A Nurse Practitioner's Experience Using Remote Presence Technology in an Isolated Community: An Autoethnography
Bibliographic record
Abstract
There are many barriers to accessing healthcare services, particularly for people living in remote communities. Embracing innovation, such as remote presence technology (RPT), is one approach to reducing barriers. Innovations for healthcare service delivery can affect the care provided at the local level.\nResearch Question and Methodology\nI examined the effect of RPT on healthcare service delivery in a remote community. Employing analytic autoethnography, I took a three-pronged approach, considering a systems level, patient care level, and nurse practitioner (NP) practice level.\nOutcomes\nSystems Level\nIn Saskatchewan, rural and remote dwellers experience a disparity in access to primary and specialist care, allied health professionals, and diagnostic services. Contributing factors involve the centralization of services, distance decay, transportation, and unfunded costs. Social determinants of health and systemic oppression contribute to the disparity. This results in patients receiving altered standards of care and poorer health outcomes. \nPatient Care Level\nRPT resulted in superior care provided to patients, resulting in a decrease in morbidity and mortality. Most patients were able to remain in the community rather than being transferred out, and patients and families were actively engaged with developing the care plan.\nNP Practice Level\nWorking directly with specialists through collaboration, mentorship, and coaching enhanced NP work confidence and competence. Professional isolation and decision fatigue decreased. Challenges included not having access to the necessary providers, provider attitudes, inflexible policies, and having to shoulder the burden of care.\nConclusion\nThe introduction of RPT can have a drastic effect on the healthcare system, which is felt most at the local level. Patients can receive appropriate and timely care in their home community. NPs have a unique role working in remote healthcare settings. This model of care could have a significant influence on NP practice. Initiatives should be community-driven and responsive to match needs with services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.009 | 0.006 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".