Background: Governments and health care providers are keen to find innovative ways to deliver care more efficiently. Interest in electronic consultation (e-consultation) has grown, but the evidence of benefit is uncertain. Objective: This study aimed to assess the evidence of delivering e-consultation using secure email and messaging or video links in primary care. Methods: A systematic review was conducted on the use and application of e-consultations in primary care. We searched 7 international databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, EconLit, and Web of Science; 1999-2017), identifying 52 relevant studies. Papers were screened against a detailed inclusion and exclusion criteria. Independent dual data extraction was conducted and assessed for quality. The resulting evidence was synthesized using thematic analysis. Results: This review included 57 studies from a range of countries, mainly the United States (n=30) and the United Kingdom (n=13). There were disparities in uptake and utilization toward more use by younger, employed adults. Patient responses to e-consultation were mixed. Patients reported satisfaction with services and improved self-care, communication, and engagement with clinicians. Evidence for the acceptability and ease of use was strong, especially for those with long-term conditions and patients located in remote regions. However, patients were concerned about the privacy and security of their data. For primary health care staff, e-consultation delivers challenges around time management, having the correct technological infrastructure, whether it offers a comparable standard of clinical quality, and whether it improves health outcomes. Conclusions: E-consultations may improve aspects of care delivery, but the small scale of many of the studies and low adoption rates leave unanswered questions about usage, quality, cost, and sustainability. We need to improve e-consultation implementation, demonstrate how e-consultations will not increase disparities in access, provide better reassurance to patients about privacy, and incorporate e-consultation as part of a manageable clinical workflow.

Purpose: The authors examine psychologically informed coaching approaches for evidence-based work-applied management through a meta-analysis. This analysis synthesized previous empirical coaching research evidence on cognitive behavioral and positive psychology frameworks regarding a range of workplace outcomes, including learning, performance and psychological well-being.Design/methodology/approach: The authors undertook a systematic literature search to identify primary studies (k = 20,n = 957), then conducted a meta-analysis with robust variance estimates (RVEs) to test the overall effect size and the effects of each moderator.Findings: The results confirm that psychologically informed coaching approaches facilitated effective work-related outcomes, particularly on goal attainment (g = 1.29) and self-efficacy (g = 0.59). Besides, these identified coaching frameworks generated a greater impact on objective work performance rated by others (e.g. 360 feedback) than on coachees' self-reported performance. Moreover, a cognitive behavioral-oriented coaching process stimulated individuals' internal self-regulation and awareness to promote work satisfaction and facilitated sustainable changes. Yet, there was no statistically significant difference between popular and commonly used coaching approaches. Instead, an integrative coaching approach that combines different frameworks facilitated better outcomes (g = 0.71), including coachees' psychological well-being.Practical implications: Effective coaching activities should integrate cognitive coping (e.g. combining cognitive behavioral and solution-focused technique), positive individual traits (i.e. strength-based approach) and contextual factors for an integrative approach to address the full range of coachees' values, motivators and organizational resources for yielding positive outcomes.Originality/value: Building on previous meta-analyses and reviews of coaching, this synthesis offers a new insight into effective mechanisms to facilitate desired coaching results. Frameworks grounded in psychotherapy and positive appear most prominent in the literature, yet an integrative approach appears most effective.

Purpose: The purpose of this paper is to identify essential psychological-informed executive coaching approaches that enhance the organisational learning and development process and outcomes through integrating existing research evidence. Since coaching has been widely used in leadership development related areas and previous studies confirmed that this generates positive effects on individual-level learning in the organisational setting. The identified frameworks and influential factors outlined in this paper can serve as explicit guidelines for the organisation and management team when setting selection and evaluation benchmarks for employing executive coaches.Design/methodology/approach: An integrated review approach was applied to narratively synthesise 234 (k=234) identified peer-review articles between 1995 and 2018. This review followed a rigorous protocol that the authors consulted ten (n=10) experts in the field. Both qualitative and quantitative psychological-focused research evidence was included in this study.Findings: First, certain psychological approaches, such as cognitive behavioural, solution-focused, GROW and strength-based approaches, were highlighted in current research evidence. Second, the essential factors and skills, for instance, building trust, transparency and rapport, and facilitating learning were identified. Third, the main organisational learning and development outcome evaluation methods were outlined in this review, such as the self-efficacy scale, organisational commitment, workplace psychological well-being, 360-degree feedback and the Multifactor Leadership Questionnaire.Research limitations/implications: It is always challenging to integrate research evidence on coaching because of the diversity of theoretical disciplines upon which coaching interventions draw. Therefore, it is difficult to generate a meta-analytic review which can generate statistical results. This review also reveals room for improvement in the quality of existing coaching evidence in accordance with the criteria for evidence-based management or practice (Brineret al., 2009), such as research methodology and evaluation design. Moreover, there is a lack of evidence on this reflective process which helps professional coaches to ensure the quality of their practice and organisational support.Practical implications: This review offers a new perspective on the role psychology plays in the organisational learning and development practices. The identified coaching approaches, influential interpersonal skills and outcome evaluation methods can serve as practical guidelines when applying external coaching to facilitate a better organisational learning and development process and outcome.Originality/value: This is the first literature review to focus on contemporary psychological-informed coaching evidence (between 1995 and 2018) in the workplace setting. Despite the rapid growth in demand for professional coaching practitioners (International Coach Federation, 2016), there is a lack of research-informed evidence to overcome the challenges faced by organisations when employing external coaches, such as what selection criteria or evaluation benchmarks to use. This review takes a practical perspective to identify essential body of knowledge and behavioural indicators required for an executive coach to facilitate an effective learning and development outcome.

Purpose: This study aims to investigate resistance to change and change management through a micro-level interpersonal perspective. Specifically, this paper addresses in what way external change experts, such as coaches, identify distinctive emotional and behavioural indicators of resistance and facilitate individuals to develop positive strengths and motivation to change.Design/methodology/approach: The authors drew upon critical realism and abductive research methodology to understand connections between coaching intervention and individual change resistance through 21 in-depth interviews with independent coaches listed in coaching associations in Germany.Findings: This study first re-evaluates the implications of resistance and extends its meaning from negative obstacles into natural emotional responses of individuals and constructive resources for change. In addition, the study results indicate resistance can be distinguished through both explicit behaviours, body language along with implicit emotional reactions, like being tired or making small jokes. Moreover, several micro-level interpersonal approaches for coaches to apply in dealing with resistance, including understanding coachees' cognitive status and working environment, adapting varied communication styles as well as drawing upon coachees' strengths.Practical implications: The research results offer organisations (e.g. managers and human resource professionals) essential guidelines in micro-level change management strategy by considering external coaching as a valuable option to deal with varied individual, social and contextual factors (e.g. organisational power and politics). From the organisational investment perspective, indicators of resistance and approaches to facilitate coachees' emotional reactions can be served as a preliminary protocol for stakeholders to evaluate the effectiveness of their change management schemes. Moreover, the framework outlined in this research can be considered in the future coaching education and professional development programmes.Originality/value: Overall, this study demonstrates that external coaching is one of the valuable approaches in responding to individual resistance in organisational change management. The research findings widen existing bipolar paradigms of resistance (either change obstacles or positive resource) into a neutral spectrum that holds an impartial view on emotional reactions to change. Furthermore, individual differences and contextual factors play essential roles in the change process, e.g. coachees' personality, personal experiences, knowledge, interpretations to change process and topics as well as organisational context (e.g. power, hierarchy and culture) need to be considered into change management strategy.