Table 02: Presents the analysis summary of the qualitative responses on both students and patients-partners under each identified theme.
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Students responses
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Large versus small group size
All students had expressed that they were very happy with the group size of 4-5 students, also stated that they felt more comfortable, got a chance to practice and engaging with such size was much easier.
“I enjoyed the small group and you feel more comfortable speaking up and that you can be heard when the groups are of this size….”
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Consequences of lack of time:
Few students said that due to lack of time, they felt they had limited discussion, hard to build up a rapport and couldn’t practice their consultation. Students expect extra time to get more feedback and have an extensive clinical discussion.
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What makes clinical communication more effective?
Pre-preparatory lectures, learning material and resources on the MSD, had helped students to understand the clinical knowledge on MSD, understand the reason behind each question being asked to the patient and make a holistic optimistic approach like a real clinician.
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Students expectations of the clinical session
Increase the frequency of the session. Students had also suggested that more flexibility on the dates, swapping the session with other students and giving advance notice on the session will be more helpful, as students experience different challenges or situations in house or living place.
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Disrupted Learning
Despite all the students agreeing they were provided with adequate information on how to deal with the technical difficulties. A common problem among the students encounter is a bad internet connection. Internet strength is not sufficient for a group video call, dropping of connection within the group, audio and video cut, lagging and some students need to turn off their video for most of the session to stay connected.
“Connection issues from the tutor and multiple students delayed the session and made it hard to follow at times”
The late joining of the participant affects the learning during the mid of the session and suggested restricting the late joining. Meantime, many students got drop-down and rejoined due to the poor connection. It is being suggested that giving time to resolve the technical check before the properly scheduled time, can minimize this issue.
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Building rapport with remote patients
Students expressed that they learned a lot during this first remote consultation session and had improved their history-taking skills. There was good rapport with the tutors. Also, the student felts as a part of the student community when they are working with others in these remote settings. Some students found it difficult to communicate and connect with the patient over this remote session, they had personally felt that they were not good in history taking and others felt that most nonverbal actions and eye contact are not being properly conveyed via the screen.
“I found it hard to connect with the patient over video and therefore didn't feel as though my history taking was as good as it normally is but perhaps it'll be something that comes with more practice”
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Patient partners responses
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Building rapport with remote patients
Students were confident; had a pleasant consultation; strong willingness to participate in this remote session; adjusted to the patient's preference; friendly facial expression; open approach; empathy; excellent ascertaining; concern about the patient satisfaction with their advice; giving reassurance.
Few students faced problems as they began to interact with their patients, but settled well. The student saws a positive resilient to adapt to the current new normal.
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Student’s knowledge on clinical communication on MSD diseases
Some students had certain gaps in their knowledge on MSD disease, few had used the wrong choice of words in their conversation; included medical terms; few did not obtain proper history, whereas few gave a care plan based on the history gathered by the colleagues.
Overall, most of the students had provided a good treatment plan, based on the health conditions and delivered reassurance. Additionally, few had gone the extra mile by recommending and providing a treatment plan if things worsen.
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Disruptive Interaction
Firstly. Technical difficulties and Internet connection are a common problem encountered and most time got wasted on fixing it, suggesting an extra time in the beginning to fix these issues
Secondly, inadequate rapport by few students. Some students found it difficult to establish a relationship and interact effectively with the patients. Few of them were very anxious, just went with the flow of the session. It should be also taken into account that, as each session scenario were split amongst the students in the group, it was challenging for each student to develop a relationship with the patient in the given time.
“….. student was very nervous about the session I felt, they were just going through the motions, they didn't engage with me as a person, they just wanted facts. No discussion about my work which was a concern or what effect it was having on my life….
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