• Michael C Matthews, Monica A Patel, Rachel A Rodenbach, Winifred Commers, and Toby C Campbell.
• University of Wisconsin Department of Medicine, Madison, Wisconsin, USA.
• J Palliat Med. 2025 Jan 17.

AbstractIntroduction: High-quality communication and shared decision making (SDM) are crucial elements of effective patient care. SDM conversations are intimate and logistically challenging to capture. Evaluating alternative methods to effectively observe how physicians conduct these conversations may improve research efforts in this core discipline of medicine. Methods: In two distinct qualitative studies (A and B), subspecialist physicians participated in a telemedicine encounter with a simulated patient facing a high-stakes treatment decision. Results: Thirty-seven transplant hematologists (A) and 21 medical oncologists (B) from across the United States successfully completed a telemedicine encounter with a trained actor, allowing for qualitative analysis of their SDM conversations. Discussion: Simulated telemedicine encounters are a feasible method for studying how a broad sample of subspecialty physicians conduct difficult conversations, such as emotionally fraught SDM conversations. This model could improve understanding of the current practice of SDM, identify opportunities for improvement, and serve as a framework for ongoing research of physician communication practices.

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