Patient-centered care and healthcare consumerism are the two most dominant ideas about the relationship between patients and providers in the United States. To identify providers’ positions between the two perspectives, we analyzed the content of direct-to-consumer healthcare service advertisements. The advertisements were collected in the state of Nevada ( N = 323) and their landing pages were analyzed for provider attributes, patient experience features, and terms referring to patients and providers. The results showed that the advertisements fully embraced the notion of patient-centeredness by commonly claiming patient-centered care and frequently using the term “patient.” The advertisements also contained multiple indicators of healthcare consumerism, although they avoided using the terms “consumer/customer/client” closely associated with consumerism. Contrary to the prominence of patient experience features, provider attributes were not common. An additional analysis of inter-specialty differences in advertising features confirmed the strong consumerism position of cosmetic surgery providers. Application of the healthcare service advertising analytic scheme developed for this study could help providers and healthcare administrators recognize how their advertising messages may reflect their values.
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Using Telehealth Technologies to Build Nurse Practitioner Student Confidence
Telehealth technologies play a vital role in delivering quality healthcare to patients regardless of geographic location and health status. Use of telehealth peripherals allow providers a more accurate method of collecting health assessment data from the patient and delivering a more confident and accurate diagnosis, saving not only time and money but creating positive patient outcomes. Advanced Practice Nursing (APN) students should be confident in their ability to diagnose and treat patients through a virtual environment. This pilot simulation was completed to help examine how APN students interacted in a simulation-based education (SBE) experience with and without peripherals, funded by the National Science Foundation’s Future of Work at the Human-Technology Frontier (FW-HTF) program. The SBE experience was created and deployed using the INACSL Healthcare Simulation Standards of Best PracticesTM and vetted by a simulation expert. APN students (N = 24), in their first assessment course, were randomly selected to be either a patient (n = 12) or provider (n = 12) in a telehealth simulation. Student dyads (patient/provider) were randomly placed to complete a scenario with (n = 6 dyads) or without (n = 6 dyads) the use of a peripheral. Students (providers and patients) who completed the SBE experience had an increased confidence level both with and without the use of peripherals. Students evaluated the simulation via the Simulation Effectiveness Tool-Modified (SET-M), and scored their perception of the simulation on a 1 to 5 point Likert Scale. The highest scoring areas were perceived support of learning by the faculty (M=4.6), feeling challenged in decision-making skills (M=4.4), and a better understanding of didactic material (M=4.3). The lowest scoring area was feeling more confident in decision making (M=3.9). We also recorded students’ facial expressions during the task to determine a probability score (0- 100) for expressed basic emotions, and results revealed that students had the highest scores for joy (M = 8.47) and surprise (M = 4.34), followed by disgust (M = 1.43), fear (M = .76), and contempt (M = .64); and had the lowest scores of anger (M = .44) and sadness (M = .36). Students were also asked to complete a reflection assignment as part of the SBE experience. Students reported feeling nervous at the beginning of the SBE experience, but acknowledged feeling better as the SBE experience unfolded. Based on findings from this pilot study, implications point towards the effectiveness of including simulations for nurse practitioner students to increase their confidence in performing telehealth visits and engaging in decision making. For the students, understanding that patients may be just as nervous during telehealth visits was one of the main takeaways from the experience, as well as remembering to reassure the patient and how to ask the patient to work the telehealth equipment. Therefore, providing students opportunities to practice these skills will help increase their confidence, boost their self- and emotion regulation, and improve their decision-making skills in telehealth scenarios.
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- Award ID(s):
- 2026516
- NSF-PAR ID:
- 10398123
- Date Published:
- Journal Name:
- 2022 ASEE Annual Conference & Exposition
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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Materials and Methods Semistructured interviews with staff (n = 9) and patients (n = 22) at an FQHC in a Midwestern state. First-cycle coding of interview transcripts was performed inductively to identify helping processes and participants’ evaluations of them. Next, these inductive codes were mapped onto deductive codes from CLT.
Results Staff intermediaries used 4 approaches to support access to, and usage of, video visits and patient portals for FQHC patients: (1) shielding patients from cognitive overload; (2) drawing from long-term memory; (3) supporting the development of schemas; and (4) reducing the extraneous load of negative emotions. These approaches could contribute to CL reduction and each was viewed as helpful to at least some patients. For patients, there were beneficial impacts on learning, emotions, and perceptions about the self and technology. Intermediation also resulted in successful visits despite challenges.
Discussion Staff intermediaries made telehealth work for FQHC patients, and emotional support was crucial. Without prior training, staff discovered approaches that aligned with CLT and helped patients access technologies. Future healthcare intermediary interventions may benefit from the application of CLT in their design. Staff providing brief explanations about technical problems and solutions might help patients learn about technologies informally over time.
Conclusion CLT can help with developing intermediary approaches for facilitating telehealth access.
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