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Gask Video Analysis. Dr. Ramesh Mehay Course Organiser (Bradford VTS) www.bradfordvts.co.uk. AIMS. To highlight the emotional issues that MUST be addressed in a consultation (GASK) This slide show has slide notes that you may wish to refer to. OBJECTIVES. GASK:
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Gask Video Analysis Dr. Ramesh Mehay Course Organiser (Bradford VTS) www.bradfordvts.co.uk
AIMS • To highlight the emotional issues that MUST be addressed in a consultation (GASK) This slide show has slide notes that you may wish to refer to
OBJECTIVES GASK: • To improve your Problem Detection Skills (beginning the consultation, picking up and responding to verbal and non verbal cues, demonstrating empathy, asking about health beliefs/concerns, ending the consultation) • To Improve your Problem Management Skills (ventilating feelings, information giving/educating, making links, negotiating, motivating change, problem solving)
Key Point 1 You will soon come to see yourself in a better light. A common first reaction to the sight of oneself on video is that you look professionally incompetent and personally unattractive – don’t worry about this.
Why Do We Need Good Communication Skills? • Diagnosis • Giving Information • Giving Support
Sources of Information in the Consultation • What the patient says (verbal cues) • What the patient does (non-verbal cues) • What the doctor perceives • How the doctor feels • Other parties (eg in 3 way consultations)
The Gask Method After Linda Gask (Psychiatrist, Manchester) Session 1 (til 3.15pm)
The Gask Method • Problem Orientated Analysis for demonstrating cues or emotional content • Facilitator/Group members can stop the tape whenever they see a cue • Can also use it to demonstrate the structure as well as skills in the consultation
How the Gask Method Works • Learners select the consultation • Learners identify issues they want to focus on (agenda setting) • Focus on the tape • Anyone can stop the tape • Focus on specific skills, not generalities • Focus on consultation skills, not clinical content • Can stop the tape to draw attention to a skill which was demonstrated, or to something which could have been done differently • In the latter case, the person who stops the tape must have a specific suggestion for an alternative way of doing it
Additional Methods Consider role-playing certain issues Can use a variety of methods • One acts as dr, one acts as pt • Whole group acts as dr, one acts as pt
The Video Tape PLEASE REMEMBER: • The doctor on the tape is offering his/her tape “as a gift for the group” Respect that! • Think of yourself in that situation before being critical
Giving Feedback Your aim is not to destroy the other person A Balancing Act between Being Too Critical Cosiness Zone The Most Important Part of Feedback is Offering an Alternative to the Skill or Task Being Analysed
Giving Feedback So, feedback requires: • Courage • Skill • Understanding • Self Respect • RESPECT FOR OTHERS
Feedback – general principles revisited Focus on • Behaviour which can be changed • Being accurate and clear • The behaviour, not the person • Observation, not inference • Description, not judgement • sharing ideas, not giving advice • Exploring alternatives, not providing answers
Feedback – general principles Also think about: • How much to give • When to give it
Feedback – Pendleton’s Rules • Clarify matters of fact • Thing that went well • How they went well • Things that could have been done differently • How they could have been done differently • The pair or group agree areas for development Doctor first, then the group Doctor first, then the group
What to look for in the Video • Look at (behaviour/skills) Performance Effects on Others • Be Aware of (tasks) What (s)he does How (s)he does it
Facilitator Notes – Gask 1 Facilitator’s roles • Monitor and facilitate discussion at each tape stop, summaries if appropriate. Make sure learner’s and group’s needs are both being attended to • Label/Identify the behaviour of the doctor on the tape and the alternative behaviours suggested by the group • Stop the tape when the patient clearly exhibits verbal and non verbal cues, if necessary prompt group to develop own skills in identifying these by asking a hierarchy of questions like: • “why do you think I stopped the tape there?” • “Did you notice anything happening at that point?” • “Did you notice anything about the patient’s voice?” • “Did you notice her voice changed when she talked about her husband?” • Make sure the group gives constructive criticism : balance between positive comments and alternative suggestions • Ask for feedback at the end from the doctor who brought the tape • Give them some praise to go home with
Facilitator Notes – Gask 2 WHAT CAN YOU TEACH WITH GASK 1 Problem Detection Skills • Beginning the consultation • Picking up/responding to verbal cues • Picking up/responding to non verbal cues • Demonstrating empathy • Asking about Health Beliefs/Concerns • End the Consultation
Facilitator Notes – Gask 3 WHAT CAN YOU TEACH WITH GASK 2 Problem Management Skills • Ventilate Feelings • Information/Education • Making Links • Negotiating • Motivating Change • Problem Solving
Facilitator Notes – Gask 4 Possible Pitfalls • First time GPR’s may tend to go for content and clinical mistakes • Encouraging role play can be difficult in both GPR1 and GPR2’s – don’t enforce it though, negotiate or let them decide (we don’t want to frighten them off video analysis) • Think of methods of encouraging and motivating a passive group