Using Assessment Processes to Improve Clinician Interpersonal Skills and Telehealth Program Outcomes

• In Event: The Parker Hotel Roundtable 2
  In Roundtable Session: Approaches and Issues in Assessing Outcomes of Training/Education Programs: A Healthcare Education Perspective

Abstract

Gains in the use of telehealth technology for routine care span disciplines and care sites. An estimated 15 million Americans received medical care remotely in 2015 through hospitals, clinics, schools, nursing homes and other sites. A survey of patients by the Health Industry Distributors Association reinforced patient satisfaction with telehealth services and appreciation for convenience and low cost. As such, clinicians are increasingly facing telehealth as a part of their responsibilities and educators need to consider this with program planning. For general practice guidelines and condition-specific recommendations, the American Telemedicine Association provides resources. Telehealth education provided by universities and organizations, mainly includes terminology, clinical applications, evidence-base, and technological aspects. In contrast, descriptions of effective computer-mediated communication (CMC) are less defined. Esser and Goosens’ framework for telehealth delivery identified doctor-patient communication and technology-mediated communication as key components reinforcing the importance of CMC. It seems reasonable that communication skills with telehealth may be a quality indicator, just as they are for face-to-face encounters. This prompts questions about how to prepare clinicians for delivering health services remotely with a focus on interpersonal skills. To address this, we gathered evidence for designing education curriculum applying tenets of the backward design method and Kirkpatrick’s four-level evaluation model. To determine outcome goals and instructional content for educators and program managers to use in the assessment and development of CMC, we employed a multiphase research design. First, results of a systematic review of the literature revealed patterns and guidelines for clinician preparation, verbal and non-verbal communication, and relationship-building behaviors and lacked outcomes goals to assess CMC. Second, data from the systematic review was integrated with data from semi-structured interviews of experienced telehealth clinicians or managers to identify promising practices for preparing and assessing interpersonal skills in telehealth. Seven themes of assessment criteria resulted from the first two stages of this project: preinteractional, verbal communication, non-verbal communication, relational, and environmental; and management/operations. In phase three, we designed an educational curriculum for CMC in telehealth. The research team determined educational goals for the four-levels of Kirkpatrick’s evaluation. Next, we selected CMC assessment measurements obtained from stages one and two to match the educational goals. With this information we designed instructional content and delivery modes. A final stage will include confirmation of a proposed curricula through feedback from patients receiving telehealth services about desired outcomes in clinician behaviors in practice and piloting learning activities with students. Ultimately, using assessment to define curricula will help to establish a portfolio of immersive education interventions for clinicians and students across multiple disciplines for development of CMC skills to improve telehealth practices. As telehealth becomes just another way to see patients and not a different specialty, learning activities about CMC may positively impact students and professionals and enhance care outcomes.

Authors

• Beverly W. Henry, Northern Illinois University

• Derryl Block

• John Vozenilek, University of Illinois at Urbana - Champaign