JMIR Publications

ABSTRACT

Background:

The growing reliance on virtual consultations in primary care has reshaped traditional General Practitioner (GP)-patient communication dynamics, presenting new challenges that affect care quality and safety.

Objective:

This study explores communication challenges and gaps, particularly relevant to virtual consultations compared to face-to-face interactions, as well as identifying mitigation strategies from both GPs’ and patients’ perspectives.

Methods:

This qualitative study employed four online focus group discussions with a purposive sample of UK-based GPs and patients. Data were analysed using a deductive-inductive thematic approach with NVivo software. The extended Shannon-Weaver Communication Model (SWCM) and the Capability, Opportunity, Motivation and Behaviour (COM-B) model guided the analysis of communication challenges and mitigation strategies, respectively. The consolidated criteria for reporting qualitative research (COREQ) were followed to ensure rigorous reporting.

Results:

A total of 21 participants (12 patients and 9 GPs) took part in four online focus group discussions, two for patients and two for GPs. Six key themes on communication challenges emerged: five aligned with the extended SWCM (related to the sender-encoder, message, channel, receiver-decoder-feedback, and context), and a new one inductively identified (patient autonomy and inclusivity). GPs, as senders, highlighted missing visual cues, affecting message clarity in remote communication channels. Patients, as receivers, reported difficulties explaining symptoms remotely and reduced emotional connection and perceived empathy, linked to contextual challenges and the need for inclusive communication. Mitigation strategies were mapped to the COM-B model: capability (training/resources), opportunity (triage/tools), and motivation (patient engagement/system adaptability), with participants emphasising tailored training, standardised approaches, and flexible models to support effective, inclusive virtual communication.

Conclusions:

This study highlights communication gaps in virtual consultations and proposes actionable mitigation strategies. Tailored use of virtual modalities, supported by structured training and policy efforts, is essential to ensure effective and safe remote communication.