Patient Rapport Research Articles

Patients' Knowledge, Attitudes, and Behaviors Toward Family Doctors When They Attend A Private Primary Care Center

Background: Healthcare systems often face imbalances, with tertiary care centers overburdened due to insufficient utilization of primary care. Family physicians, key players in holistic and cost-effective healthcare delivery, are underutilized due to limited public awareness. This study aimed to assess the knowledge, perceptions, attitudes, and practices of patients visiting a private primary care center regarding family physicians to support the promotion of family medicine as a vital specialty. Methods: This study was conducted at a primary care center. A pre-tested questionnaire collected data from 300 patients meeting inclusion criteria. The questionnaire evaluated socio-demographic information, knowledge, perceptions, attitudes, and practices concerning family physicians. Responses were analyzed using descriptive statistics and SPSS version 19.0. A 5-point Likert scale was employed, with results condensed into three categories for simplicity. Results: Participants demonstrated high awareness (96.7%) of the role of family physicians and expressed strong confidence in their abilities to provide holistic and cost-efficient care. Positive attributes such as attentive listening, professionalism, and patient involvement in decision-making were acknowledged by over 95% of respondents. While 88% identified family physicians as their preferred initial healthcare contact, actual practice patterns revealed preferences for specialists in areas like pediatric care (66.2%), obstetrics (81.6%), and diabetes management (52%). Consistent consultations improved patient familiarity and rapport with family physicians. Conclusion: Despite favorable knowledge and attitudes, many patients opted for specialists over family physicians for specific health concerns. Further initiatives to enhance public awareness, address perception gaps, and expand the scope of family medicine are essential to strengthen its role in integrated healthcare systems.

Zoom Improv is accessible and enhances medical student empathy

BackgroundEmpathy declines during medical training, despite its importance.MethodologyIn this randomized controlled trial, we assessed the impact of Zoom improv on medical student empathy using a concurrent mixed-methods approach. Quantitative assessment with three survey tools and qualitative assessment by content analysis of Zoom session field notes were conducted.ResultsZoom improv participants had higher empathy scores in perspective-taking and fantasy and lower scores in personal distress compared with the control group. Medical students who participated in Zoom improv exercised emotional expression, active listening, and giving “gifts,” which apply to healthcare settings in which affirming team members with empathic concern can advance communication, patient rapport, and teamwork.DiscussionThis pilot study highlights promising findings for the incorporation of Zoom improv in medical education, including enhanced empathy, self-reflection, and understanding how these skills impact work in healthcare. Future studies may expand on the optimal timing to teach improv. Future studies conducted on virtual platforms may also further investigate our finding that the fantasy domain of empathy increases after Zoom improv sessions, whereas this increase in fantasy was absent from previous in-person studies. Given the increase in telehealth and virtual medical visits, exercising empathy skills through a screen during training may be an important addition to medical curricula.

Broadening the View of Holistic Care: Integrating Arts and Humanities Into Physician Assistant Education.

The integration of arts and humanities (A&H) into physician assistant (PA) preclinical curriculum may enhance student performance and improve their patient rapport. Arts and humanities content could promote the personal and professional qualities we desire in clinicians including competence, compassion, and empathy. The aim of this research was to determine what PA students report learning from A&H modules designed to foster personal insight and perspective-taking. The "Introduction of Humanities & Arts into Physician Assistant Education" (IHAPAE) project is an intercampus collaboration between 2 Midwest Universities. The IHAPAE faculty collaboratively created and delivered A&H-based modules within first-year communication courses. Two cohorts of PA students (N = 130) participated in modules and subsequently attended exploratory focus groups to elicit their perceptions of the A&H curriculum. Using a constructivist grounded theory approach for data analysis, we found that PA students perceived multiple benefits. Specifically, module content promoted reflection and stress reduction, improved their continuity of care notes, provided utility in cultivating empathy in patient communication, and introduced students to A&H approaches they could recommend to patients. The process model that emerged from student perceptions fits well with existing emotional regulation theory and provides empirical evidence for cultivation of empathy and patient-centeredness. Given the positive outcomes of our project, PA programs should consider the value of incorporating the A&H activities into their curriculum to enhance the student experience and develop essential provider attributes and skills.

Utilization of Telemedicine to Supervise Medical Students in the Post-Acute/Long-Term Care Setting

ObjectivesTelemedicine has become a widely accepted alternative to face-to-face patient encounters. Although there have been several peer-reviewed journal articles on incorporating telemedicine into the medical school curriculum, particularly during the COVID-19 pandemic, assessments of the effectiveness of remote supervision of medical students have not been reported. This prospective cohort study of student subjects using observational survey data evaluated the efficacy of telemedicine as an educational resource by comparing learning outcomes between osteopathic medical students receiving direct (physically present) supervision with a group who received remote (telemedicine) supervision by clinical faculty within a post-acute/long-term care (PA/LTC) setting. Learning outcomes in the domains of patient rapport, attitudes, knowledge, and behavior were measured using standardized survey instruments. DesignProspective cohort study of student subjects using observational survey data. Setting and ParticipantsA total of 167 fourth-year osteopathic medical students at a teaching nursing home (TNH). MethodsA total of 167 fourth-year osteopathic medical students (OMS-4s) were randomly assigned face-to-face PA/LTC patient encounters at the TNH. The encounters were follow-up visits to residents of the TNH that were supervised by faculty geriatricians. Half were accompanied by the physician and the other half were supervised by the physician through telemedicine. Evaluation using validated survey instruments measured patient rapport, verbal communication, and physical examination skills as well as attitudes, knowledge, and behaviors of the student/subjects. ResultsA nonparametric statistical analysis of 4 dependent variables measuring patient rapport, attitudes, knowledge and behavior showed no significant difference between the 2 teaching modalities. Conclusions and ImplicationsThe results of this prospective cohort study indicate that telemedicine supervision is comparable (noninferior) to direct supervision of medical student trainees in a PA/LTC setting.

“It’s so scary, and you’re so alone with it”: Clinicians’ perspectives on suicide risk management in integrated primary care

Primary care clinics serve many patients experiencing latent or evident suicide risk and may benefit from implementing suicide care improvements such as the Zero Suicide model. However, little is known about the readiness of clinics to implement such initiatives. We interviewed a range of clinicians (e.g., medical providers, behavioral health providers, nurses; n = 24) from six integrated primary care clinics to better understand strengths and limitations of the milieu, how suicide risk is currently detected and managed, and which implementation strategies could be employed to improve suicide prevention. We found clinics were extremely busy and resource-constrained but had a strong and longitudinal commitment to patients and families. Suicide risk was detected in a variety of ways and clinicians had limited resources to offer these patients. Clinicians sought to preserve patients’ autonomy and trust while also ensuring their safety. Preferred strategies included dissemination of protocols and tools, training, electronic health record changes, and improved staffing. Our findings suggest that suicide prevention initiatives in primary care should attend to the constraints of the care setting, adapting their approach to ensure they fit with workflow while also centering patient autonomy and rapport.

Experiences of Motivational Interviewing in Virtual Health-care Visits for Adults With Type 2 Diabetes Mellitus: A Qualitative Analysis

ObjectivesThe purpose of this qualitative study is to identify barriers minimizing the effectiveness of motivational interviewing during virtual clinic encounters for individuals with type 2 diabetes based on the capability, opportunity, motivation, and behaviour (COM-B) model. MethodsOne-on-one semistructured interviews were conducted from March to June 2023, with 17 adults with type 2 diabetes (64.7% female; median age 69 years [range 47 to 83 years]) followed at St. Michael’s Hospital (Toronto, Canada). Themes from transcribed interviews were identified through descriptive analysis using a grounded theory approach. ResultsThe following main themes were identified: 1) face-to-face appointments strengthen provider–patient rapport and collaboration; 2) virtual encounters reduce patient accountability and hinder health-seeking behaviour; and 3) individuals with physical disabilities and/or low technological proficiency experience decreased provider accessibility. Protective factors that can mitigate these negative impacts include establishing rapport during in-person appointments before transitioning to virtual appointments and incorporating a video component during virtual encounters. ConclusionsSeveral barriers of virtual appointments currently limit the effectiveness of motivational interviewing for individuals with type 2 diabetes and make it difficult to provide person-centred care, especially by phone. However, there are protective factors that help to maintain healthy lifestyle behaviours, even after transitioning to virtual settings, and are areas for optimization moving forward.

A complementary medicine student-led telehealth clinic: evaluating learning & teaching perceptions

ObjectivesThis study evaluates a multi-centered complementary medicine (CM) student-led telehealth clinic during the COVID-19 pandemic. Likert and qualitative responses explore student and educator learning and teaching perceptions of the implementation of a successful telehealth clinic.Results51 students and 17 educators completed the survey. Respondents agreed that support from educators (90%) and orientation (70%) assisted effective performance. Over 90% (93%) of all respondents supported telehealth in student-led clinics, whilst 87% encountered barriers such as technical and infrastructure issues. Respondents agreed that telehealth practice skills improved in case history taking (90%), treatment (90%) and building patient rapport (60%). Respondents (61%) disagreed that physical examination was effectively performed, and 100% of respondents agreed telehealth was a valuable learning experience. This study is the first to explore student and educator perceptions of telehealth in an Australian University multi-centered CM student-led clinic. To be successful in an educational environment, students and educators require digital literacy and adequate telehealth practice infrastructure. Whilst some in-person practice skills are transferable to telehealth, educators need to adapt curriculum to ensure counselling and physical examination skills are specifically taught for virtual consultations. Telehealth in clinical practice requires continued investigation and educational development.

Visual Intelligence Education as a Tool for Enhancing Medical Students' Self-Perception of Communication Skills.

Visual arts-based exposure and training are effective tools to enhance medical education. The visual arts can increase emotional intelligence and critical thinking skills. This study, conducted at Georgetown University School of Medicine (GUSoM) and the National Gallery of Art (NGA) in Washington, DC, was designed to measure the effect of a visual arts elective course on medical students' self-perception of their communication skills. This 6-week course involved lessons at the NGA and GUSoM for16 second-year medical students. The intervention students were age and gender-matched to14 second-year medical student control participants who took different elective courses. Prior to and following the intervention, the participants completed the Communication Skills Attitude Scale (CSAS). Statistical analysis was performed with either the 2-sided t-test or 2-sided Wilcoxon rank-sum test. There were no statistically significant differences in the presurvey scores between the groups. However, there were 6 CSAS questions in the postsurveys that had statistically significant differences between the 2 groups. Within each group, there were also numerous statistically significant differences between their presurvey and postsurvey responses, with positive changes occurring in the intervention group (IG) and primarily negative changes occurring in the control group (CG). The NGA course improved the self-perception of communication skills, with students reporting stronger views on the importance of communication skills in teamwork and patient rapport. The CG, on the other hand, did not have as many improved perceptions of communication skills and had stronger opinions regarding not needing the ability to communicate well to be a good physician. This study indicates that medical student communication skills can benefit from exposure to visual arts activities and experiences. Future physicians must become effective communicators, and this study paves the way for research investigating the relationship between visual arts education and the development of a physician's communication skills.

Racialised staff–patient relationships in inpatient mental health wards: a realist secondary qualitative analysis of patient experience data

BackgroundThe current study is a secondary analysis of qualitative data collected as part of EURIPIDES, a study which assessed how patient experience data were used to improve the quality of...

Patient perceptions of microaggressions and discrimination toward patients during emergency department care.

Disparities in emergency department (ED) care based on race and ethnicity have been demonstrated. Patient perceptions of emergency care can have broad impacts, including poor health outcomes. Our objective was to measure and explore patient experiences of microaggressions and discrimination during ED care. This mixed-methods study of adult patients from two urban academic EDs integrates quantitative discrimination measures and semistructured interviews of discrimination experiences during ED care. Participants completed demographic questionnaires and the Discrimination in Medical Settings (DMS) scale and were invited for a follow-up interview. Transcripts of recorded interviews were analyzed leveraging conventional content analysis with line-by-line coding for thematic descriptions. The cohort included 52 participants, with 30 completing the interview. Nearly half the participants were Black (n = 24, 46.1%) and half were male (n = 26, 50%). "No" or "rare" experiences of discrimination during the ED visit were reported by 22/48 (46%), some/moderate discrimination by 19/48 (39%), and significant discrimination in 7/48 (15%). Five main themes were found: (1) clinician behaviors-communication and empathy, (2) emotional response to health care team actions, (3) perceived reasons for discrimination, (4) environmental pressures in the ED, and (5) patients are hesitant to complain. We found an emergent concept where persons with moderate/high DMS scores, in discussing instances of discrimination, frequently reflected on previous health care experiences rather than on their current ED visit. Patients attributed microaggressions to many factors beyond race and gender, including age, socioeconomic status, and environmental pressures in the ED. Of those who endorsed moderate to significant discrimination via survey response during their recent ED visit, most described historical experiences of discrimination during their interview. Previous experiences of discrimination may have lasting effects on patient perceptions of current health care. System and clinician investment in patient rapport and satisfaction is important to prevent negative expectations for future encounters and counteract those already in place.

Barriers to Telemedicine Use: Qualitative Analysis of Provider Perspectives During the COVID-19 Pandemic.

Though telemedicine is a promising approach for removing barriers to care and improving access for patients, telemedicine use for many medical specialties has decreased from its peak during the acute COVID-19 public health crisis. Understanding the barriers and facilitators to the maintenance of web-based visits-one key component of telemedicine-is critical for ensuring the continuous availability of this service for patients. The purpose of this study is to describe medical providers' perceived barriers and facilitators to the continued use of web-based visits to inform quality improvement efforts and promote sustainability. We performed a qualitative content analysis of free-text responses from a survey of medical providers administered from February 5-14, 2021, at a large, midwestern academic institution, including all providers from medical professions that offered telemedicine (eg, physicians, residents or fellows, nurse practitioners, physicians assistants, or nurses) who completed at least 1 web-based visit from March 20, 2020, to February 14, 2021. The primary outcome was the experience of providing web-based visits, including barriers and facilitators to continued usage of web-based visits. Survey questions included 3 major domains: quality of care, technology, and satisfaction. Responses were coded using qualitative content analysis and further analyzed through a matrix analysis to understand the providers' perspectives and elucidate key barriers and facilitators of web-based visit usage. Of 2692 eligible providers, 1040 (38.6%) completed the survey, of whom 702 were providers from medical professions that offered telemedicine. These providers spanned 7 health care professions and 47 clinical departments. The most common professions represented were physicians (486/702, 46.7%), residents or fellows (85/702, 8.2%), and nurse practitioners (81/702, 7.8%), while the most common clinical departments were internal medicine (69/702, 6.6%), psychiatry (69/702, 6.6%), and physical medicine and rehabilitation (67/702, 6.4%). The following 4 overarching categories of provider experience with web-based visits emerged: quality of care, patient rapport, visit flow, and equity. Though many providers saw web-based visits as a tool for improving care access, quality, and equity, others shared how appropriate selection of web-based visits, support (eg, patient training, home devices, and broadband access), and institutional and nationwide optimization (eg, relaxation of licensing requirements across state borders and reimbursement for phone-only modalities) were needed to sustain web-based visits. Our findings demonstrate key barriers to the maintenance of telemedicine services following the acute public health crisis. These findings can help prioritize the most impactful methods of sustaining and expanding telemedicine availability for patients who prefer this method of care delivery.

Gender Differences in Letters of Recommendation for Gynecology Surgical Fellowship Applicants: Analysis of One Program's Recruitment Cycle

To evaluate if there are gender differences in the letters of recommendation (LOR) written for residents applying to gynecology surgical fellowships. Retrospective study. Single, academic institution. LOR for applicants to gynecology oncology, urogynecology, and minimally invasive gynecology fellowships during the 2019-2020 application cycle. Not applicable. We analyzed the linguistic content of the letters for the presence of 4 summary variables and 21-word categories based on previous studies using a validated computerized text analysis software. We used multivariable analysis using linear mixed models to compare letter linguistic characteristics by applicant gender. We performed qualitative content on letters and compared the frequency of code themes by gender. The mixed-method design was planned to analyze domains not captured in text analysis. Among 680 letters written for 186 applicants, 124(18.2%) were written for men and 556 (81.8%) were written for women. There were no differences in the least square mean (SE) word counts for LOR written for men and women applicants, 465(20.0) v. 458(9.4) words, p=.74. On multivariable analysis, LOR written for men had higher authentic tone and more risk words (p=.005 and p=.03, respectively). LOR written for women contained more communal (relationship-oriented) words (p=.006). The qualitative analysis demonstrated ability, interpersonal traits, surgical skills, and research were the most mentioned themes. Comments about compassion/empathy, leadership potential, teaching, interpersonal skills, and patient rapport were found more in letters for men. More doubt raisers (words that raise doubt or concern) were present in letters for men, but letters for both genders had similar levels of negative criticism. In contrast, comments on ability, being "drama-free", and self-awareness were found more in letters for women. There were gender differences in LOR written for obstetrics and gynecology surgical sub-specialty fellowship applicants indicating presence of gender bias.

Pattern of life style in patients from one subset of rural Tamil Nadu-India, after coronary angioplasty

Abstract Funding Acknowledgements Type of funding sources: None. Background Life after percutaneous coronary angioplasty (PTCA) has been sparsely studied unlike the plethora of studies after coronary bypass surgery (CABG). It is mandatory that the patient make life style changes and be drug compliant, post PTCA in order to improve life expectancy. The magnitude of the life style changes made, also depends to a certain extent on the patient’s age, number of vessels stented, complexity of the coronary anatomy, residual disease in other vessels and associated co morbidities. Purpose This study aimed to assess the pattern of life in patients after elective or emergency PTCA. Methods One hundred and fifty patients (114 males and 36 females) were reviewed every month for 6 months after PTCA. One hundred and eleven (74%) had co morbidities, the most common being diabetes (DM) and hypertension (HT). Results Good drug compliance, to dual antiplatlets (DAPT) and other medications was seen in 83 (55.3%). Irregularity with medications was seen initially in 52 (34.7%), who corrected themselves after further reviews and motivation. Eight (5.3%),were perpetual defaulters and 7(4.7%) were lost to follow up after one or two reviews. Most of them were farm labourers and rice, continued to be their staple diet even after PTCA, though a handful had switched to foxtail millet (Thinai) or par boiled rice which have a lower glycaemic index. Quantity of rice and oil consumed was however reduced. Majority also avoided deep fried food. Sixteen(69.6%) of the smokers had stopped smoking after PTCA One hundred and eighteen(78.7%) post PTCA, in contrast to the 66 (44%) before PTCA, were able to easily walk 300 metres or more in a 6 minute walk test without becoming symptomatic One hundred and thirty two (88%), had resumed work in one week to 2 months after PTCA, in contrast to 99 (66%) who were able to work before PTCA. Older age, manual labourers, severe LV dysfunction and chronic kidney disease (CKD) contributed to the bulk of work dropouts post PTCA. Recurrent hospitalisations (>3) occurred in 11(7.3%), and most of them were drug defaulters. The Left Ventricular function had failed to improve or deteriorated in 8(5.3%), mostly due to residual other coronary vessel disease, poor control of DM or HT, continued smoking or CKD. One hundred and thirty four (89.3%), enjoyed a better quality of life now, than before PTCA, in terms of reduced or absent symptoms and better functional capacity. Six(4%) patients underwent further revascularisation. Five had PTCA and one underwent CABG. Conclusion Good doctor patient rapport and meticulous patient education following PTCA, plays a pivotal role in reinforcing the importance of drug compliance, life style changes and follow up,as mandatory for stent patency and to avoid recurrent hospitalisations and revascularisations. People who followed a disciplined life post PTCA had better functional capacity, improved quality of life and early return to work.

A 7-Domain Framework That Can Bridge Clinical Care, Health Systems Science, and Health Equity: Lessons From the H&P 360.

The H&P 360 is a reconceptualized history and physical (H&P), which clinical medical students have reported reveals clinically relevant information not elicited by the traditional H&P, informs care planning, promotes interprofessional team care, and enhances patient rapport. In addition to the traditional checklist focused on patients' medical conditions, the H&P 360 includes prompts for gathering limited but critical information in 6 other domains directly relevant to patients' overall health-patient values, goals, and priorities; mental health; behavioral health; social support; living environment and resources; and function. Clinicians are thus reminded to elicit relevant information from each domain appropriate to the context of each clinical encounter. As health systems explore ways to identify and address social drivers of health, medical schools are rapidly expanding curricula beyond biomedical conditions, as reflected in the multifaceted health systems science curriculum. Many of today's medical students struggle to find connections among the core tasks of mastering biomedical clinical medicine, their evolving professional identity and career trajectory, and addressing systemic and societal barriers to population health. The authors argue that the 7-domain framework can serve as a conceptual bridge that links the care of individual patients with topics in the health systems science curriculum to promote health equity. The authors provide illustrative examples of the 7 domains as an organizing lens that can promote curiosity and understanding of seemingly disparate topics, such as interpersonal violence, social drivers of health, and structural racism, as well as help students expand and define their professional identities as physicians beyond diagnosis and treatment of biomedical conditions. The authors invite discussion and experimentation around the use of the 7-domain framework in teaching, assessment, and curriculum development and point to resources for clinical educators for teaching and measuring the effects of the H&P 360 on learners, preceptors, and patients.

Pilot testing fentanyl test strip distribution in an emergency department setting: Experiences, lessons learned, and suggestions from staff.

Fentanyl test strips (FTSs) are increasingly used to address fentanyl contamination of the illicit drug supply by testing a drug for the presence of fentanyl, allowing people who use drugs (PWUD) to engage in overdose prevention. While emergency departments (EDs) have implemented various harm reduction strategies for PWUD, to date distribution of FTSs in EDs is limited and not evaluated. Thus, we sought to explore ED staff experiences distributing FTSs. Twenty-one staff serving different roles (e.g., physician, nurse, technician, social worker, certified recovery specialist) within two urban EDs in a major metropolitan area were enrolled in a pilot study to distribute FTS to patients who use drugs. Participants were interviewed about their experience at 3 weeks and again at 3 months. Interviews were recorded, transcribed verbatim, and coded using a conventional content analysis approach. All participants endorsed the utility of FTS distribution in the ED. Across 42 interviews, participants discussed evolving strategies to approach patients about FTS, primarily favorable patient reactions to FTSs, improved dynamics between participants and patients, mixed intervention support from other staff, and named challenges of FTS distribution and recommendations to make FTS distribution in the ED widespread. Recommendations included medical records prompts to offer FTS, offering via different types of staff, and offering FTS during triage. Implementing FTS distribution may improve patient rapport while providing patients with tools to avoid a fentanyl overdose. Participants generally reported positive experiences distributing FTSs within the ED but the barriers they identified limited opportunities to make distribution more integrated into their workflow. EDs considering this intervention should train staff on FTSs and how to identify and train patients and explore mechanisms to routinize distribution in the ED environment.

Endocrinologists’ Experiences With Telehealth: A Qualitative Study With Implications for Promoting Sustained Use

ObjectiveEndocrinology is well-suited to telehealth, with high rates of use and known benefits. Clinician attitudes toward telehealth will be critical to ensuring sustained use after the pandemic. We examined endocrinologists’ experiences with synchronous telehealth to identify factors affecting experiences with and acceptance of the technology. MethodsWe conducted qualitative interviews and directed-content analysis with a purposive sample of 26 U.S. endocrinologists. Factors affecting clinicians’ experiences were mapped to the human-organization-technology fit (HOT-fit) framework. ResultsWe found that clinicians’ experiences with synchronous telehealth were influenced by: (1) Clinician factors: Clinicians welcomed telehealth but expressed concerns about patient interest, rapport building, and clinical appropriateness, desiring more data to support its use. Many clinicians feared missing clinical findings on virtual examination, despite no such personal experiences. Effects on professional and personal life contributed to satisfaction, through increased flexibility but also increased workload. (2) Organizational factors: Departmental meetings and trainings supported clinicians’ technical, logistical, and clinical needs, reducing resistance to telehealth use. Shifting staff responsibilities in clinical workflows improved clinicians’ experiences and supported telehealth use, while mixed telehealth and in-person schedules impeded workflow. (3) Technology factors: Most clinicians preferred video visits to telephone. Usability and reliability of telehealth platforms, integration of patient self-monitoring data, and availability of IT support were crucial to a positive experience. ConclusionClinician acceptance of telehealth is influenced by clinician, organizational, and technology factors that can be leveraged to improve buy-in. Organizational leaders’ attention to addressing these factors will be critical to support endocrinologists’ continued provision of telehealth for their patients.

Difficult Conversations.

Difficult Conversations.

Learning in the Pandemic: Medical Students' Perceived Effects of COVID-19 on Their Clinical Experiences and Career Choices During the Internal Medicine Clerkship.

The COVID-19 pandemic forced changes to undergraduate medical education with its impact still not fully understood. This is the first US study to assess the pandemic's perceived impact on medical education after return to in-person clerkships. We conducted a survey of third-year medical students completing their medicine clerkship during the 2020-2021 and 2021-2022 academic years (AY). Survey questions assessed students' attitudes on perceived risk of COVID-19 infection, impact on clinical encounters, and students' specialty interests. Of 312 students enrolled, 283 (90.71%) completed the survey. Concern for COVID-19 infection was highest in the second rotation (3.98 [95% CI 3.64, 4.31]) of the 2020-2021 AY and the third rotation of the 2021-2022 AY (3.41 [95% CI 3.06, 3.76]), corresponding to the surges of COVID-19 cases and subsequent variants. Conversely, as incidence increased, students reported a greater perceived impact on histories, physicals, and time spent with patients with no differences in patient rapport or specialty interests. Although concern for infection was initially high, it decreased after the introduction of the COVID-19 vaccine despite increasing incidence nationally and then peaked again during the Omicron surge. The degree of concern did not exceed initial levels, despite unprecedentedly high disease prevalence. Higher infection rates correlated with greater perceived impact on clinical experiences. Our study underscores the importance of vaccination, highlights learners' concerns and resilience throughout the pandemic, and should be considered in balancing student exposure with maintaining clinical opportunities. The online version contains supplementary material available at 10.1007/s40670-022-01589-8.

Satisfaction with telemedicine among anesthesiologists during the COVID-19 pandemic

The COVID-19 pandemic has rapidly changed the way that health care providers interact with patients, particularly through the widespread implementation of telemedicine. Previous studies in other medical specialties have examined the role of telemedicine and physician satisfaction with the modality [1], but no such studies have been reported in the field of anesthesiology. The purpose of the study was to evaluate the scope of use and satisfaction with telemedicine among anesthesiologists who were ASA and ESAIC members.We developed a survey that was sent out to anesthesia providers through the European Society of Anaesthesiology and Intensive Care (ESAIC) and the American Society of Anesthesiology (ASA). The survey was open for the duration of 30 days, after which it was closed and no new responses could be generated. The survey comprised three major sections and examined, (1) the characteristics of the anesthesia providers, (2) the settings within which they were using telemedicine, and (3) their satisfaction with the experience. We performed analyses to determine if there was a significant difference in satisfaction for those who used telemedicine prior to COVID-19 compared to those who started using it during the pandemic.There were a total of 708 responses from various provider demographics. Satisfaction with developing patient rapport was higher than satisfaction with airway and physical exam. Providers who were using telemedicine before the pandemic had consistently higher rates of satisfaction across all the subcategories. Familiarity with the software could have played a role in this result. Overall, satisfaction among users was high and the majority of practitioners, 86.3%, plan to continue using telemedicine in their practice.

Patient and Physician Satisfaction with Telemedicine in Cancer Care in Saskatchewan: A Cross-Sectional Study.

Background: Telemedicine is a useful tool that connects patients to their care team remotely and improves access to medical care for rural residents. This study aimed to determine the telemedicine experience of both rural patients with cancer and their physicians, and to explore factors associated with a positive patient experience. Methods: In this cross-sectional study, cancer patients and physicians in Saskatchewan completed a paper-based survey composed of 32 items or an electronic survey of 18 items, respectively. Logistic regression analysis was performed to assess patient satisfaction in relation to various sociodemographic and cancer-related factors. Results: Overall, 25 physicians and 165 patients participated in the study. Among the physicians, 94% were confident in their telemedicine assessment, 58% agreed that telemedicine improved clinical efficiency, and 73% agreed that doctor–patient rapport was unimpaired with telemedicine. Of 165 patients, 61% had used telemedicine for the first time, 81% felt that their needs were met, 83% were satisfied with the quality of their care, and 88% had a positive experience. Overall, 83% patients vs. 45% physicians preferred telemedicine to a face-to-face clinic visit (p = 0.005). On univariate analysis, patients ≥ 65 years old had a greater positive telemedicine experience compared to patients < 65 years old (odds ratio 4.1 [1.2–13.8], p = 0.02). Conclusion: Both patients and physicians have a high rate of positive experiences with telemedicine. However, patients have a higher preference for telemedicine over face-to-face visits compared to physicians. In addition, elderly patients have more positive telemedicine experiences compared to younger patients.