The ecological model of communication in medical encounters: A scoping review.

Abstract

The ecological model of communication in medical encounters (EMCME) could provide a framework for examining issues related to health equity in healthcare interactions. This study seeks to understand how scholarship has engaged with the model and the extent of its use in health equity work. A scoping review of the EMCME was conducted using three major databases: Scopus, Web of Science, and Google Scholar in September 2023. Databases were searched for works citing the article explicating the model. The search returned 336 unique documents. After inclusion and exclusion criteria were applied, 85 documents remained and were analyzed. Many pieces described the model or used the model to frame their work; far fewer pieces used the model to test empirical relationships. Most works, however, focused on a single context: interpersonal. Twenty-five works directly used the model in relation to health equity. There are several contexts of the model that remain underexplored. More attention to these contexts may not only help to better the clinical encounter but advance health equity. Increased use of the full EMCME in all facets - research, practice, and teaching - could provide a framework for framing and organizing work around health equity.