With care moving to various virtual formats it was inevitable that as medical students we would have to become well versed with these technologies. Prior to my first virtual care experience, I was fortunate enough to have a practice session organized by my school. I can recall how awkward it felt, to have serious conversations about topics such as caring for elderly parents with dementia and anxiety-provoking situations with the standardized patient. Earlier, we were taught how to pick up on non-verbal cues and mirror the patient’s tone especially when having tough conversations. However, this proved to be a challenge through the virtual format. While speaking to the patient we were told to look directly at the camera which is usually at the top of the screen, whereas the patient window would be somewhere in the middle. This is to ensure, the patient can see you looking directly at them. I often found myself missing nonverbal cues and at times due to connectivity issues I also found myself interrupting the patient as there was a lag in the sound being transmitted.
These were just some of the issues that arose in the practice session, I was quite nervous for my first real patient encounter in the virtual environment. The day came when I was asked to lead a patient encounter via video. This was an encounter with a 5-year-old boy and his mother. This was a complicated first visit, as I not only had to gather history from the child but also communicate with his mother. Reflecting on this encounter, it felt as if I was provided with a glimpse into the life of this patient. Normally, when we see the patient in the office with grey walls, the focus is on their chief complaint and it’s hard to imagine their day-to-day life. In these video encounters, their living situation is brought to the center stage. There was so much variety in the ways patients were logging onto these calls, some were speaking from a designated office/workspace room and others from their living/dining room. At times it seemed like an extremely casual way to have conversations about important topics such as genetic testing and implications for future pregnancies.
Nevertheless, these encounters provided me with a unique opportunity to learn how to show empathy via a laptop screen. I learned that while empathetic statements can still be used, their delivery is even more important than when communicated in person. It is important to look directly into the camera during these moments, to ensure the patient knows they have your full attention. Lastly, pauses even though they can be awkward in a virtual environment have the same effect, as in-person visits. It allows the patient to take a moment to gather their thoughts and not feel rushed through the appointment. These are just some of the techniques I have learned thus far. I am sure to come across various preceptor’s styles and develop a virtual care toolkit to use during future patient encounters.