Peer Review History

Original SubmissionMarch 26, 2024
Decision Letter - Christoph Strumann, Editor

PONE-D-24-11694Medical students’ and educators’ opinions of teleconsultation in practice and undergraduate education: a UK-based mixed-methods studyPLOS ONE

Dear Dr. O'Carroll,

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We look forward to receiving your revised manuscript.

Kind regards,

Christoph Strumann

Academic Editor

PLOS ONE

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Additional Editor Comments:

The manuscript has been evaluated by two reviewers. While one Reviewer suggest to accept the manuscript, the other reviewer suggest that the manuscript needs to be revised before it could be accepted for publication.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Very interesting and actual scientific article, showing pro and cons of tele consultation. I approved after read and debate with other colleagues. In fact I teach teleheatlh at the university and I agree with the authors about the conclusion and discussion.

Reviewer #2: This study investigated undergraduate medical students’ and medical educators’ opinions on teleconsultation practice in general, as well as their perspectives on teleconsultation education. The topic is interesting and emerging. The amount of data collected is sufficient for the purpose, and the methodological description is adequate. However, some revisions are necessary to improve the readability of the manuscript:

- The section “Opinions of teleconsultation practice” should be shortened and presented more concisely. In its current form, it is redundant and less suitable for a scientific paper compared to a PhD thesis.

- The role of the PhD should be highlighted in the authors' contributions rather than in the introductory phases of the work.

- Describe the age of the participants.

- The authors could highlight whether any sex-related differences emerged.

- In the introduction and/or discussion, it would be helpful to add references to recent manuscripts (e.g., Health Serv Res. 2024 Aug 2;24(1):885. doi: 10.1186/s12913-024-11365-6).

- How were the interview questions selected?

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Reviewer #1: No

Reviewer #2: No

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Revision 1

Thank you to the reviewers and editor for the feedback on our manuscript. We would like to highlight our responses as follows:

Feedback from Reviewer 2:

1. The section “Opinions of teleconsultation practice” should be shortened and presented more concisely. In its current form, it is redundant and less suitable for a scientific paper compared to a PhD thesis.

This section has been reduced as advised.

We shifted parts of theme 4 to theme 3 to avoid repetition and make the information more succinct.

In addition, we deleted 5 quotes and moved one quote to theme 6 (under opinions of teleconsultation education)

2. The role of the PhD should be highlighted in the authors' contributions rather than in the introductory phases of the work.

We rephrased the sentence in the introduction, highlighting that this paper is part of a larger study: “This paper focuses on the findings related to two objectives of a larger study which aimed to investigate the factors that inform the development of teleconsultation education in undergraduate medical education in the UK.”

Additionally, we added a statement below the “Author contributions”: “This study was part of the first author’s PhD supervised by VOC and AOM at the School of Medicine, University of St Andrews (Scotland).”

3. Describe the age of the participants.

We did not collect information on the participants’ ages (neither in the questionnaire nor the interviews). We acknowledge that this might pose a limitation, however, due to the explorative nature of this study, we believe that this information would not add additional information relevant to exploring students’ and educators’ opinions of teleconsultation in medical education. We added a statement in the subsection “Study limitations” – see next comment.

4. The authors could highlight whether any sex-related differences emerged.

This was – similar to point 3 – not the focus of this study. We flagged this in the subsection “Study limitations”: “Due to the exploratory nature of this mixed-methods study, in-depth interferential statistics that allowed an explanatory comparison between and adjustment for participants’ characteristics such as age and gender were not prioritised. Future studies, teleconsultation education evaluations, or quality improvement projects could consider these variables in their data analysis plan.”

5. In the introduction and/or discussion, it would be helpful to add references to recent manuscripts (e.g., Health Serv Res. 2024 Aug 2;24(1):885. doi: 10.1186/s12913-024-11365-6).

Thank you for bringing this study from Italy to our attention. We acknowledge the fast-developing area of teleconsultation/telehealth research and added this and other references:

Recommended study = reference #34: Marsilio, M., Calcaterra, V., Infante, G., Pisarra, M., & Zuccotti, G. (2024). The digital readiness of future physicians: Nurturing the post-pandemic medical education. BMC Health Services Research, 24(1), 885. https://doi.org/10.1186/s12913-024-11365-6

Additional review = reference #21: Alashek, W. A., & Ali, S. A. (2024). Satisfaction with telemedicine use during COVID-19 pandemic in the UK: A systematic review. Libyan Journal of Medicine, 19(1), 2301829. https://doi.org/10.1080/19932820.2024.2301829

Additional study = reference #87: Davies, L., Lawford, B., Bennell, K. L., Russell, T., & Hinman, R. S. (2023). Telehealth education and training in entry-to-practice physiotherapy programs in Australian universities: A qualitative study with university educators. Musculoskeletal Care, 21(2), 491–501. https://doi.org/10.1002/msc.1723

6. How were the interview questions selected?

Thank you for highlighting the lack of reporting here. We added the following statement to the subsection “Development and administration of the research instrument”: “The questions were informed by qualitative research published in this field and related to previous learning and practical application of teleconsultation (54) and the opinions on the implementation of teleconsultation in medical education (54, 55).”

Attachments
Attachment
Submitted filename: Response to Reviewers - v1.1 (1).docx
Decision Letter - Christoph Strumann, Editor

Medical students’ and educators’ opinions of teleconsultation in practice and undergraduate education: a UK-based mixed-methods study

PONE-D-24-11694R1

Dear Dr. O'Carroll,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Christoph Strumann

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Your revised manuscript has only been reviewed by one reviewer (Reviewer 2), as Reviewer 1 has already accepted your manuscript in its previous form.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors have adequately revised the work, addressing all the issues raised. The limitations have been discussed. The manuscript is acceptable in its current form.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #2: No

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Formally Accepted
Acceptance Letter - Christoph Strumann, Editor

PONE-D-24-11694R1

PLOS ONE

Dear Dr. O'Carroll,

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on behalf of

Dr. Christoph Strumann

Academic Editor

PLOS ONE

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