Abstract of the research

Students identified technology issues, organisational issues, lack of patient rapport, potential lower quality of care, lack of confidence in clinical ability, fear of litigation, preference for ‘face to face’ medicine, and the inability to conduct physical examinations as key barriers to telehealth. Students mentioned the following benefits: access benefits for both patients and clinicians, reduced clinical isolation, increased availability of specialist services, reduced travel and new business models. Despite the variability in telehealth exposure, students had some knowledge of telehealth and its application in medicine but showed little interest in providing telehealth services themselves. Students’ appreciation of telehealth was notably higher when they had witnessed that policies, procedures, systems, and technology were working well and trained staff knew what they were doing.

What is the purpose of the research?

Having a workforce ready to embrace telehealth is key to improving healthcare access and equity in rural Australia. Known barriers to uptake amongst health professionals include: liability/law issues; traditional attitudes; business models; time constraints; and lack of workforce support, incentives, billing, funding, information technology (IT) skills, and patient rapport. Whether medical students share these same perspectives was unclear at the time. This study sought to explore the knowledge, exposure and attitudes of medical students on telehealth.

What did the researchers do?

Focus groups were conducted upon completion of a 12-month rural placement. Questions focussed on students’ exposure and experiences with telehealth, their perspectives on those experiences, their desire to learn more about telehealth, and their perspective on who should drive the implementation of telehealth services. Thematic analysis was conducted to identify key themes.

What did the researchers find?

Exposure to telehealth consults varied and appears ad-hoc. Overall interest in telehealth was low but they recognised the value in specific circumstances such as for scripts, complicated/rare cases and reduced social isolation for patients and doctors. Overall students felt that rural rather than urban-based clinicians need to drive the telehealth agenda and further telehealth skills training frameworks, and guidelines are required. Some students felt that some urban doctors used telehealth to expand their own patient base.

How can the research be used?

• Student education around guidelines, litigation issues with telehealth, promotion of sustainable telehealth business models and practicalities of using telehealth is needed to increase their confidence with telehealth. This in turn may increase uptake of telehealth in rural areas and by new clinicians.
• Enhancing telehealth education and training during medical school training through increased exposure, experience and capability building will make medical students more workforce ready to be able to develop and work in new models of telehealth care.
• Given the fast advancement of technology, a capability framework or approach could be used. We also recommend that medical students are involved in the design of new models of telehealth care.
• Future research could also explore the impact of urban doctors building their patient base in rural areas using telehealth, whilst filling a need, this may further jeopardise the move of new doctors into rural and remote areas.

Read the full research report published in the Health Education in Practice Journal - Vol. 1 | No. 2 | 2018