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Pediatric Clinicians' Use of Telemedicine: Qualitative Interview Study
Julia B Finkelstein1, Elise S Tremblay2, Melissa Van Cain3
1Department of Urology, Boston Children's Hospital, Boston, MA, United States.
Insights
Pediatric clinicians need enhanced training in webside manner for effective telemedicine. Addressing privacy and rapport is crucial for successful virtual patient care, highlighting the need for updated curricula.
Area of Science:
- Digital Health
- Medical Education
- Patient Communication
Background:
- Bedside manner traditionally governs in-person patient interactions.
- Telemedicine necessitates virtual communication skills, termed webside manner.
- Effective webside manner may differ from traditional bedside manner.
Purpose of the Study:
- To explore telemedicine provider experiences with virtual visits and family communication.
- To inform program development and training for clinicians in telemedicine.
- To understand challenges and best practices in pediatric virtual care.
Main Methods:
- Conducted 2 focus groups with 11 pediatric clinicians experienced in pre-pandemic telemedicine.
- Used a semistructured guide to discuss experiences, preparedness, rapport, and suggestions.
- Analyzed digitally recorded sessions and transcripts to identify key themes.
Main Results:
- Identified 3 key themes: best practices, scalability barriers, and patient rapport.
- Privacy concerns were prominent across all themes.
- Clinicians desired more training, noting telemedicine requires new interaction skills.
Conclusions:
- Telemedicine offers benefits and challenges in healthcare delivery.
- Pediatric clinicians stressed safety and privacy for effective webside manner.
- Integrating webside manner training into curricula is vital for telemedicine adoption.
Background:
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.
Objective:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
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