Abstracts
Abstract
Background: Virtual care (VC) was rapidly adopted during the COVID-19 pandemic to ensure continuity of primary care. In this study, we explored Family Medicine (FM) residents’ evolving experiences with VC across early (2020), late (2022), and post-pandemic (2024) phases in Saskatchewan, focusing on satisfaction, preparedness, supervision, and perceived impact on training and well-being.
Methods: FM residents across eight distributed sites were surveyed at three time points using a standardized tool. Responses were analyzed using chi-square, Kruskal-Wallis, and post hoc Mann-Whitney U tests (p < 0.05).
Results: Seventy-eight residents participated (2020: n = 26; 2022: n = 19; 2024: n = 33). Satisfaction with VC tended to decline over time (p = 0.074), while requests for additional VC training did not change (p = 0.269). Confidence to use VC post-residency dropped significantly from 100% (2020) to 60.6% (2024; p < 0.001), despite a consistent and moderate amount of supervision. The negative impact of COVID-19 on training declined by 2024 (p = 0.008), while trust in the provincial response to the COVID-19 pandemic also decreased (p < 0.0001).
Conclusions: Although FM residents adapted to VC during the pandemic, long-term sustainability to use VC requires improved training, structured supervision, and curricular integration. Embedding VC competencies into postgraduate education is essential to support hybrid models of care in the evolving primary care landscape.
Résumé
Contexte : Les soins virtuels (SV) ont été rapidement adoptés pendant la pandémie de COVID-19 afin d'assurer la continuité des soins primaires. Dans cette étude, nous avons exploré l'évolution des expériences des résidents en médecine familiale (MF) avec les SV au cours des phases précoce (2020), tardive (2022) et post-pandémique (2024) en Saskatchewan, en nous concentrant sur la satisfaction, la préparation, la supervision et l'impact perçu sur la formation et le bien-être.
Méthodes : Les résidents en MF de huit sites répartis ont été interrogés à trois moments différents à l'aide d'un outil standardisé. Les réponses ont été analysées à l'aide des tests du chi carré, de Kruskal-Wallis et post hoc de Mann-Whitney U (p < 0,05).
Résultats : Soixante-dix-huit résidents ont participé (2020 : n = 26 ; 2022 : n = 19 ; 2024 : n = 33). La satisfaction à l'égard des SV a eu tendance à diminuer au fil du temps (p = 0,074), tandis que les demandes de formation supplémentaire en SV n'ont pas changé (p = 0,269). La confiance dans l'utilisation des SV après la résidence a considérablement diminué, passant de 100 % (2020) à 60,6 % (2024 ; p < 0,001), malgré un niveau de supervision constant et modéré. L'impact négatif de la COVID-19 sur la formation a diminué en 2024 (p = 0,008), tandis que la confiance dans la réponse provinciale à la pandémie de COVID-19 a également diminué (p < 0,0001).
Conclusions : Bien que les résidents en MF se soient adaptés aux SV pendant la pandémie, la viabilité à long terme de l'utilisation des SV nécessite une formation améliorée, une supervision structurée et une intégration dans les programmes d'études. L'intégration des compétences en matière de SV dans la formation postdoctorale est essentielle pour soutenir les modèles hybrides de soins dans le paysage en évolution des soins primaires.
Appendices
Bibliography
- Shaver J. the state of telehealth before and after the COVID-19 pandemic. Prim Care. 2022 Dec;49(4):517-530. Epub 2022 Apr 25. https://doi.org/10.1016/j.pop.2022.04.002.
- Wong A, Bhyat R, Srivastava S, Boisse Lomax L, Appireddy R. Patient care during the COVID-19 pandemic: use of virtual care. J Med Internet Res. 2021;23(1):e20621. https://doi.org/10.2196/20621
- Bokolo Anthony J. Use of telemedicine and virtual care for remote treatment in response to COVID-19 pandemic. J Med Syst. 2020;44(7):132. https://doi.org/10.1007/s10916-020-01596-5
- Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Intern Med. 2018;178(6):745-746. https://doi.org/10.1001/jamainternmed.2018.1314
- College of Family Physicians of Canada. Patient medical home. Available from: https://www.cfpc.ca/en/policy-innovation/health-policy-goverment-relations/the-patient-s-medical-home. [Accessed on Sep 15, 2025].
- Canadian Institutes of Health Research Natural Sciences and Engineering Research Council of Canada and Social Sciences and Humanities Research Council of Canada. Tri-Council Policy statement: ethical conduct for research involving humans - TCPS 2 (2022). Government of Canada. Available from https://ethics.gc.ca/eng/policy-politique_tcps2-eptc2_2022.html. Published 2022. [Accessed Mar 19, 2023].
- Calton B, Abedini N, Fratkin M. Telemedicine in the time of Coronavirus. J Pain Symptom Manage. 2020;60(1):e12-e14. https://doi.org/10.1016/j.jpainsymman.2020.03.019
- Mann DM, Chen J, Chunara R, Testa PA, Nov O. COVID-19 transforms health care through telemedicine: Evidence from the field. J Am Med Inform Assoc. 2020;27(7):1132-1135. https://doi.org/10.1093/jamia/ocaa072
- Wosik J, Fudim M, Cameron B, et al. Telehealth transformation: COVID-19 and the rise of virtual care. J Am Med Inform Assoc. 2020;27(6):957-962. https://doi.org/10.1093/jamia/ocaa067
- Smith N, Newton C, Barbacuta D, Tseng OL. An unexpected transition to virtual care: family medicine residents' experience during the COVID-19 pandemic. BMC Prim Care. 2022;23(1):127. https://doi.org/10.1186/s12875-022-01728-5
- Touchie, C. AFMC Entrustable Professional Activities for Medical School to Residency Transition. The Association of Faculties of Medicine of Canada. Canada. Retrieved from https://coilink.org/20.500.12592/qgtj2q. COI: 20.500.12592/qgtj2q. Published 2021. [Accessed on Sept 17, 2025].
- College of Family Physicians of Canada. Triple C Competency-based curriculum: report of the working group on postgraduate curriculum review – Part 1. Mississauga, ON: CFPC; 2020. https://www.cfpc.ca/CFPC/media/Resources/Education/WGCR_TripleC_Report_English_Final_18Mar11.pdf Accessed on Sept 17, 2025].
- College of Family Physicians of Canada. Virtual care in the Patient’s Meical Home. Mississauga, ON: CFPC; 2021. https://patientsmedicalhome.ca/files/uploads/PMH_Virtual-Care-Supplement_ENG_FINAL_REV.pdf [Accessed on Sept 17, 2025].
- College of Family Physicians of Canada. Priority topics and key features for the assessment of competence in family medicine. Mississauga, ON: CFPC; 2020. https://www.cfpc.ca/CFPC/media/Resources/Certificate-of-Added-Competence/Priority-Topics-and-KFs-with-skills-and-phases-Jan-2011.pdf [Accessed on Sept 17, 2025].
- Lawrence K, Cho J, Torres C, Alfaro-Arias V. building virtual health training tools for residents: a design thinking approach. Front Digit Health. 2022 Jun 13;4:861579. https://doi.org/10.3389/fdgth.2022.
- Shanafelt TD, Ripp J, Trockel M. Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. 2020;323(21):2133–2134. https://doi.org/10.1001/jama.2020.5893
- Bhatia RS, Jamieson T, Shaw J, et al. Virtual care use before and during the COVID-19 pandemic: regional variation and implications for equity in access. CMAJ Open. 2021;9(1):E22-E28. https://doi.org/10.9778/cmajo.20200311
- Ho JSS, Leclair R, Braund H, Bunn J, et al. Transitioning to virtual ambulatory care during the COVID-19 pandemic: a qualitative study of faculty and resident physician perspectives. CMAJ Open. 2022 Aug 16;10(3):E762-E771. https://doi.org/10.9778/cmajo.20210199.
- College of Family Physicians of Canada. A new vision for Canada: family practice—the patient’s medical home 2019. 2019. Available from: https://patientsmedicalhome.ca/files/uploads/PMH_VISION2019_ENG_WEB_2.pdf. [Accessed Feb 04, 2025].
- Nakagawa K, Yellowlees P. Inter-generational effects of technology: why millennial physicians may be less at risk for burnout than baby boomers. Curr Psychiatry Rep. 2020 Jul 13;22(9):45. https://doi.org/10.1007/s11920-020-01171-2.
- Powell RE, Henstenburg JM, Cooper G, Hollander JE, Rising KL. Patient perceptions of telehealth primary care video visits. Ann Fam Med. 2017 May;15(3):225-229. https://doi.org/10.1370/afm.2095.