Video consultations: a potential gamechanger in clinical education

[摘要] Newly published research by Greenhalgh et al 1 uncovers reasons why GPs rarely do video consultations. They found that when face-to-face consultations are an option, video consultations are perceived as providing insufficient added benefit over telephone to justify their additional operational complexity. While discussing their findings, Greenhalgh et al reference Rogers2 in identifying that the adoption of any innovation is contingent on whether potential adopters perceive any benefit over existing practice. So, it appears that this innovation has not caught-on because GPs do not perceive it adds sufficient value in terms of clinical care.At first sight this could suggest that video consulting in primary care was a temporary response to the COVID-19 pandemic and therefore has had its day. However, there is another perspective to consider — the education perspective. GPs may not perceive that video consultations confer sufficient advantage for clinical care, but what about for clinical education? From this perspective, video consultations could be a gamechanger.PRACTICAL BENEFITS FOR CLINICAL EDUCATION Recent studies have elicited the perspective of primary care-based educators and medical students in relation to remote consulting.3,4 They have also established the feasibility of medical students undertaking consultations from their own homes.4 These studies suggest video consultations may confer a number of practical benefits for clinical education. First, they do not require clinically equipped consulting rooms, or for students to travel to a healthcare facility to undertake consultations. Second, they provide insight into people’s living conditions, giving valuable learning around the social context of patient presentations. They also enable clinical learners to access patients who may be too medically vulnerable to justify a face-to-face conversation where there is no discernible clinical benefit for the patient. Furthermore, they allow multiple clinical learners to participate in real-time consultations while being geographically dispersed.Healthcare facilities are overflowing with medical students and other work-based learners. With the increasing need to accommodate new advanced practitioner roles, practices are running out of consulting rooms,5 potentially precipitating their withdrawal from teaching. Transporting learners to distant primary care centres may provide access to unused teaching capacity and diverse population groups, but that has a financial and environmental cost. Some use of students undertaking off-site video consultations may help mitigate these problems. While, from a situated learning point of view,6 this may not provide students with the same experience as being physically located at a GP practice, its potential to enable high-quality clinical supervision could partially compensate for lack of physical presence.Video consultations could therefore offer access to educationally valuable cultural contexts/patients, unlock extra teaching capacity, and contribute to environmentally sustainable medical education.

[学科分类] 卫生学