Beyond the Bedside: How Are Your 'Webside' Manners?

Marlene Busko

Disclosures

February 07, 2018

In addition to developing a good bedside manner, physicians of today and tomorrow also need to acquire good "webside" manner. As "virtual visits" with patients are becoming increasingly more common, a few US medical schools are leading the way in teaching their students how to interact with a patient on the screen in front of them.

Telemedicine, or "the practice of medicine when the doctor and patient are widely separated using two-way voice and visual communication,"[1] covers phone calls, emails, and video chats between clinicians and patients—possibly with patients who have sensors relaying information such as blood pressure. Although the patient and physician are not in the same room, and the physician cannot perform a physical examination, the physician's "webside manner," or "the manner in which a healthcare professional interacts with patients remotely in telehealth or telemedicine," is still important.

"In some ways, this is not new," says Susan Skochelak, MD, adjunct professor of family and community medicine, Northwestern Feinberg School of Medicine, in Chicago, Illinois, and group vice president for medical education at the American Medical Association (AMA). "When I was in my training years ago," she told Medscape, "we had a whole program on telemedicine," but it was focused on phone conversations.

Simulation Center in North Dakota, Telemedicine in Arizona

Formal training in telemedicine is "not widely offered to physicians-in-training," according to an AMA statement.[2] However, "exposure to and evidence-based instruction in telemedicine's capabilities and limitations at all levels of physician education will be essential to harnessing its potential," said AMA past president Robert M. Wah, MD, global chief medical officer, DXC Technology. The organization is encouraging accrediting bodies for undergraduate and graduate medical education to include core competencies for telemedicine in their programs.

In the meantime, as part of its Accelerating Change in Medical Education initiative led by Dr Skochelak, the AMA has awarded $12.5 million in grants to 32 medical schools since 2013 to develop innovative curricula. With funds from this initiative, the University of North Dakota School of Medicine and Health Sciences developed a simulation center in which multidisciplinary teams of students from medicine, nursing, and pharmacy learn skills to deliver healthcare to patients in rural communities. The Indiana University School of Medicine has created an electronic health record, using de-identified patient data, to train student in how to handle this aspect of care.

Skochelak emphasized that the information gleaned from these initiatives is shared by the consortium and then disseminated to other medical schools. The University of Arizona, which is not part of this consortium, has had a long-standing telemedicine program aimed at providing healthcare to remote rural areas, Elizabeth A. Krupinski, PhD, an experimental psychologist at Emory University, in Atlanta, Georgia, and associate director of evaluation for the Arizona Telemedicine Program, told Medscape. "I think people very quickly realized that real-time telemedicine is not the same thing as being there in person," she said. "There is, in a sense, an etiquette and some training that has to be done to develop that webside manner."

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