Provider Communication Research Articles

Cultural competence: the key to enhancing patient satisfaction and outcomes in physiotherapy

Tajuddin Chitapure, Rinkle Malani and Utkarsha Kawathekar discuss cultural competence and how it promotes improved patient–provider communication, leading to better diagnoses, treatment adherence and overall satisfaction.

Healthcare provider Communication and Data-Informed Message Strategies for Encouraging Older Adults to Stay up to Date on COVID-19 Vaccination.

Older adults are a high in risk of severe COVID-19 disease outcomes and experience "vaccine hesitancy." Guided by health communication models such as the Reasoned Action Approach and the Extended Parallel Process Model, online surveys designed to inform statewide public health communication efforts were administered in West Virginia, a primarily rural and fully Appalachian state, in Winter 2021 (n = 272) and Fall 2022 (n = 248). Adults ages 50+ years (N = 520) reported attitudes, intentions, and behaviors regarding COVID-19 vaccination and their related patient-provider communication. Vaccine usefulness/safety, perceived effectiveness, and subjective norms predicted behavior while perceived severity, efficacy, and usefulness/safety predicted intention to get a booster, specifically the updated Fall 2022 Omicron (bivalent) booster. As patient-provider communication (which a minority reported receiving) was a strong predictor of behavioral outcomes, characteristics of effective healthcare provider communication and considerations for public message construction are discussed.

Abstract 6297: “They should get a cardiologist to be a part of the team when you first go”: A qualitative analysis of racial differences in the cancer care experience amongst breast cancer patients receiving cardiotoxic therapy

Abstract Background: Black breast cancer survivors are up to three times more likely to develop cancer therapy-related cardiac dysfunction (CTRCD) when compared to White survivors. Reasons behind this disparity are not fully understood, and studies examining these disparities have been limited. One contributor may be variations in communications about CTRCD risk and risk prevention strategies between providers and patients by race and ethnicity. This study assessed racial differences in Black versus White breast cancer patients with provider communication regarding cardiotoxic treatments. Methods: Study participants were recruited from a comprehensive cancer center. Eligibility included identifying as a Black/African American or White woman, a diagnosis of stage I-III breast cancer, and receipt of anthracyclines and/or trastuzumab. Semi-structured interviews were conducted with survivors. Interviews were audio-recorded, transcribed, and were reconciled using Dedoose. Results: Interviews were conducted with 16 survivors (8 Black, 8 White) with a median age at diagnosis of 53 years. Prior to starting treatment, 100% of white survivors reported that a provider discussed CTRCD risk, however only 75% black survivors reported CTRCD discussion. Although all women received information on prevention strategies including exercise and nutrition, there were differences in timing of information delivered. Black women desired to have information at the beginning of treatment, but no White women mentioned a desire to receive information earlier. A greater proportion of White women reported engaging in prevention strategies such as exercising and eating healthy during treatment. In terms of knowledge gained, 75% of White Women reported being satisfied with the information given regarding cardiotoxic risk and prevention whereas only 45% of Black women reported being satisfied.As 65% of Black women (vs. White) reported being less than satisfied with the information given, Black women were also more likely to recommend access to additional resources. For example, one Black woman suggested that “they [care team] should get a cardiologist to be a part of the team when they first go. Conclusion & Implications: Fewer Black women reported being satisfied with their medical visits regarding CTRCD risk and prevention strategies. Racial differences in assessments of these experiences highlight opportunities to develop culturally-tailored communication interventions to reduce racial disparities in CTRCD; however, future research is needed to assess interpersonal aspects of care during the receipt of cardiotoxic treatment. Citation Format: Ashley Turner, America Vijil, Sara Gómez-Trillos, Victoria Williams, Paulette Omeaku, Susan Hong, Arnethea L. Sutton. “They should get a cardiologist to be a part of the team when you first go”: A qualitative analysis of racial differences in the cancer care experience amongst breast cancer patients receiving cardiotoxic therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6297.

Evaluating Laboratory Communications to NKF-WG Recommended Stakeholders during Implementation of the CKD-EPI 2021 Equation.

In 2022, the National Kidney Foundation's Laboratory Engagement Working Group (NKF-WG) released recommendations for clinical implementation of the race-free Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 estimated glomerular filtration rate (eGFR) equation.This study examined laboratory communications during CKD-EPI 2021 implementation including communication methods and delivery, content inclusion, and alignment with stakeholder inclusion as defined by the NKF-WG. An anonymous web-based survey was distributed to members of ADLM (AACC) and the American Society for Clinical Laboratory Science (ASCLS) in November 2022 to solicit laboratory directors of CLIA-licensed clinical laboratories in the United States. Seventeen questions covering topics related to implementation of CKD-EPI 2021, stakeholder inclusion, methods and timing of communications delivery, and content inclusion were surveyed. All participating laboratories (n = 28) reported including physicians/advanced practitioners in implementation communications, while only 10.7% reported inclusion of patients. When reporting on methods of communication, 81.5% (n = 27) of respondents reported using multiple methods of communication with providers and 88.8% issued provider communications prior to implementation. In contrast, when patient communications were delivered, 87.5% (n = 8) issued these communications exclusively after CKD-EPI 2021 implementation and the majority (6 of 8) reported using only one method of communication during delivery. When reporting on content inclusion, 64.3% (n = 28) of laboratories reported including concerns regarding previous race-based eGFR equations in communications with physicians/advanced practitioners, while only 16.7% (n = 18) of those who included this information did so with patients. Participants reported limited engagement in CKD-EPI 2021 laboratory-to-patient implementation communications as well as limited inclusion of additional stakeholder groups, as defined in the NKF-WG recommendations. Laboratories utilized multiple communication methods and deliveries in physician/advanced practitioner communications; however, this strategy was not replicated when engaging with additional NKF-WG stakeholder groups.

Barriers to Cardiac Rehabilitation among Patients Diagnosed with Cardiovascular Diseases-A Scoping Review.

Cardiovascular diseases (CVDs) are a rising global burden. Preventative strategies such as cardiac rehabilitation (CR) have shown a marked reduction in disease burden. Despite this, CR is underutilized worldwide. This study aims to identify the barriers to CR among patients diagnosed with CVD. A scoping review of the literature was conducted following the Joanna Briggs Institute (JBI) guidelines. Four major databases, including CINAHL, PubMed, EBSCOhost, and Scopus, were used to obtain studies published between 2010 and 2023. Search terms such as "Cardiac rehab*", "Barrier*", "Cardiovascular", "Disease", and "diagnosis*" were utilized in order to obtain subject-specific studies relevant to the research question. From the initial 2098 studies, only 14 were included in the final analysis, consisting of both qualitative and quantitative designs. The thematic analysis included "healthcare system-related factors", "Socioeconomic factors", and "individual characteristics". Healthcare system-related factors were mostly related to the poor availability of CR programs, lack of proper referral strategies, inadequate knowledge of CR provider and inter-provider communication issues, and lack of alternative methods of CR delivery. The socioeconomic barriers were lack of education, longer distance to CR facilities, high cost of care, unemployment, and poor income status. The identified individual characteristics were female gender, older age, and comorbidities. Lack of resources, poor access, educational attainment, and high cost of care were some of the barriers to CR, particularly in low- and middle-income countries (LMICs). Health policymakers and healthcare providers should implement strategies incorporating the issues identified in this scoping review. Systematic reviews may be required to confirm these findings.

Satisfaction of Students Regarding Communication with Healthcare Providers at College Health Services

This quantitative descriptive study focuses on how satisfied college students are with communication from medical professionals at Atharva Business College in Nepal. The study was conducted from April 2023 to June 2023. The study includes 89 students, mostly female, aged 18 to 29, who received medical assistance at the on-campus Student Health Centre. Participants completed a questionnaire survey to score their satisfaction with several aspects of provider communication. The results show a high overall acceptance rate, with specific areas such as the greeting process, respectful treatment, and interest in patients' suggestions garnering positive comments. Most participants reported that they had excellent communication about their health problems, were involved in decision-making, and understood medical information. The findings highlight the importance of excellent provider communication in improving patient outcomes and satisfaction in a campus healthcare setting.

The COMFORT Model: Moving the Initiative Outside of the Academy

ABSTRACT Reflexive and prospective in nature, the creators of the COMFORT model describe experiences of moving this research outside of the academy. The COMFORT model represents the seven basic principles of healthcare provider communication: C – Connect, O – Options, M – Making Meaning, F – Family Caregivers, O – Openings, R – Relating, T – Team. The COMFORT initiative began as a call for change in healthcare communication education. Originally published as a final chapter in a volume on family and palliative care communication, it was the start of an extensive translational program of trainings and tools addressing healthcare provider communication.

Understanding Antenatal Care Service Quality for Malaria in Pregnancy through Supportive Supervision Data in Tanzania.

Malaria in pregnancy (MiP) is associated with maternal anemia, spontaneous abortion, and infant and maternal death. In Tanzania, MiP service data are collected through routine Malaria Services and Data Quality Improvement (MSDQI) supportive supervision rounds at antenatal care (ANC) facilities. Using structured assessment tools, the U.S. President's Malaria Initiative Impact Malaria Project reviewed two annual rounds of MSDQI data (492 facilities in 2021 and 522 facilities in 2022), including ANC records and client satisfaction interviews. We assessed coverage of key MiP care components, used logistic regression to analyze uptake of the recommended three or more doses of intermittent preventive treatment in pregnancy (IPTp3+), and assessed client satisfaction. Coverage of most MiP care components exceeded 80%; however, only 38% of women received all components. Odds of receiving IPTp3+ were much lower among late ANC initiators than among those who initiated ANC during their first trimester (odds ratio [OR], 0.46; 95% CI, 0.38-0.57). Uptake of IPTp3+ increased almost exponentially by number of ANC visits. Women with seven visits were 30 times more likely than those with three visits to receive IPTp3+ (OR, 30.71; 95% CI, 11.33-83.22). Just 54% of clients had anemia screening and only 46% received IPTp3+. Client satisfaction with services and provider communication was high (98% and 97%, respectively); only 8% of client visits exceeded 3 hours. Increased ANC visits could boost IPTp3+ coverage. Routine MSDQI supportive supervision data are useful to assess quality of care, identify service delivery gaps, and guide policies to improve quality of MiP services.

Is Primary Care Patient Experience Associated with Provider-Patient Language Concordance and Use of Interpreters for Spanish-preferring Patients: A Systematic Literature Review.

Healthcare provided by a bilingual provider or with the assistance of an interpreter improves care quality; however, their associations with patient experience are unknown. We reviewed associations of patient experience with provider-patient language concordance (LC) and use of interpreters for Spanish-preferring patients. We reviewed articles from academic databases 2005-2023 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Joanna Briggs Institute Checklists to rate study quality. We reviewed 217 (of 2193) articles, yielding 17 for inclusion. Of the 17 included articles, most articles focused on primary (n = 6 studies) or pediatric care (n = 5). All were cross-sectional, collecting data by self-administered surveys (n = 7) or interviews (n = 4). Most assessed the relationship between LC or interpreter use and patient experience by cross-sectional associations (n = 13). Two compared subgroups, and two provided descriptive insights into the conversational content (provider-interpreter-patient). None evaluated interventions, so evidence on effective strategies is lacking. LC for Spanish-preferring patients was a mix of null findings (n = 4) and associations with better patient experience (n = 3) (e.g., receiving diet/exercise counseling and better provider communication). Evidence on interpreter use indicated better (n = 2), worse (n = 2), and no association (n = 2) with patient experience. Associations between Spanish-language preference and patient experience were not significant (n = 5) or indicated worse experience (n = 4) (e.g., long waits, problems getting appointments, and not understanding nurses). LC is associated with better patient experience. Using interpreters is associated with better patient experience but only with high-quality interpreters. Strategies are needed to eliminate disparities and enhance communication for all Spanish-preferring primary care patients, whether with a bilingual provider or an interpreter.

The potential influence of patient-centered communication, online provider communication, and social determinants of health on cancer screening

ObjectiveTo understand how breast and cervical cancer screening are influenced by communicating with a healthcare provider, patient activation, and social determinants of health. MethodData were from the National Cancer Institute’s Health Information National Trends Survey, focusing on women with no history of cancer at least 21 years old (N = 1466) to study cervical cancer screening and those at least 40 years old (N = 1114) to study breast cancer screening. Variables included patient-centered communication, electronic healthcare communication, patient activation, race/ethnicity, education, health insurance status, Appalachian residence, and financial insecurity. ResultsElectronic communication predicted both cancer screens, but especially for White women. Patient-centered communication influenced cervical cancer screening only for women with insurance. It only influenced mammography for those without insurance. Patient activation did not influence either cancer screen behavior. ConclusionThese data demonstrate more nuance is needed to parse potential effects of advocated-for healthcare behaviors. Use of publicly available datasets from can be informative but are limited methodologically. Practice implicationsHealthcare providers and systems should promote use of patient portals and other electronic means of interaction outside regular clinical visits for all patients. However, attention needs to be paid to the unequal benefits they afford to patients.

Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment.

Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N=121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2)=1.19, p=0.55; RMSEA < 0.01; CFI=1.00; SRMR=0.02). Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.

Exploration of Latina/Hispanic women’s experiences living with non-alcoholic fatty liver disease: a qualitative study with patients in Houston

ObjectivesA deeper understanding of the lived experiences of Hispanic patients with non-alcoholic fatty liver disease (NAFLD) can help guide the development of behavioural programmes that facilitate NAFLD management. This paper...

Harris Poll Migraine Report Card: population-based examination of high-frequency headache/migraine and acute medication overuse

BackgroundMigraine is a disabling neurologic disease that can fluctuate over time in severity, frequency, and acute medication use. Harris Poll Migraine Report Card was a US population-based survey to ascertain quantifiable distinctions amongst individuals with current versus previous high-frequency headache/migraine and acute medication overuse (HFM+AMO). The objective of this report is to compare self-reported experiences in the migraine journey of adults with HFM+AMO to those who previously experienced HFM+AMO but currently have a sustained reduction in headache/migraine frequency and acute medication use.MethodsAn online survey was available to a general population panel of adults (≥18 years) with migraine per the ID Migraine™ screener. Respondents were classified into “current HFM+AMO” (within the last few months had ≥8 headache days/month and ≥10 days/month of acute medication use; n=440) or “previous HFM+AMO” (previously had HFM+AMO, but within the last few months had ≤7 headache days/month and ≤9 days/month of acute medication use; n=110). Survey questions pertained to demographics, diagnosis, living with migraine, healthcare provider (HCP) communication, and treatment.ResultsParticipants in the current HFM+AMO group had 15.2 monthly headache days and 17.4 days of monthly acute medication use in last few months compared to 4.2 and 4.1 days for the previous HFM+AMO group, respectively. Overall, current preventive pharmacologic treatment use was low (15-16%; P>0.1 for current vs previous) in both groups. Previous HFM+AMO respondents reported better current acute treatment optimization. More respondents with current (80%) than previous HFM+AMO (66%) expressed concern with their current health (P<0.05). More than one-third of both groups wished their HCP better understood their mental/emotional health (current 37%, previous 35%; P>0.1 for current vs previous) and 47% (current) to 54% (previous) of respondents worried about asking their HCP too many questions (P>0.1 for current vs previous).ConclusionApart from optimization of acute medication, medical interventions did not significantly differentiate between the current and previous HFM+AMO groups. Use of preventive pharmacological medication was low in both groups. Adults with current HFM+AMO more often had health concerns, yet both groups expressed concerns of disease burden. Optimization of acute and preventive medication and addressing mental/emotional health concerns of patients are areas where migraine care may impact outcomes regardless of their disease burden.Graphical

Effectiveness of provider communication training for increasing human papillomavirus vaccine initiation at a safety-net health system

BackgroundStrong provider recommendation can increase uptake of human papillomavirus (HPV) vaccination. Therefore, we developed and implemented a provider education intervention on communication strategies for recommending HPV vaccination with clinic-level audit and feedback (HPV: Communicating about HPV to Adults and Teens [HPV CHAT]). We aimed to evaluate the effect of HPV CHAT on HPV vaccine uptake in seven family medicine and pediatric clinics in a large urban health system (USA). MethodsWe used a quasi-experimental design, where the eligible population included people aged 9–26 years with at least one encounter in June 2020–February 2023 at one of the participating community health clinics. We used interrupted time-series analysis to assess changes in the prevalence of HPV vaccine uptake. We used segmented Poisson regression with a log link function to estimate prevalence ratios (PR) and 95% confidence limits (CL) for level (immediate) and slope (over time) changes with adjustment for seasonality using Fourier transformation. ResultsOur study population comprised 60,328 observations in which the median age was 17 years (interquartile range: 13–21). A majority (58%) were female and 87% were racial/ethnic minorities. Overall, we observed no sizeable effect of the intervention on HPV vaccination uptake. Nonetheless, heterogeneity was observed by age group with modest increases in individuals aged 9–12 and 13–17 years. ConclusionOur provider feedback intervention had minimal effect on increasing prevalence of HPV vaccination in seven family medicine and pediatric clinics. Novel strategies are needed to address provider barriers related to HPV vaccination.

Understanding perceptions of tumor genomic profile testing in Black/African American cancer patients in a qualitative study: the role of medical mistrust, provider communication, and family support.

Tumor genomic profiling (TGP) examines genes and somatic mutations specific to a patient's tumor to identify targets for cancer treatments but can also uncover secondary hereditary (germline) mutations. Most patients are unprepared to make complex decisions related to this information. Black/African American (AA) cancer patients are especially at risk because of lower health literacy, higher levels of medical mistrust, and lower awareness and knowledge of genetic testing. But little is known about their TGP attitudes or preferences. Five in-person focus groups were conducted with Black/AA cancer patients (N = 33) from an NCI-designated cancer center and an affiliated oncology unit in an urban safety-net hospital located in Philadelphia. Focus groups explored participants' understanding of TGP, cultural beliefs about genetics, medical mistrust, and how these perceptions informed decision-making. Participants were mostly female (81.8%), and one-third had some college education; mean age was 57 with a SD of 11.35. Of patients, 33.3% reported never having heard of TGP, and 48.5% were not aware of having had TGP as part of their cancer treatment. Qualitative analysis was guided by the principles of applied thematic analysis and yielded five themes: (1) mistrust of medical institutions spurring independent health-information seeking; (2) genetic testing results as both empowering and overwhelming; (3) how provider-patient communication can obviate medical mistrust; (4) how unsupportive patient-family communication undermines interest in secondary-hereditary risk communication; and (5) importance of developing centralized patient support systems outside of treatment decisions. Results improve understanding of how Black/AA patients perceive of TGP and how interventions can be developed to assist with making informed decisions about secondary hereditary results.

“Navigating chaos”: Urban, Rural, and Remote Patient Experiences in Accessing Healthcare with Indigenous and Non-Indigenous Perspectives of Living with Chronic Low Back Pain

ABSTRACT Background Healthcare access for chronic low back pain is complex and should consider not only the health system, but patient care seeking experiences as well. People who live in rural and remote communities and/or identify as being Indigenous may often encounter additional barriers to accessing care for chronic low back pain; thus, these contexts must be considered to fully understand barriers and facilitators. Aims The aim of this study was to understand care-seeking experiences of people living with chronic back pain in Saskatchewan and determine unique experiences facing urban, rural, remote, and/or Indigenous peoples. Methods Thirty-three participants with chronic low back pain completed a preliminary survey followed by individual semistructured interviews. Participants were categorized as urban, rural, or remote including Indigenous status. A qualitative interpretive research approach with inductive thematic analysis was employed. Results Three overarching themes were identified with the following subthemes: (1) healthcare access challenges: challenges to accessing care, challenges within the health system, and challenges leading to self-directed management/coping strategies; (2) healthcare access facilitators: funded care, participant education and knowledge, patient–provider communication, and care closer to home; and (3) participant recommendations for improved care provision: coordination of care, integrative and holistic care, and patient-centered care and support. Rural and remote participants highlighted travel as a main barrier. Indigenous participant experiences emphasized communication with healthcare providers and past experiences influencing desire to access care. Conclusion Participants identified a range of challenges and facilitators as well as recommendations for improving access to care for chronic low back pain, with unique barriers for rural, remote, and Indigenous participants.

Patients' Experiences of Dental Diagnostic Failures: A Qualitative Study Using Social Media.

Despite the many advancements made in patient safety over the past decade, combating diagnostic errors (DEs) remains a crucial, yet understudied initiative toward improvement. This study sought to understand the perception of dental patients who have experienced a dental diagnostic failure (DDF) and to identify patient-centered strategies to help reduce future occurrences of DDF. Through social media recruitment, we conducted a screening survey, initial assessment, and 67 individual patient interviews to capture the effects of misdiagnosis, missed diagnosis, or delayed diagnosis on patient lives. Audio recordings of patient interviews were transcribed, and a hybrid thematic analysis approach was used to capture details about 4 main domains of interest: the patient's DDF experience, contributing factors, impact, and strategies to mitigate future occurrences. Dental patients endured prolonged suffering, disease progression, unnecessary treatments, and the development of new symptoms as a result of experiencing DE. Poor provider communication, inadequate time with provider, and lack of patient self-advocacy and health literacy were among the top attributes patients believed contributed to the development of a DE. Patients suggested that improvements in provider chairside manners, more detailed patient diagnostic workups, and improving personal self-advocacy; along with enhanced reporting systems, could help mitigate future DE. This study demonstrates the valuable insight the patient perspective provides in understanding DEs, therefore aiding the development of strategies to help reduce the occurrences of future DDF events. Given the challenges patients expressed, there is a significant need to create an accessible reporting system that fosters constructive clinician learning.

Barriers and Facilitators to Screening for Kidney Disease Among Older Adults with Hypertension and Diabetes in Mbarara Southwestern Uganda: Healthcare Providers' Perspective.

Screening for kidney disease (KD) among high-risk patients (patients with hypertension or diabetes) allows early diagnosis, intervention and delayed progression of the disease. In low- and middle-income countries (LMIC), KD screening is still sub-optimal. This study explored the healthcare providers' perceived barriers and facilitators to KD screening among older adults with hypertension and diabetes in Mbarara southwestern Uganda. This was a descriptive qualitative study among healthcare providers caring for older adults with diabetes mellitus and hypertension at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. In-depth interviews were conducted using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed to develop themes of barriers and facilitators. We conducted 30 in-depth interviews among healthcare providers. Barriers to screening for kidney disease included patient related factors according to healthcare providers (financial hardships, poor health seeking behavior, limited knowledge and awareness), healthcare factors (work overload, ineffective patient healthcare provider communication) and system/policy related factors (lack of laboratory supplies, lack of guidelines and poor medical record keeping and documentation). With respect to facilitators, we found formation of peer support groups, effective team, and continuous medical education (CME). Healthcare providers encounter substantial but modifiable barriers in screening older adults for KD. The identification of barriers and facilitators in timely KD detection gives us an outlook of the problem in Uganda and leads for proposals of action. Interventions that address these barriers and promote facilitators may improve the healthcare provider's effectiveness and capacity to care including screening for patients at risk of KD.

Virtual Reality for Developing Patient-Facing Communication Skills in Medical and Graduate Education: Protocol for a Scoping Review.

Clinician-patient communication is an integral component in providing quality medical care. However, research on clinician-patient communication has shown overall patient discontent with provider communication skills. While virtual reality (VR) is readily used for procedural-based learning in medical education, its potential for teaching patient-facing communication skills remains unexplored. This scoping review aims to evaluate the effectiveness and feasibility of VR applications used for patient-facing communication skills development in medical education. The primary objective is to synthesize and evaluate the effectiveness of available VR tools and applications used for patient-facing communication skills development in medical education. The secondary objectives are to (1) assess the feasibility of adapting VR applications to develop patient-facing communication skills in medical education and (2) provide an overview of the challenges associated with adapting VR applications to develop patient-facing communication skills in medical education. A total of 4 electronic databases (ERIC, Embase, PubMed, and MEDLINE) were searched for primary peer-reviewed articles published through April 11, 2023. Articles evaluating the implementation of non-, semi-, and fully immersive VR training for patient- or caregiver-facing communication skills training provided to graduate, medical, or other allied health care professions students were included. Studies that assessed augmented reality, mixed reality, artificial intelligence, or VR for non-communication-based training were excluded. Study selection will include a title, abstract, and full-text screening by 4 authors. Data from eligible studies will be extracted and entered into a database and presented in tabular format. Findings will be reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. As of April 11, 2023, the search strategy has been confirmed and the search has been completed. We are currently at the title and abstract screening stage. Once complete, the articles will undergo full-text screening according to eligibility criteria as described in the methods. The findings of this review will inform the development of a graduate-level clinical skills research course within the Institute of Medical Science graduate department at the University of Toronto. It is also expected that these findings will be of interest to other health care-specific faculties inside and beyond our institution. Further, our scoping review will summarize the limited field of literature on VR use in medical communications training and identify areas for future inquiry. DERR1-10.2196/53901.

Assessing Camp Provider Needs Related to the Mental, Emotional, and Social Health of Youth and Staff: Implications for Parent Communication, Human Resources, and Transition of Care

Children, adolescents, and young adults are experiencing increases in mental, emotional, and social health (MESH) challenges including anxiety and depression. Out-of-school time (OST) program providers such as summer camps rely on effective communication with parents and other stakeholders to provide for these MESH needs, and the development of before and after program communication processes are viewed as a promising strategy for MESH response across youth program settings. In addition, OST program providers seek human and educational resources for meeting the MESH needs of program participants, and they also try to match available MESH resources to the work demands of their frontline staff who are tasked with responding to youth MESH needs when they arise. The importance of these topics is not reflected in available research informing recommended OST provider practices. Thus, this study examined program provider communications with parents about their youth’s MESH needs as well as program provider MESH resource utilization. Our three research questions were as follows: (1) What parent communication approaches do camp providers use to support youth MESH needs?; (2) What information is communicated to parents, teachers, or healthcare providers regarding youth MESH before and after camp?; and (3) What supports and resources do camp providers need to better manage MESH issues? Findings from this research highlight camp provider MESH-related parent communications and resource utilization. Notably, while respondents indicated requesting general MESH information on the health history form, further assessment and documentation of these identified MESH issues within- and across-camp seasons was lacking. Respondents also indicated camp nurses as the most prevalent human resource. Collectively, these results indicate that camp providers and out-of-camp stakeholders acknowledge the benefit of health history reporting and communication with regard to MESH challenges as well as providing MESH resources to meet employee job demands.