Avoiding artificiality in teleconsultations.

The ideal videoconferencing environment would produce the minimum feeling of artificiality for its users. We assessed nurse and patient perceptions of artificiality by varying the technical and operational procedures for telemedicine in a minor injuries unit. Twenty-five patients and eight emergency nurse practitioners (ENPs) participated in simulated teleconsultations under a variety of different conditions and completed a Likert-scale survey. There was a close correlation between the ENPs' ratings and the patients' ratings for the various factors (r > 0.99). In relation to technical factors, a flicker-free television screen and the user being seated close to the screen were preferred. Similarly, in relation to operational procedures, an initial explanation of telemedicine, introductions and adequate preparation were also preferred. The study suggests that careful attention to technical specifications and operational procedures can reduce the perceived artificiality of teleconsultations.