlan, L., Procter, R., & Dale, J. (2022). Global evidence on the rapid adoption of telemedicine in primary care during the first 2 years of the COVID-19 pandemic: a scoping review protocol. Systematic reviews, 11(1), 124. https://doi.org/10.1186/s13643-022-01934-3

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Published

2023-01-30

How to Cite

Skelly, K., Thompson, J. A., Chu, K., Carlin, C., Fong, S., Power, D., & Rosenbaum, M. (2023). Teachers’ perspectives on communication in the context of supervising learners during telehealth encounters. Qualitative Health Communication, 2(1), 24–40. https://doi.org/10.7146/qhc.v2i1.132129

Issue

Vol. 2 No. 1 (2023)

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