A corporeal conundrum: Challenges posed by remote consultation for postgraduate medical education

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-10-09 DOI:10.1111/tct.13672

John R. Campion, Peter Cantillon

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Abstract

Background

The COVID-19 pandemic accelerated the use of remote consultation in hospital outpatient clinics. Remote consultation alters the clinical environment and the learning environment in ways that are incompletely understood. This research sought to explore how trainees negotiate training and learning in such an environment when it is novel to them.

Methods

Purposive sampling was used to recruit eight doctors from the gastroenterology department of an academic teaching hospital. Four consultants and four trainees participated in individual, semi-structured interviews. Interpretative phenomenological analysis of interview transcripts was employed and themes developed from the analysis, to characterise the experience of learning and teaching in remote consultation clinics, as described by participants.

Results

Participants described how they try to create mental representations of each patient they review by remote consultation. Whilst consultants found this task relatively easy, trainee physicians found remote consultation more challenging and highlighted the importance of the physical presence of the patient to help them form a holistic sense of the patient's condition. Doctors in training also struggled to develop a workable mental model of the patient's condition when physical examination was precluded by remote consultation.

Conclusions

This study highlights the place of the patient's physical presence as an essential educational stimulus to facilitate teaching and learning. Further research is needed to characterise the processes clinicians use to formulate mental models of patients who are physically absent from the consultation room.

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一个物质难题：远程会诊给研究生医学教育带来的挑战。

背景：新冠肺炎疫情加速了医院门诊远程会诊的使用。远程会诊以不完全理解的方式改变了临床环境和学习环境。这项研究试图探索受训者如何在这样一个陌生的环境中协商培训和学习。方法：采用目的性抽样方法，从某教学医院消化内科招募8名医生。四名顾问和四名受训人员参加了半结构化的个人访谈。如参与者所述，采用了对访谈记录的解释性现象学分析，并从分析中发展出主题，以描述远程会诊诊所的学习和教学体验。结果：参与者描述了他们如何试图通过远程咨询为他们审查的每个患者创建心理表征。虽然顾问们发现这项任务相对容易，但实习医生发现远程会诊更具挑战性，并强调了患者身体存在的重要性，以帮助他们对患者的病情形成整体感。当远程会诊无法进行体检时，接受培训的医生也很难为患者的病情建立一个可行的心理模型。结论：本研究强调，患者的身体存在是促进教学的重要教育刺激因素。需要进一步的研究来描述临床医生用来为身体不在诊室的患者建立心理模型的过程。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.