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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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Videotaping medical student consultationsa teaching and learning technique for communication and behaviour change counselling skills Graham BresickSadickSaban4th yr Family MedicinePHFM Health Sciences Faculty
Outline • Introduction / background • Aims / objectives • What we do (method) • What students say (results) • Conclusion / discussion / recommendations
……….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
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
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
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
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
STUDY SITE: Green Point Community Health Centre- Easily accessible from UCT medical school, space available.
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
Each student conducts interview with a different patient Video clip
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
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%)
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%)
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%)
Discussion • Conclusion: what do the findings mean? • Discussion & Recommendations