Restricted accessResearch articleFirst published online 2021-3
Health Care Professionals’ and Patients’ Management of the Interactional Practices in Telemedicine Videoconferencing: A Conversation Analytic and Discursive Systematic Review
Telemedicine has developed as a tool for increasing access to health-related services. However, clinicians are required to achieve effective communication and provide quality care despite the remoteness of patients. The aim of this review was to focus on the interactional components of telemedicine consultations, identifying the social and embodied practices that health care professionals and patients draw on when managing the complexities of videoconferencing technology. A systematic review of telemedicine research using conversation analysis and discursive psychology was conducted, resulting in six articles eligible for inclusion. Interactional practices were synthesized into three categories: positioning utterances, visual and audiological clarification, and directional feedback. These categories demonstrate complex but ordered multimodal interactions that position the technology and health care professional as key to ensuring effective communication. Their interactional relevance highlights a gap in telemedicine research, where the need to focus more on the communicative and clinical richness of these unique consultations is reinforced.
AndreassenH. K.TrondsenM.KummervoldP. E.GammonD.HjortdahlP. (2006). Patients who use e-mediated communication with their doctor: New constructions of trust in the patient-doctor relationship. Qualitative Health Research, 16(2), 238–248. https://doi.org/10.1177/1049732305284667
BeachW. A.EasterD. W.GoodJ. S.PigeronE. (2005). Disclosing and responding to cancer “fears” during oncology interviews. Social Science & Medicine, 60, 893–910. https://doi.org/10.1016/j.socscimed.2004.06.031
4.
EkbergS.DanbyS.TheobaldM.FisherB.WyethP. (2019). Using physical objects with young children in “face-to-face” and telehealth speech and language therapy. Disability and Rehabilitation, 41(14), 1664–1675. https://doi.org/10.1080/09638288.2018.1448464
5.
GoodwinC. (1981). Conversational organization: Interaction between speakers and hearers. New York, NY: Academic press.
6.
HeathCLuffP (1992). Media space and communicative asymmetries: Preliminary observations of video mediated interaction. Human-Computer interaction7(3), 315–346. https://doi.org/10.1207/s15327051hci0703_3
7.
HenryB. W.BlockD. E.CieslaJ. R.McGowanB. A.VozenilekJ. A. (2017). Clinician behaviors in telehealth care delivery: A systematic review. Advances in Health Sciences Education, 22(4), 869–888. https://doi.org/10.1007/s10459-016-9717-2
8.
HerringS.SteinD.VirtanenT. (Eds.). (2013). Pragmatics of computer-mediated communication (Vol. 9). Walter de Gruyter.
JeffersonG. (2004). Glossary of transcript symbols with an introduction. In LernerG. H. (Ed). Conversation Analysis: Studies from the First Generation (pp: 13–31). Amsterdam: John Benjamins.
LuffP.JirotkaM.YamashitaN.KuzuokaH.HeathC.EdenG. (2013). Embedded interaction: The accomplishment of actions in everyday and video-mediated environments. ACM Transactions on Computer-Human Interaction (TOCHI), 20(1), 1–22. https://doi.org/10.1145/2442106.2442112
13.
Lundvoll NilsenL. (2011). Collaborative work by using videoconferencing: Opportunities for learning in daily medical practice. Qualitative Health Research, 21(8), 1147–1158. https://doi.org/10.1177/1049732311405683
14.
MairF.WhittenP. (2000). Systematic review of studies of patient satisfaction with telemedicine. British Medical Journal, 320(7248), 1517–1520. https://doi.org/10.1136/bmj.320.7248.1517
15.
MatusitzJ.BreenG. M. (2007). Telemedicine: Its effects on health communication. Health Communication and New Information Technologies, 21(1), 73–83. https://doi.org/10.1080/10410230701283439
16.
MillerE. A. (2003). The technical and interpersonal aspects of telemedicine: Effects on doctor–patient communication. Journal of Telemedicine and Telecare, 9(1), 1–7. https://doi.org/10.1258/135763303321159611
17.
MillerE. A. (2011). The continuing need to investigate the nature and content of teleconsultation communication using interaction analysis techniques. Journal of Telemedicine and Telecare, 17(2), 55–64. https://doi.org/10.1258/jtt.2010.100203
MondadaL. (2013). The conversation analytic approach to data collection. In SidnellJ.StiversT. (Eds.), The handbook of conversation analysis. 32–56. Chichester: Blackwell Publishing Ltd. https://doi.org/10.1002/9781118325001.ch3
20.
MondadaL (2014), 2Instructions in the operating room: How the surgeon directs their assistant’s hands. Discourse Studies, 16(2), 131–161. https://doi.org/10.1177/1461445613515325
21.
NowakP. (2011). Synthesis of qualitative linguistic research—A pilot review integrating and generalizing findings on doctor-patient interaction. Patient Education and Counseling, 84, 429–441. https://doi.org/10.1016/j.pec.2011.01.022
22.
OngL. M. L.de HaesJ. C. J. M.HoosA. M.LammesF. B. (1995). Doctor-patient communication: A review of the literature. Social Science & Medicine, 40, 903–918. https://doi.org/10.1016/0277-9536(94)00155-M
23.
OnorM. L.MisanS. (2005). The clinical interview and the doctor-patient relationship in telemedicine. Telemedicine and e-Health, 11(1), 102–105. https://doi.org/10.1089/tmj.2005.11.102
24.
PappasY.SealeC. (2009). The opening phase of telemedicine consultations: An analysis of interaction. Social Science & Medicine, 68(7), 1229–1237. https://doi.org/10.1016/j.socscimed.2009.01.011
25.
PappasY.SealeC. (2010). The physical examination in telecardiology and televascular consultations: A study using conversation analysis. Patient Education and Counseling, 81(1), 113–118. https://doi.org/10.1016/j.pec.2010.01.005
26.
PappasY.VseteckovaJ.MastellosN.GreenfieldG.RandhawaG. (2019). Diagnosis and decision-making in telemedicine. Journal of Patient Experience, 6(4), 296–304. https://doi.org/10.1177/2374373518803617
27.
ParryR. (2010). Video-based conversation analysis. In BourgeaultI.DingwallR.de VriesR. (Eds.), SAGE handbook of qualitative methods in health research (pp. 373–396). SAGE.
28.
ParryR.LandV. (2013). Systematically reviewing and synthesizing evidence from conversation analytic and related discursive research to inform healthcare communication practice and policy: An illustrated guide. BMC Medical Research Methodology, 13(9), Article 69. https://doi.org/10.1186/1471-2288-13-69
29.
ParryR.LandV.SeymourJ. (2014). How to communicate with patients about future illness progression and end of life: A systematic review. BMJ Supportive & Palliative Care, 4, 331–341. http://dx.doi.org/10.1136/bmjspcare-2014-000649
30.
RobinsonJ. D. (1998). Getting down to business: Talk, gaze, and body orientation during openings of doctor-patient consultations. Human Communication Research, 25(1), 97–123. https://doi.org/10.1111/j.1468-2958.1998.tb00438.x
31.
SävenstedtS.ZingmarkK.HydénL. C.BrulinC. (2005). Establishing joint attention in remote talks with the elderly about health: A study of nurses’ conversation with elderly persons in teleconsultations. Scandinavian Journal of Caring Sciences, 19(4), 317–324. https://doi.org/10.1111/j.1471-6712.2005.00346.x
32.
SilvermanR. D. (2003). Current legal and ethical concerns in telemedicine and e-medicine. Journal of Telemedicine and Telecare, 9(1), 67–69. https://doi.org/10.1258/135763303322196402
33.
StommelW.GoorH. V.StommelM. (2019). Other-attentiveness in video consultation openings: A conversation analysis of video-mediated versus face-to-face consultations. Journal of Computer-Mediated Communication, 24(6), 275–292. https://doi.org/10.1093/jcmc/zmz015
34.
ten HaveP. (2007). Doing conversation analysis—A practical guide. SAGE.
35.
WhittenP. S.MairF. S.HaycoxA.MayC. R.WilliamsT. L.HellmichS. (2002). Systematic review of cost effectiveness studies of telemedicine interventions. British Medical Journal, 324(7351), 1434–1437. https://doi.org/10.1136/bmj.324.7351.1434
36.
World Health Organization. (2010). Global observatory for ehealth series, Vol. 2. Telemedicine: Opportunities and developments in member states: Report on the second global survey on ehealth.
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