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Author Spotlight: Deciphering the Cognitive and Neural Mechanisms of Gesture in Communication

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Communication Challenges and Mitigation Strategies in Primary Care Virtual Consultations: Qualitative Study.

Ahmed Alboksmaty¹, Tetiana Lunova¹, Ara Darzi¹

¹Department of Surgery and Cancer, Institute of Global Health Innovation, Imperial College London, St Mary's Campus, Norfolk Place, London, W21PG, United Kingdom, 44 7916827620.

Journal of Medical Internet Research

|January 20, 2026

Summary

Virtual consultations in primary care present communication challenges for general practitioners (GPs) and patients. Strategies like tailored training and flexible models can improve virtual care quality and safety.

Keywords:

communication patient-physician relationship remote care telehealth virtual care

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Area of Science:

Primary Care Medicine
Health Communication
Digital Health

Background:

The increasing adoption of virtual consultations in primary care has significantly altered traditional general practitioner (GP)-patient interactions.
These shifts introduce novel challenges impacting the quality and safety of patient care.

Purpose of the Study:

To investigate communication challenges and gaps specific to virtual consultations compared to face-to-face encounters.
To identify effective mitigation strategies for these challenges from both GP and patient viewpoints.

Main Methods:

A qualitative study involving 4 online focus groups with 21 UK-based general practitioners (GPs) and patients.
Analysis utilized a deductive-inductive thematic approach, guided by the extended Shannon-Weaver communication model and the Capability, Opportunity, Motivation and Behavior (COMB) model.
Reporting adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Main Results:

Six key communication themes emerged: five aligned with the Shannon-Weaver model (sender-encoder, message, channel, receiver-decoder-feedback, context) and one new theme (patient autonomy and inclusivity).
GPs noted missing visual cues impacting message clarity; patients reported difficulties describing symptoms, reduced emotional connection, and empathy.
Mitigation strategies focused on enhancing capability (training), opportunity (triage/tools), and motivation (patient engagement/system adaptability).

Conclusions:

Virtual consultations present distinct communication gaps that require targeted solutions.
Actionable strategies, including tailored training, standardized approaches, and flexible models, are crucial for effective and inclusive virtual communication.
Policy and structured training are essential to ensure safe and effective remote primary care.