Improving teleconsultation services for Francophone communities

Faculty of Education
Education
Health-care
Health technologies
Research and innovation
Michelle Dorion
Image: C. L. Cusack
Transformative innovations in teleconsultation accelerated during the pandemic. When Michelle Dorion (BHSc ’99; ’03, PhD ’24), a physiotherapist, part-time professor, and clinician-researcher at the Institut de Savoir Montfort, experienced firsthand this rapid shift from face-to-face to virtual consultations, she knew it was an opportunity to connect more francophone patients with healthcare providers.

Measuring levels of satisfaction with teleconsultation services in minority language contexts, however, was a problem. “There was a lack of evaluation tools available in French,” says Dorion. It was an observation that marked the beginning of her doctoral research project and the path towards a PhD in education with a concentration in teaching for health professionals.   

Dorion's research, supported by scholarships from the Social Sciences and Humanities Research Council and the Consortium Nationale de formation en santé, aims to improve the availability and accessibility of healthcare services in francophone communities. When she recently walked across the stage to receive her doctorate in education, it was another success along her professional journey in the service of others. 

This conversation is part of our Scholars in Education series. 

Tell us about yourself and your inspiration for pursuing a doctoral degree.

I’ve always been a sporty person. I played on the University of Ottawa water polo team during my undergraduate years. So, it was a natural transition for me to want to promote health by becoming a physiotherapist. Helping people feel better after an injury or an illness is its own reward.  

As a physiotherapist and clinician by training, I've worked in the healthcare sector for 20 years. I am currently a professional practice advisor at the Montfort Hospital. It's a job that allows me to implement best practices from the interprofessional care model and provide quality care to our population.

I worked in an outpatient cardiac and pulmonary rehabilitation clinic, and we did a lot of education on prevention with our patients. That's when I said to myself, I love education, that's what I want to do! I put the two together – healthcare and teaching. I'm passionate about my work and I'm a proud Franco-Ontarian. This is why I decided to go back to school to be able to teach the next generation of healthcare professionals in French. 

In my work as a hospital physiotherapist (before the pandemic), we were already starting to do teleconsultations and wanted to evaluate our virtual services. But, we didn't have any tested measurement tools in French. This is really when my doctoral project started to take shape.

What motivated you to focus on telemedicine?

My professional background enables me to understand clinical realities and to integrate new technologies aimed at improving access to healthcare in minority French-language contexts. The lack of tested evaluation tools in French for measuring patients' and healthcare professionals' satisfaction with virtual consultations at the Montfort Hospital (the only French-speaking teaching hospital in Ontario) sparked my interest in designing measurement instruments.  I was determined to find practical options for the clinical environment. I hope the patient and professional satisfaction measurements that emerged from my project will provide a better understanding of the issues in teleconsultation and offer concrete solutions based on the needs of French-speaking minority communities. All of this is in the current healthcare context, as we experience major transitions in the integration of technology.

Who do you hope will benefit from your work?

Satisfaction measurement is commonly used as an indicator of quality to support clinical, administrative, and professional decisions in health care. However, developing tools to measure satisfaction remains a complex undertaking. This is why I hope spin-offs from my doctoral project will enable professionals who focus on measurement (such as researchers, clinicians, and psychometricians) to pay particular attention to the importance of the methodological choices and analysis involved in designing measurement instruments. This will ensure that clinical decisions and initiatives are supported by tools whose validity has been demonstrated within a rigorous and transparent framework. As for the sociolinguistic issues, the implementation of validated satisfaction questionnaires in French will make it possible to respond to a pressing need to develop sensitive clinical tools adapted to the specific needs of Francophones. This last point is critical to the effective implementation of teleconsultation in clinical environments, and to reducing health disparities. The questionnaires developed during my study will be available in English and French for other healthcare establishments seeking to measure outcomes and satisfaction. 

Were their any unexpected findings from your research?

The development of scientifically-based measurement instruments is not as simple as it may seem. It requires a rigorous approach to ensure that we are measuring what we want to measure. We need to take into account the specific features of our measurement scale. For example, the number of categories or the semantics of the categories can influence the conclusions drawn from the interpretation of the scores. The subtlety of the choice of words can also influence how participants interpret and respond to a question.  In the French-speaking context of my study, a high percentage of patients and healthcare professionals (80%) chose to complete the questionnaire in French. This shows the importance of offering services in French in order to capture the feelings of francophone populations. Despite the rapid rise of teleconsultation in the healthcare sector, we need to proceed with caution. There are advantages to using devices in the clinical setting, but issues remain and risk widening social disparities in healthcare. For example, there are people with varying levels of digital literacy who would need more support in using technology.

Why did you choose the University of Ottawa?

The University of Ottawa is a vibrant academic environment where I’ve had opportunities contribute to scientific knowledge in French and disseminate my research. I'm privileged to have been surrounded by passionate people and to pursue doctoral studies in a place in Canada where there is a large population of francophone researchers interested in medical education, and particularly in the field of evaluation. 

Learn more about Dorion's research findings in her doctoral thesis 'Développement et validation de questionnaires de satisfaction quant à l'utilisation de la téléconsultation auprès des patients et professionnels de la santé en contexte francophone minoritaire.'