Training primary care staff in delivering the primary care consultation remotely: a systematic review

Abstract

Background: Remote consultation is widely used in primary care, and its use has increased greatly since the onset of the COVID-19 pandemic. Despite this, primary care clinicians lack formal training in delivering remote consultation. There is a need to understand how training might best be delivered, and what evidence there is to support this.

Aim: To summarise existing published literature about training primary care staff in conducting primary care consultation remotely, to outline which models of training may be effective, and to identify unanswered questions for future research.

Design & setting: Systematic review of English language studies in primary care included in Medline (Ovid), Cochrane Database, PubMed, Embase (Ovid), Web of Science, and CINAHL from 2010-2021; and in Google results from 2010-2022.

Method: Databases were searched using a predefined search strategy. Title, abstract, and full-text screening was conducted to identify eligible studies for inclusion in the review. The quality of included studies was assessed, and findings were synthesised to answer the research questions.

Results: We included 10 studies. Seven examined training on remote consultation with trainee GPs or residents, and three examined training on remote consultation with qualified primary care clinicians. Training described led to positive change overall, including increased confidence and self-efficacy in delivering remote consultations. Furthermore, trainees reported increased use of remote consultation, increased efficiency, and increased engagement from patients. Studies where training involved workshops or didactic learning alongside experiential learning resulted in more positive feelings and more confidence about how technology could aid consultations.

Conclusion: There is limited evidence on training primary care staff in conducting remote consultation. Available evidence indicates that training has a positive impact on the ability of clinicians and staff to deliver remote consultation.

Keywords: education, medical, graduate; internship and residency; primary health care; remote consultation; self efficacy; staff development; general practitioners.