Reducing uncertainties in virtual consultation: the impact of media naturalness and mental model alignment on patient satisfaction in doctor-patient communication

Shi, Yuxi (2020) Reducing uncertainties in virtual consultation: the impact of media naturalness and mental model alignment on patient satisfaction in doctor-patient communication. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

Virtual consultation (VC) can be simply referred to as a telemedicine service that enables patients to access doctors remotely. It has been largely used by patients with many potential benefits. Nevertheless, many patients still have uncertainties regarding the consultation processes and results, which mostly concern communication with doctors. This thesis aims to answer the following two questions: 1) What uncertainties do patients have during VC, and how do these uncertainties affect patients’ satisfaction towards the consultation? 2) How does the medium affect patients’ perceived uncertainties and their satisfaction with VC? Two studies were conducted to examine the impact of media on perceived uncertainty and patients’ attitudes in doctor-patient computer-mediated communication (CMC), based on uncertainty reduction theory, media naturalness theory, and mental model theory.The first study is a content analysis to analyze why patients are willing to visit doctors virtually and what uncertainties patients have about VC. Patients’ online reviews on five famous virtual consultation systems were collected to do content analysis. The results show that the uncertainties patients have during patient-doctor communication in VC are mainly on doctors’ behaviour, describing symptoms, understanding doctors, doctors’ feelings and emotions, doctors’ attitudes, and VC process. This study helps to understand patients’ concerns about using healthcare systems to do VC and reconceptualizes uncertainty in the context of patient-doctor CMC. The second study is a field experiment to explore how media naturalness (selection of media) and mental model alignment (media content) influence the patients’ perceived uncertainties which then impact on the patients’ satisfaction with the VC experience. After three rounds of pre-tests, 327 valid questionnaires were obtained in the main test and used to do data analysis. The results support the following hypotheses: a) Higher levels of media naturalness reduce patients’ perceived uncertainty level. b) Higher levels of mental model alignment (i.e., the alignment of VC design with patients’ mental models) decrease patients’ perceived uncertainty level. c) Patients’ lower level of perceived uncertainty increases their level of satisfaction. This thesis contributes by revealing the meaning of uncertainties in VC and improving our understanding of how to reduce the patients’ perceived uncertainties by better designing VC system. It provides empirical evidence on how media naturalness and mental model alignment increase patients’ satisfaction on VC by reducing their uncertainties. The results can serve as a basis for further research on how to enhance the design of VC systems to fit patients’ psychological and cognitive processes when they use these systems to visit doctors online. The thesis contributes practically by facilitating healthcare providers to understand patients’ concerns and uncertainties while partaking in VC, and by guiding the design of VC systems to enhance communication between patients and doctors, and thus increase patient satisfaction.

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