Video-based feedback using real consultations for a formative assessment in communication skills

M C Dohms,C F Collares,I C Tibério

doi:10.1186/s12909-020-1955-6

Abstract

BackgroundPre-recorded videotapes have become the standard approach when teaching clinical communication skills (CCS). Furthermore, video-based feedback (VF) has proven to be beneficial in formative assessments. However, VF in CCS with the use of pre-recorded videos from real-life settings is less commonly studied than the use of simulated patients.To explore: 1) perceptions about the potential benefits and challenges in this kind of VF; 2) differences in the CCC scores in first-year medical residents in primary care, before and after a communication program using VF in a curricular formative assessment.MethodWe conducted a pre/post study with a control group. The intervention consisted of VF sessions regarding CCS, performed in a small group with peers and a facilitator. They reviewed clinical consultations pre-recorded in a primary care setting with real patients. Before and after the intervention, 54 medical residents performed two clinical examinations with simulated patients (SP), answered quantitative scales (Perception of Patient-Centeredness and Jefferson Empathy Scale), and semi-structured qualitative questionnaires. The performances were scored by SP (Perception of Patient-Centeredness and CARE scale) and by two blind raters (SPIKES protocol-based and CCOG-based scale). The quantitative data analysis employed repeated-measures ANOVA. The qualitative analysis used the Braun and Clarke framework for thematic analysis.ResultsThe quantitative analyses did not reveal any significant differences in the sum scores of the questionnaires, except for the Jefferson Empathy Scale. In the qualitative questionnaires, the main potential benefits that emerged from the thematic analysis of the VF method were self-perception, peer-feedback, patient-centered approach, and incorporation of reflective practices. A challenging aspect that emerged from facilitators was the struggle to relate the VF with theoretical references and the resident’s initial stress to record and watch oneself on video.ConclusionVF taken from real-life settings seems to be associated with a significant increase in self-perceived empathy. The study of other quantitative outcomes related to this VF intervention needs larger sample sizes. VF with clinical patients from real healthcare settings appears to be an opportunity for a deeper level of self-assessment, peer-feedback, and reflective practices.

Highlights

Pre-recorded videotapes have become the standard approach when teaching clinical communication skills (CCS)
The main potential benefits that emerged from the thematic analysis of the Video feedback (VF) method were self-perception, peer-feedback, patient-centered approach, and incorporation of reflective practices
VF taken from real-life settings seems to be associated with a significant increase in self-perceived empathy

Summary

Introduction

Pre-recorded videotapes have become the standard approach when teaching clinical communication skills (CCS). VF in CCS with the use of pre-recorded videos from real-life settings is less commonly studied than the use of simulated patients. Pre-recorded videotapes have become the standard approach when teaching clinical communication skills (CCS) [1]. What do we know about videobased feedback in CCS using pre-recorded videos from real-life settings? The closer the assessment is to reality, the more valid it is likely to be [4], studies about VF using pre-recorded videos in a real-life setting have been less frequent than video feedback with simulated patients. Using real consultations allows for a real-life setting analysis and, a better formative assessment [4, 5]. While it may seem threatening to learners at first, it can be potentially more stimulating and rewarding [1, 2]

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