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Outline

Videotaping medical student consultations a teaching and learning technique for communication and behaviour change counselling skills Graham Bresick Sadick Saban 4 th yr Family Medicine PHFM Health Sciences Faculty. Outline. Introduction / background Aims / objectives What we do (method)

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Outline

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  1. Videotaping medical student consultationsa teaching and learning technique for communication and behaviour change counselling skills Graham BresickSadickSaban4th yr Family MedicinePHFM Health Sciences Faculty

  2. Outline • Introduction / background • Aims / objectives • What we do (method) • What students say (results) • Conclusion / discussion / recommendations

  3. ……….the factors influencing health actions are mainly social and psychological rather than physiological, anatomical and biochemical. Zola K. Pathways to the doctor - from person to patient. Soc Sci Med. 1973:7:677

  4. Communication in the health care contextthe doctor-patient relationship • Biopsychosocial approach • Growing need for effective communication • evidence for patient-centred consultations • shift in the burden of disease to preventable, lifestyle diseases • Effective communication - essential competency

  5. Medical education teaching communication skills • Teaching & assessing communication skills • Growing body of evidence for videotaping • reviewing videotaped consultations improves outcomes • allows students to observe themselves applying their skills • enhances experiential learning • student self-assessment possible • tutor feedback more objective and meaningful • Easy access to videotaping equipment • Use not widespread

  6. Videotaping in the Division of Family Medicine • Videotaping for many years (4th & 6th yrs; PGs) • Use remains limited as a teaching tool • Not used in formal assessment • Students’ evaluation not reported to date

  7. AIMS / OBJECTIVES • To describe the use of videotaping in the teaching and learning communication skills • To document students’ evaluation of the use of the videotaping and review session

  8. METHODS(what we do)

  9. STUDY SITE: Green Point Community Health Centre- Easily accessible from UCT medical school, space available.

  10. Working community, 200 pts/day, comprehensive service

  11. CHC Staff: 4 doctors, 15 nurses, 4 pharmacists

  12. Four separate interviewing rooms

  13. Participants • Students (Interviewers) • 4th yr Medical Students completing Family Medicine block • Prior learning in in Communication Skills (BCC) • All 172 students attended the videotaping session • Friday mornings at Green Point CHC during 2011 • Patients (Interviewees) • Outpatients attending the CHC on Fri am • Chronic medical condition (E.g. Diabetes, Hypertension, Asthma) • Gave informed consent to participate in the session • Not debilitated, could climb the stairs to interviewing rooms • Facilitators • 2 medical doctors teaching communication skills

  14. Procedures and Instrument

  15. Set up Interviewing Rooms

  16. Recruit Patients

  17. Student orientation and tutorial

  18. Facilitator shows student how to use the video camera

  19. Student get signed informed consent from allocated patient

  20. Each student conducts interview with a different patient Video clip

  21. Patient returns to see GP CHC doctor

  22. Student interview review with facilitator in small groups

  23. Students complete questionnaire evaluating session

  24. RESULTS and DATA ANALYSES(What the students say) • 138/172 evaluation sheets completed (80.23%) • All students said: first video interview • All students completed the entire interview • Student refusals = 0 • Data captured and analysed in Excel • Quantitative: Frequency Distributions – Bar Graphs • Qualitative: Most common themes extracted

  25. Quantitative Data

  26. Qualitative Data

  27. Mention 2 or 3 things you found helpful 5 most common themes: • Reviewing my interview to identify bad habits – 123 (89.1%) • Critique from students and colleagues - 123 (89.1%) • Preparatory tutorial before the interview - 22 (15.9) • Interviewing REAL patients - 21 (15.2%) • Watching other students’ interviews - 4 (3.0%)

  28. Mention 2 or 3 things you found unhelpful 5 most common themes: • “Nothing” - 37 (26.8%) • Patient feedback - 8 (5.8%) • Prep tutorial can be done previously - 5 (3.6%) • Difficult to do > 1 item in interview – 4 (2.9%) • Language barrier with patient - 4 (2.9%)

  29. What would you change? 5 most common themes • “Nothing” – 20 (14.5%) • Receive cassette, review in own time – 13 (9.4%) • Have more of these sessions, helpful – 7 (5.1%) • Have more tutors - 5 (3.6%) • Have more time to interview – 4 (3.0%)

  30. Discussion • Conclusion: what do the findings mean? • Discussion & Recommendations

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