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Forschungsdesigns erfordern Flexibilität. Wichtig ist aber, dass Anpassungen nicht immer ausschließlich mit Nachteilen verbunden sein müssen. In dieser Forschungsnotiz möchten wir unsere Überlegungen zu den Auswirkungen von COVID-19 auf die Durchführung von qualitativen Interviews mit irregulären Migrant*innen veranschaulichen. Die Ausführungen wurden in Anlehnung an eines unserer eigenen Projekte entwickelt, bei dem sich die Feldarbeit derzeit in der Planungsphase befindet. Aufgrund ihrer möglichen Relevanz für ähnliche Projekte möchten wir unsere methodischen Überlegungen teilen. Wir liefern Anmerkungen zur aktuellen Situation irregulärer Migrant*innen in verschiedenen (europäischen) Ländern sowie eine Einschätzung der methodischen Durchführbarkeit von qualitativen Face-to-Face-Interviews mit irregulären Migrant*innen und möglicher Alternativen zu dieser Methode (insbesondere verschiedener Formen von Ferninterviews). Abschließend kommen wir auf unsere Entscheidung zu sprechen, mit einem Mixed-Mode-Ansatz zu arbeiten, der es uns erlaubt, verschiedene Fernbefragungsmodi zu nutzen, und damit die nötige Flexibilität zur Anpassung an den Verlauf derartiger gesundheitlicher und gesellschaftlicher Krisen bietet.

Due to the COVID-19 pandemic, most graduate medical education (GME) training programs conducted virtual interviews for prospective trainees during the 2020-2021 application cycle. Many internal medicine (IM) subspecialty fellowship programs hosted virtual interviews for the first time with little published data to guide best practices. To evaluate how IM subspecialty fellowship applicants perceived the virtual interview day experience. We designed a 38-item questionnaire that was sent via email to applicants in eight IM subspecialty programs at a single tertiary academic medical center (University of California, San Francisco) from September-November, 2020. Seventy-five applicants completed the survey (75/244, 30.7%), including applicants from all eight fellowship programs. Most survey respondents agreed that the length of the virtual interview day (mean = 6.4 hours) was long enough to gather the information they needed (n = 65, 86.7%) and short enough to prevent fatigue (n = 55, 73.3%). Almost all survey respondents agreed that they could adequately assess the clinical experience (n = 71, 97.3%), research opportunities (n = 72, 98.6%), and program culture (n = 68, 93.2%). Of the respondents who attended a virtual educational conference, most agreed it helped to provide a sense of the program's educational culture (n = 20, 66.7%). Areas for improvement were identified, with some survey respondents reporting that the virtual interview day was too long (n = 11) or that they would have preferred to meet more fellows (n = 10). Survey respondents indicated that the virtual interview was an adequate format to learn about fellowship programs. These findings can inform future virtual interviews for GME training programs.

(1) COVID-19 pandemic restrictions caused a dramatic shift in research activities, forcing the adoption of remote practices and methods. Despite the known benefits of remote testing, there is limited knowledge on how to prepare and conduct such studies in the industrial context where the target users are experts and company employees. (2) In this article, we detail how we organized VR user tests in five industrial cases during the pandemic, focusing on practicalities and procedures. We cover both on-site testing, including disinfecting and other safety protocols, as well as remote and hybrid setups where both remote and on-site participants were involved. Subject matter experts from eight countries were involved in a total of 22 tests. (3) We share insights for VR user test arrangements relevant to the pandemic, remote and hybrid setups, and an industrial context, among others. (4) Our work confirms that with careful planning it is possible to organize user tests remotely. There are also some limitations in remote user testing, such as reduced visibility and interaction with participants. Most importantly, we list practical recommendations for organizing hybrid user tests with safety and disinfecting procedures for on-site VR use.

There is much interest in virtual consultations using video technology. Randomized controlled trials have shown video consultations to be acceptable, safe, and effective in selected conditions and circumstances. However, this model has rarely been mainstreamed and sustained in real-world settings. The study sought to (1) define good practice and inform implementation of video outpatient consultations and (2) generate transferable knowledge about challenges to scaling up and routinizing this service model. A multilevel, mixed-method study of Skype video consultations (micro level) was embedded in an organizational case study (meso level), taking account of national context and wider influences (macro level). The study followed the introduction of video outpatient consultations in three clinical services (diabetes, diabetes antenatal, and cancer surgery) in a National Health Service trust (covering three hospitals) in London, United Kingdom. Data sources included 36 national-level stakeholders (exploratory and semistructured interviews), longitudinal organizational ethnography (300 hours of observations; 24 staff interviews), 30 videotaped remote consultations, 17 audiotaped face-to-face consultations, and national and local documents. Qualitative data, analyzed using sociotechnical change theories, addressed staff and patient experience and organizational and system drivers. Quantitative data, analyzed via descriptive statistics, included uptake of video consultations by staff and patients and microcategorization of different kinds of talk (using the Roter interaction analysis system). When clinical, technical, and practical preconditions were met, video consultations appeared safe and were popular with some patients and staff. Compared with face-to-face consultations for similar conditions, video consultations were very slightly shorter, patients did slightly more talking, and both parties sometimes needed to make explicit things that typically remained implicit in a traditional encounter. Video consultations appeared to work better when the clinician and patient already knew and trusted each other. Some clinicians used Skype adaptively to respond to patient requests for ad hoc encounters in a way that appeared to strengthen supported self-management. The reality of establishing video outpatient services in a busy and financially stretched acute hospital setting proved more complex and time-consuming than originally anticipated. By the end of this study, between 2% and 22% of consultations were being undertaken remotely by participating clinicians. In the remainder, clinicians chose not to participate, or video consultations were considered impractical, technically unachievable, or clinically inadvisable. Technical challenges were typically minor but potentially prohibitive. Video outpatient consultations appear safe, effective, and convenient for patients in situations where participating clinicians judge them clinically appropriate, but such situations are a fraction of the overall clinic workload. As with other technological innovations, some clinicians will adopt readily, whereas others will need incentives and support. There are complex challenges to embedding video consultation services within routine practice in organizations that are hesitant to change, especially in times of austerity.

COVID-19 pandemic has affected the entire world in many ways. It has sparked a prominent pedagogical shift for university level students, as it has changed the way students learn, attend classes, or communicate with teachers. Globally, every student is forced to adopt Emergency Remote Learning (ERL) as a result of immediate transformation of physical classes into remote education. This two-fold study investigated the differences between traditional distance, online, and virtual learning solutions and the new Emergency Remote Learning (ERL) method for the university level education. Furthermore, a pragmatic mix-method study is conducted in the form of surveys, semi-structured interviews, and diary study spanning across 10 months of pandemic, to examine self-reported insights on ERL challenges, experiences, and learning engagement of the students from Finland and India. Cumulative findings suggest that scheduling, distractions, pessimistic emotions, longer durations, and concentration were the highest challenges faced by the students which impacted their learning experiences and engagement. The study also found that the ERL specific factors like low-interactivity, technical limitations, non-structured, and non-standardized methods had a prominent impact on the effectiveness of remote education. Furthermore, the study has suggested guidelines for improving remote learning experience as a futuristic solution beyond COVID-19 pandemic.

The aim of this paper is to explore the usage and impact of the Internet-of-Things-based Smart Home Technology (IoT-SHT) in Malaysia. Face-to-face interviews were conducted with a total of eleven IoT-SHT users who had a minimum of 2-year usage experience. The semi-structured interview consisted of six questions which were compartmentalised into two sections. Common themes were identified through constant comparison of the inductive data in the coding process. The in-depth interview uncovered six uses of IoT-SHT. Mainly, it was used for real-time remote control, surveillance, sensing, home automation, entertainment, and family communication. It seems clear that the IoT-SHT helped people to save time, changed their lives, improved security, safety, environment condition, fun, convenience, and comfort within the home ground. It also facilitated better health tracking, family care, and energy conservation. Psychologically, the IoT-SHT also enhanced one’s image, offered better companionship, and improved the sense of belongingness, and closeness within the family. This study fills the research gap by providing insights into how the IoT-SHT was used, thereby benefiting users in Malaysia. With the arrival of industrial revolution 4.0, a comprehensive knowledge on the usage of IoT is pertinent. The findings of this study may also serve as a foundation for future research in IoT-SHT adoption. Practically, this study accelerates IoT-SHT diffusion by providing insights to vendors in designing better IoT products and services, based on the popular usages and impactful benefits.

Objective To evaluate a “telephone first” approach, in which all patients wanting to see a general practitioner (GP) are asked to speak to a GP on the phone before being given an appointment for a face to face consultation.Design Time series and cross sectional analysis of routine healthcare data, data from national surveys, and primary survey data.Participants 147 general practices adopting the telephone first approach compared with a 10% random sample of other practices in England.Intervention Management support for workload planning and introduction of the telephone first approach provided by two commercial companies.Main outcome measures Number of consultations, total time consulting (59 telephone first practices, no controls). Patient experience (GP Patient Survey, telephone first practices plus controls). Use and costs of secondary care (hospital episode statistics, telephone first practices plus controls). The main analysis was intention to treat, with sensitivity analyses restricted to practices thought to be closely following the companies’ protocols.Results After the introduction of the telephone first approach, face to face consultations decreased considerably (adjusted change within practices −38%, 95% confidence interval −45% to −29%; P<0.001). An average practice experienced a 12-fold increase in telephone consultations (1204%, 633% to 2290%; P<0.001). The average duration of both telephone and face to face consultations decreased, but there was an overall increase of 8% in the mean time spent consulting by GPs, albeit with large uncertainty on this estimate (95% confidence interval −1% to 17%; P=0.088). These average workload figures mask wide variation between practices, with some practices experiencing a substantial reduction in workload and others a large increase. Compared with other English practices in the national GP Patient Survey, in practices using the telephone first approach there was a large (20.0 percentage points, 95% confidence interval 18.2 to 21.9; P<0.001) improvement in length of time to be seen. In contrast, other scores on the GP Patient Survey were slightly more negative. Introduction of the telephone first approach was followed by a small (2.0%) increase in hospital admissions (95% confidence interval 1% to 3%; P=0.006), no initial change in emergency department attendance, but a small (2% per year) decrease in the subsequent rate of rise of emergency department attendance (1% to 3%; P=0.005). There was a small net increase in secondary care costs.Conclusions The telephone first approach shows that many problems in general practice can be dealt with over the phone. The approach does not suit all patients or practices and is not a panacea for meeting demand. There was no evidence to support claims that the approach would, on average, save costs or reduce use of secondary care.

A mobile-based consultation service, or telehealth, can be used for remote consultations with health care professionals for screening, self-care management, and referral. In rural Bangladesh, where there is high demand for scarce male and even scarcer female doctors, remote consultations may help women seeking maternal and child health care. Aponjon is a mHealth service in Bangladesh that provides weekly voice or text messages to pregnant women, new mothers, and family members on various aspects of maternal, neonatal, and infant health. Subscribers can also access a dedicated 24*7 call center to discuss maternal, neonatal, and infant health or emergencies with medically trained doctors. The service provides advice, primary diagnoses, prescriptions, and referrals to subscriber callers. We investigated the Aponjon service to understand access, acceptability, usability, benefits, and challenges of a mobile phone-based consultation service. We conducted call log data analysis for September to November 2015 to understand how many unique subscribers accessed the service, who accessed the service, the geographical distribution of callers, and the purpose of the calls. We also conducted a qualitative exploratory substudy of eight married women and eight married men who were subscribers to and accessed the service during this time to understand their experiences. We interviewed 11 doctors from the same service who provided phone consultations to subscribers. Approximately 3894 unique subscribers accessed the service for single or multiple consultations during the study period; 68.36% (2662/3894) of subscribers were from rural households, and 53.00% (2064/3894) of calls were made by pregnant women or new mothers. Approximately 96.08% (5081/5288) calls were nonurgent, 2.69% (142/5288) semiurgent, and 1.23% (65/5288) urgent. Almost 64.7% (134/207) semiurgent or urgent calls came between 8 PM and 8 AM. Callers found the consultation service trustworthy, cost-effective, and convenient. The doctors dispelled misconceptions and promoted good health care practices, regular health check-ups, and responsible use of medicine. They helped families understand the severity of sicknesses and advised them to seek care at health facilities for semiurgent or urgent conditions. The service lacked a pro-poor policy to support talk times of subscribers from poor households and a proper referral system to help patients find the right care at the right facilities. Although a regular messaging service is constrained by a one-way communication system, this service using the same platform, gave subscribers access to an abbreviated \"consultation\" with medical doctors. The consultations provided subscribers with valued medical advice and support, although they were limited in their population reach and their integration into the wider medical system. Further research is required to understand the impact of advice and referral, cost-effectiveness, and willingness to pay for mHealth consultation services, but this research suggests that these services should be supported or even expanded.

Background There is a limited understanding of how older patients perceive the potential of using wearables for remote monitoring (RM) at home. Exploring patients' perspectives prior to the implementation of wearables in healthcare can offer valuable insights into what may enhance the effectiveness and outcomes of RM. Objectives The objective of this study was to explore the expectations of older patients with a susceptible chronic illness towards prospective use of the Oura Ring for health monitoring at home. Unlike previous research, which primarily addresses patients' experiences during or after RM has taken place, we explored their perspective before the use. Methods Healthcare professionals identified the 10 study participants among those who were undergoing a diagnostic procedure for the chronic neurological disease iNPH at the Kuopio University Hospital in Finland. All invited patients consented to participate. Qualitative interview data were analysed using reflexive thematic analysis by Braun and Clarke. Findings Patients expected Oura to support both health and broader well‐being through self‐tracking and proactive health management, presenting themselves as active contributors to their care. Being monitored by healthcare professionals or caregivers was viewed as reassuring, mirroring the increasing digitalisation of healthcare and a reduction in in‐person contact. Conclusion The findings highlight the relevance of approaching older patients with chronic conditions to gauge interest in home‐based RM. This emphasises involving the patient perspective early on in RM processes, including decisions about the specific solutions to be used. Patient or Public Contribution The second author is a trained patient expert by experience who ensured that the analysis and the findings were grounded in authentic patient perspectives. The findings were shared with the study participants in the form of an information leaflet, the quality of which was ensured by the expert by experience.

This paper is in response to the article entitled “The process of designing for learning: understanding university teachers’ design work” (Bennett et al., Educ Tech Res Dev 65:125–145, 2017). Bennett et al. (Educ Tech Res Dev 65:125–145) present a descriptive model of the design process that reports findings from a qualitative study investigating the design processes of 30 instructors from 16 Australian universities through semi-structured interviews. This exploratory study provides rich, contextualized descriptions about university teachers’ design process and pinpoints key design characteristics as top-down, breadth-first, iterative, responsive, and reflective. These key design characteristics revealed by the rich contextual descriptions could provide applicable insights into the design process especially for new instructors. The findings of the study could inform how learning design could be adapted during an emergency remote teaching (ERT) as it is dynamic and open to revision. A noteworthy limitation of the study is that complementary data such as design artifacts could be utilized to ensure data triangulation in addition to self-reported data obtained via interviews. The study found that university instructors’ design process did not appear to draw on instructional design models. Therefore, future studies could focus on to what extent and how such models could be used by university instructors. Lastly, future studies may explore how technology is used in ERT design to support their needs. In this article, I share how design can be informed by humanizing pedagogy and pedagogy of care during ERT.