Background Video consultations have proven to be an efficient source of support for patient-doctor interactions and have become increasingly used in orthopedics, especially during the COVID-19 pandemic. This study analyzed both patients’ and doctors’ acceptance of an orthopedic telemedical consultation (OTC) and compared the results of OTC examinations to the results of live consultation (LC) to identify discrepancies. Methods The study was carried out in an orthopedic department of a German hospital between 2019 and 2020. After written informed consent was obtained, patients voluntarily presented for follow-up by OTC and LC. The experience with and attitudes toward OTC among both patients and doctors was evaluated (using Likert scale-scored and open questions, 26 to 28 items). The results of the OTC and LC examinations were compared using a 12-item checklist. The data were analyzed by quantitative and qualitative statistics. Results A total of 53 patients were included, each of whom completed an OTC and an LC. The OTC was rated as pleasant, and the experience was rated as very satisfying (average rating on a 5-point Likert scale, with 1 indicating strong agreement: doctors: 1.2; patients: 1.3). Various technical and organizational challenges were identified. Compared to LC, OTC showed no significant differences in patient history or in inspection, palpation, or active range of motion results. Only for the functional or passive joint assessment did LC show significantly higher suitability (p < 0.05) than OTC. Recommendations for further procedures did not differ significantly between OTC and LC. Conclusions Because of the high acceptance and the objective benefits of OTC and the similarity of clinical results with LC, OTC is recommendable for orthopedic follow-up examinations. To better assess joint functionality, meaningful digital alternatives for established examination methods should be further investigated.
Background The COVID-19 pandemic has not only brought many aspects of disaster medicine into everyday awareness but also led to a massive change in medical teaching due to the necessity of contact restrictions. This study aimed to evaluate student acceptance of a curricular elective module on disaster and deployment medicine over a 5-year period and to present content adjustments due to COVID-19 restrictions. Methods Since 2016, 8 semesters of the curricular elective module took place in face-to-face teaching (pre-COVID-19 group). From the summer semester of 2020 to the summer semester of 2021, 3 semesters took place as online and hybrid courses (mid-COVID-19 group). Student attitudes and knowledge gains were measured using pretests, posttests, and final evaluations. These data were statistically compared across years, and new forms of teaching under COVID-19 conditions were examined in more detail. Results A total of 189 students participated in the module from the summer semester of 2016 through the summer semester of 2021 (pre-COVID-19: n = 138; mid-COVID-19: n = 51). There was a high level of satisfaction with the module across all semesters, with no significant differences between the groups. There was also no significant difference between the two cohorts in terms of knowledge gain, which was always significant (p < 0.05). COVID-19 adaptations included online seminars using Microsoft Teams or Zoom, the interactive live-streaming of practical training components, and digital simulation games. Conclusion The high level of satisfaction and knowledge gained during the module did not change even under a digital redesign of the content offered. The curricular elective module was consistently evaluated positively by the students, and the adaptation to online teaching was well accepted. Experiences with digital forms of teaching should also be used after the COVID-19 pandemic to create digitally supported blended learning concepts in the field of deployment and disaster medicine and thus further promote the expansion of teaching in this important medical field.
Zusammenfassung Hintergrund Im Rahmen der COVID-19-Pandemie hat die Online-Videosprechstunde einen zunehmenden Stellenwert in der Orthopädie und Unfallchirurgie erhalten. In der Literatur werden verschiedene Adaptationsmöglichkeiten für digitale orthopädisch-unfallchirurgische klassische Gelenk- und Funktionsuntersuchungen für eine Online-Videosprechstunde beschrieben. Methodik Es wurde eine systematische Literaturrecherche der wissenschaftlichen Publikationen für passive digitale Gelenk- und Funktionsuntersuchungen auf der Datenbank PubMed (Zeitraum: Januar 2010 bis April 2021) durchgeführt. Die identifizierten Untersuchungstechniken wurden anschließend systematisch nach Körperregion und Pathologie zusammengefasst, detailliert beschrieben und mit reproduzierten Fotografien nachgestellt. Ergebnisse Es konnten 17 Artikel eingeschlossen werden. Die beschriebenen Untersuchungstechniken waren überwiegend an die klassischen orthopädischen Tests angelehnt und so adaptiert, dass sie selbstständig durch den Patienten durchgeführt werden können. Als Hilfsmittel wurden alltägliche Gegenstände beschrieben. In 5 Publikationen wurde die Durchführung der Online-Videosprechstunde mit klassischen orthopädischen Untersuchungen verglichen. Die Funktionsuntersuchungen in der Online-Videosprechstunde zeigte im Vergleich zur Inspektion und ROM-Testung eine schlechtere Übereinstimmung mit der klassischen orthopädischen Untersuchung. Zusammenfassung In der Literatur existiert eine breite Grundlage an bereits publizierten Untersuchungstechniken für die orthopädisch-unfallchirurgische Videosprechstunde. Die beschriebenen Untersuchungen orientieren sich weitgehend an den klassischen orthopädisch-unfallchirurgischen Tests. Die vorgestellten Untersuchungsmöglichkeiten müssen in Zukunft auf ihre Evidenz geprüft, validiert und ggf. weiter angepasst werden.
Background: Video consultations have proven to be a powerful support for patient-doctor interactions, not only at times of the Covid-19 pandemic. This study analyzed both patients’ and doctors’ acceptance of an orthopedic telemedical consultation (OTC) and compared the examination results of OTC to live consultation (LC) results for discrepancies.Methods: The study was carried out in an orthopedic department of a German hospital between 2019 and 2020. After written informed consent, patients presented voluntarily for follow-ups by OTC and additionally in LC. Both patients and doctors were evaluated for their OTC experience and attitude (Likert-scaled and open questions, 26 to 28 items). The examination results of the OTC versus the LC were compared using a 12-items-checklist. Data was analyzed by quantitative and qualitative statistics. Results: A total of 53 patient cases were included. The OTC atmosphere was rated as pleasant and the experience as very satisfying (average rating on 5-point Likert-Scale, with 1 as strong agreement: doctors: 1.2; patients: 1.3). Various technical and organizational challenges could be identified. OTC, compared to LC, showed no significant differences in patient history, and for results in inspection, palpation and active range of motion. Only in the functional or “passive joint assessment” LC showed a significantly higher suitability (p < 0.05) compared to OTC. Recommendations for further procedures as a result from the OTC, did not significantly differ from the LC.Conclusion: Because of the positive acceptance and the objective benefit of OTC, with very similar clinical results to LC, OTC is recommendable for orthopedic follow-up examinations. In order to assess the functionality of a joint even better, meaningful digital alternatives for already established examination methods should be further investigated.
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