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Shin TM, Dodenhoff KA, Pardy M, Wehner AS, Rafla S, McDowell LD, Denizard-Thompson NM. Providing Equitable Care for Patients With Non-English Language Preference in Telemedicine: Training on Working With Interpreters in Telehealth. MedEdPORTAL 2023; 19:11367. [PMID: 38098759 PMCID: PMC10719426 DOI: 10.15766/mep_2374-8265.11367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/18/2023] [Indexed: 12/17/2023]
Abstract
Introduction The COVID-19 pandemic has led to a large increase in telemedicine encounters. Despite this rise in virtual visits, patients who speak non-English languages have experienced challenges accessing telemedicine. To improve health equity, medical education on telehealth delivery should include instruction on working with interpreters in telehealth. Methods We developed a 25-minute self-directed module with collective expertise of faculty with experience in medical education, interpreter training, and communication training. The module was delivered online as part of a longitudinal health equity curriculum for third-year medical students. In addition to didactic information, the module contained video examples of interpreter interactions in telehealth. Results Sixty-four third-year medical students participated in the study, and 60 completed a postmodule survey. Students were satisfied with the content of the module, as well as the duration of time required to complete the tasks. Approximately 90% would recommend it to future students. Nearly 80% of students rated the module as being quite effective or extremely effective at increasing their comfort level with visits with patients with non-English language preference. Discussion Our module provides a basic framework for medical students on how to successfully work with interpreters during a language-discordant virtual visit. This format of asynchronous learning could also be easily expanded to resident physicians and faculty seeking more resources around working with interpreters in telemedicine.
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Affiliation(s)
- Tiffany M. Shin
- Assistant Professor, Department of Pediatrics, Wake Forest University School of Medicine
| | - Kristen A. Dodenhoff
- Second-Year Resident, Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Mariana Pardy
- Project Manager, Department of Social Sciences and Health Policy, Wake Forest University
| | - Abigail Smith Wehner
- Third-Year Resident, Department of Emergency Medicine, Wake Forest University School of Medicine
| | - Samuel Rafla
- Third-Year Resident, Department of Anesthesiology, Icahn School of Medicine at Mount Sinai
| | - Leslie Doroski McDowell
- Quality Improvement Specialist and Curriculum Developer, Northwest Area Health Education Center
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Irby M, Lesser GJ, Penzien D, Dressler EVM, Rini C, Keefe F, Snavely A, Ang D, Danhauer S, Brown M, Blackwell-Young C, Boothe S, Craver K, Lawson H, Pardy M, Stanfield B, Turner J, Vitolins M, Weaver KE. Internet-delivered management of pain among cancer treatment survivors (IMPACTS WF-1901). J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.tps12151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TPS12151 Background: Pain is a common symptom among cancer patients and often is inadequately treated. Treatment guidelines recommend patients have access to behavioral interventions that educate about pain and pain management. Pain coping skills training (PCST) accomplishes these goals through teaching cognitive and behavioral coping skills shown to reduce pain. When delivered in in-person, PCST can substantially improve chronic pain conditions. Yet, these interventions are underused due to myriad barriers (high costs, shortage of therapists, travel needs). There is a critical need for improved options to help reduce cancer-related pain and related impairment that should include evidence-based PCST interventions capable of overcoming access barriers. To address this need, we developed a web-based PCST program using a novel expert systems approach that retains critical features of in-person PCST in an automated program that requires no therapist. PainTRAINER, is an 8-week, interactive PCST program using tailoring algorithms, a knowledge database, and a virtual coach to guide development of essential skills for coping with chronic pain. Methods: With funding from the NIH HEAL Initiative, we have undertaken a randomized, prospective, comparative effectiveness trial through the Wake Forest NCI Community Oncology Research Program (NCORP) Research Base to determine the impact of painTRAINER on pain outcomes when compared to Enhanced Usual Care (EUC). Participants have a documented diagnosis of invasive cancer who are undergoing anticancer therapy or within 5 years of completing all cancer therapy. Participants must report cancer-related pain most days of the week of 4 or greater on the PROMIS Pain Intensity Scale; with pain of new onset or significantly exacerbated since cancer diagnosis. All participants receive usual care provided by their physician along with pain education materials. PainTRAINER arm participants have access to the painTRAINER program and a tutorial on how to use the program, and complete the painTRAINER modules on their own (1 session/week for 8 weeks). To enhance study access, patients without internet availability are provided a WiFi/cellular-enabled tablet during the intervention period. This trial examines short- and long-term outcomes measured immediately post-intervention and 3- and 6- months post-intervention. Primary outcomes are: pre- to post-intervention change in pain interference/severity. Secondary outcomes are: pain severity/interference at 3- and 6-month follow-up, opioid/analgesic use, health-related quality of life, and pain management self-efficacy. Qualitative interviews are conducted with a random sample of diverse participants who have completed the painTRAINER, and all who exit the study early, to subjectively assess experiences with pain and the clinical trial. Enrollment for this trial has begun (n = 36 of 456 patients enrolled) and is ongoing at 12 sites. Clinical trial information: NCT04462302.
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Affiliation(s)
- Megan Irby
- Wake Forest School of Medicine, Clemmons, NC
| | | | | | | | | | | | - Anna Snavely
- Wake Forest School of Medicine, Winston Salem, NC
| | - Dennis Ang
- Wake Forest School of Medicine, Winston Salem, NC
| | | | - Mark Brown
- Wake Forest School of Medicine, Winston Salem, NC
| | | | | | - Karen Craver
- Wake Forest School of Medicine, Winston Salem, NC
| | | | | | | | - Julie Turner
- Wake Forest School of Medicine, Winston Salem, NC
| | - Mara Vitolins
- Wake Forest University School of Medicine, Winston Salem, NC
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