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Educating the Patient for Health Care Communication in the Age of the World Wide Web: A Qualitative Study

Woodward-Kron, Robyn PhD; Connor, Melanie PhD; Schulz, Peter J. PhD; Elliott, Kristine PhD

Academic Medicine:
doi: 10.1097/ACM.0000000000000101
Research Reports

Purpose: Communication skills teaching in medical education has yet to acknowledge the impact of the Internet on physician–patient communication. The authors present a conceptual model showing the variables influencing how and to what extent physicians and patients discuss Internet-sourced health information as part of the consultation with the purpose of educating the patient.

Method: A study exploring the role physicians play in patient education mediated through health information available on the Internet provided the foundation for the conceptual model. Twenty-one physicians participated in semistructured interviews between 2011 and 2013. Participants were from Australia and Switzerland, whose citizens demonstrate different degrees of Internet usage and who differ culturally and ethnically. The authors analyzed the interviews thematically and iteratively. The themes as well as their interrelationships informed the components of the conceptual model.

Results: The intrinsic elements of the conceptual model are the physician, the patient, and Internet based health information. The extrinsic variables of setting, time, and communication activities as well as the quality, availability, and usability of the Internet-based health information influenced the degree to which physicians engaged with, and were engaged by, their patients about Internet-based health information.

Conclusions: The empirically informed model provides a means of understanding the environment, enablers, and constraints of discussing Internet-based health information, as well as the benefits for patients’ understanding of their health. It also provides medical educators with a conceptual tool to engage and support physicians in their activities of communicating health information to patients.

Author Information

Dr. Woodward-Kron is associate professor, Healthcare Communication, Medical Education Unit, Melbourne Medical School, University of Melbourne, Melbourne, Australia.

Dr. Connor is postdoctoral fellow, Institute of Communication and Health, University of Lugano, Lugano, Switzerland.

Dr. Schulz is professor and director, Institute of Communication and Health, University of Lugano, Lugano, Switzerland.

Dr. Elliott is senior lecturer, Medical Education Unit, Melbourne Medical School, University of Melbourne, Melbourne, Australia.

Funding/Support: The University of Melbourne provided study leave funding for Dr. Woodward-Kron to travel to the University of Lugano in 2011.

Other disclosures: None reported.

Ethical approval: The study had ethical approval from the University of Melbourne, Medical Education Unit Human Ethics Advisory Group (HEAG approval 1136463a).

Previous presentations: This study was presented in part at the Communication, Medicine and Ethics Conference (COMET) in Trondheim, Norway, June 28–30, 2012 (paper); at the European Association of Communication in Healthcare at St Andrews, Scotland, September 4–7, 2012 (colloquium); at the Communicating Health Symposium, University of Melbourne December 4, 2012 (paper); and at a departmental seminar at the Royal Children’s Hospital, Melbourne, August 2012.

Correspondence should be addressed to Dr. Woodward-Kron, Medical Education Unit, Melbourne Medical School, 202 Berkeley St., University of Melbourne, Victoria 3010, Australia; telephone: (61) 3-8344-3072; fax: (61) 3-9035-8873; e-mail:

© 2014 by the Association of American Medical Colleges