Paired Observation and Video Editing (POVE)
description
Transcript of Paired Observation and Video Editing (POVE)
Paired Paired Observation and Observation and
Video EditingVideo Editing(POVE)(POVE)Blending Continuous Peer Feedback Blending Continuous Peer Feedback and Reflection to and Reflection to
Strengthen Communication TrainingStrengthen Communication Training
Larry Mauksch, M.Ed, University of WashingtonLarry Mauksch, M.Ed, University of Washington
AcknowledgmentsAcknowledgments
Angel Platus, MDAngel Platus, MD
Kim O’Conner, MDKim O’Conner, MD
Stu Farber, MDStu Farber, MD
Tom Greer, MD, MPHTom Greer, MD, MPH
Many in this roomMany in this room
A challenge in teaching and A challenge in teaching and assessingassessing
communication in medicine…communication in medicine…
Without protected time, it is difficult Without protected time, it is difficult
for learners to intentionallyfor learners to intentionally….….
Practice Practice
Define Define
ReflectReflect upon upon
Refine the use ofRefine the use of
AssessAssess
IntegrateIntegrate
……communication skillscommunication skills
Goals: Goals: Paired Paired Observation Observation
and Video Editingand Video Editing To help students develop a lasting, To help students develop a lasting,
articulate “observer self”--the ability to articulate “observer self”--the ability to
reflect on and refine (communication) skill reflect on and refine (communication) skill
use to optimize interactions with patients.use to optimize interactions with patients.
To demonstrate “growing competence” in To demonstrate “growing competence” in
using core communication skills.using core communication skills.
To create a learning laboratory for facultyTo create a learning laboratory for faculty
Course PhilosophyCourse Philosophy Clinicians have a strong, but often Clinicians have a strong, but often
undisclosed desire to become more undisclosed desire to become more effective communicators.effective communicators. They experience They experience ineffable inadequacyineffable inadequacy
If given the language, time, and If given the language, time, and responsibility, trainees will help one responsibility, trainees will help one another increase competence.another increase competence.
Assessment and learning should be part of Assessment and learning should be part of one integrated, ongoing process.one integrated, ongoing process.
Differentiation Precedes Differentiation Precedes IntegrationIntegration
Observing and categorizing Observing and categorizing behavior enhances articulation behavior enhances articulation
One’s precision (differentiation) in One’s precision (differentiation) in describing skills is proportional to describing skills is proportional to one’s ability to be creative in skill one’s ability to be creative in skill application (integration).application (integration).
With a distant reference to Michael Polyani’s book, Personal Knowledge
Course Design: 4 weeksCourse Design: 4 weeks
Paired Observation PhasePaired Observation Phase 3 weeks3 weeks
Video Editing and Presentation Video Editing and Presentation PhasePhase 1 week1 week
Paired Observation: Paired Observation: First 3 weeksFirst 3 weeks
Students see patients on preceptors’ scheduleStudents see patients on preceptors’ schedule They They alwaysalways see patients together alternating see patients together alternating
roles as observer and “physician” roles as observer and “physician” Tracking forms are used to:Tracking forms are used to:
structure observation and feedbackstructure observation and feedback catalog interviews for video editingcatalog interviews for video editing
Instructor(s) give mini didactics, review videos Instructor(s) give mini didactics, review videos and discuss encounters with studentsand discuss encounters with students
Interviews are videotaped, with patient consentInterviews are videotaped, with patient consent
Mini Talk TopicsMini Talk Topics4 week course (12-14 hours of 4 week course (12-14 hours of
presentation)presentation) Orientation to courseOrientation to course
Giving and receiving Giving and receiving
feedbackfeedback
Video recording, editing Video recording, editing
and patient consentand patient consent
Overview: relationship, Overview: relationship,
communication and communication and
efficiencyefficiency
Mindful practiceMindful practice
Upfront, collaborative Upfront, collaborative
agenda settingagenda setting Eliciting the patient Eliciting the patient
perspectiveperspective Reaching common Reaching common
groundground Family assessmentFamily assessment Behavior change / Behavior change /
primary care counselingprimary care counseling Requested topicsRequested topics
Schedule: Paired Schedule: Paired Observation Observation
MonMon TuesTues WedWed ThursThurs FriFriOrient, Orient, Giving Giving FeedbacFeedbackk
ClinicClinic
Agenda Agenda settingsetting
ClinicClinic
ClinicClinic ClinicClinic
DebriefDebrief
ClinicClinic
Shared Shared DecisioDecisionn
ClinicClinic
OverviewOverview
ClinicClinic
DebriefDebrief
Cues Cues and PPIand PPI
ClinicClinic
ClinicClinic
Video Video reviewreview
ClinicClinic
Tape Tape catalogcatalog
Video Editing-4th weekVideo Editing-4th week Students create a Students create a video essayvideo essay examining examining
their growththeir growth
Students design, film and edit a role-Students design, film and edit a role-
played played teaching tapeteaching tape
Students present their work in one or Students present their work in one or
more interactive seminars to fellow more interactive seminars to fellow
students, residents and facultystudents, residents and faculty
Videotape Editing:Videotape Editing: Instructions for Students Instructions for Students
For video essay, “study your growth by For video essay, “study your growth by
including..”:including..”: Baseline skillsBaseline skills
StrugglesStruggles
Best performancesBest performances
Use protected time to review, catalog and Use protected time to review, catalog and
editedit Create a teaching tapeCreate a teaching tape Be creative and have fun!Be creative and have fun!
Schedule: Video Editing Schedule: Video Editing MonMon TuesTues WedWed ThursThurs FriFri
Video Video review review and and editingediting
ClinicClinic Video Video review review and and editingediting
TeachinTeaching tape g tape creatiocreationn
EvalEval
TeachinTeaching tape g tape creatiocreationn
Video Video review review and and editingediting
Video Video review review and and editingediting
PresentPresent TeachinTeaching tape g tape creatiocreationn
PresentPresent
Summary of a 4 Week Summary of a 4 Week CourseCourse
Student pairs see 50-60 patients in 3 Student pairs see 50-60 patients in 3 weeks weeks
75% of patients consent to be videotaped75% of patients consent to be videotaped
Video essay is 25- 30 minutes.Video essay is 25- 30 minutes.
Video essay presentations easily take 90 Video essay presentations easily take 90 minutes because discussion is expansive.minutes because discussion is expansive.
Teaching tapes have been used to train Teaching tapes have been used to train hundreds of students and facultyhundreds of students and faculty
All students demonstrate All students demonstrate growth in:growth in:
Upfront collaborative agenda settingUpfront collaborative agenda setting
Picking up on patient cues and Picking up on patient cues and
exploring patient, family and cultural exploring patient, family and cultural
perspectiveperspective
Expression of empathyExpression of empathy
Reaching mutual agreement on a planReaching mutual agreement on a plan
EfficiencyEfficiency
Student EvaluationsStudent Evaluations( 11 pairs of 4th year students)( 11 pairs of 4th year students) ““Peak experience”Peak experience” ““Best course in medical school”Best course in medical school” Students feel:Students feel:
More organizedMore organized More able attend to the patientsMore able attend to the patients More able to learn about disease, More able to learn about disease,
because they are…because they are… Less anxious about time managementLess anxious about time management Interviewing is less mysteriousInterviewing is less mysterious
POVE - secondary POVE - secondary outcomesoutcomes
Faculty learningFaculty learning
Students learn teamwork skillsStudents learn teamwork skills
Student pairs are efficientStudent pairs are efficient
Contribution to the educational Contribution to the educational
communitycommunity
Other ApplicationsOther Applications Use only Paired Observation (no video): Use only Paired Observation (no video):
Medical student / Residency training on a larger scale Medical student / Residency training on a larger scale
Faculty developmentFaculty development
CMECME
Conceptual preparation can be done without Conceptual preparation can be done without
faculty time: videos, reading, Powerpointfaculty time: videos, reading, Powerpoint
Videotapes(or CDs or DVDs) become portfoliosVideotapes(or CDs or DVDs) become portfolios
LimitationsLimitations
Not all rotations would workNot all rotations would work Decreased patient volume?Decreased patient volume? Start-up cost for AV and computer Start-up cost for AV and computer
equipment equipment Some people may have difficulty learning to Some people may have difficulty learning to
accept and give feedbackaccept and give feedback Paired observation may feel burdensome to Paired observation may feel burdensome to
preceptors (…but it takes no more time)preceptors (…but it takes no more time) POVE design deserves research…POVE design deserves research…
Video Editing TipsVideo Editing Tips
Orientation takes < 40 minutes (iMovie 2)Orientation takes < 40 minutes (iMovie 2)
Introduce students to editing by using three, Introduce students to editing by using three,
one minute clips of themselves in role playsone minute clips of themselves in role plays
Use software tutorial programsUse software tutorial programs
Tapes should be no longer than 30 minutesTapes should be no longer than 30 minutes
Use short clips, 15 seconds to 3 minutesUse short clips, 15 seconds to 3 minutes
Clips should include enough lead to create Clips should include enough lead to create
context for the viewer-- 3-10 secondscontext for the viewer-- 3-10 seconds
Video Editing- Video Editing- Costs and EquipmentCosts and Equipment
Current prices of PCs and Macs between Current prices of PCs and Macs between
$1100 and $2500 and beyond$1100 and $2500 and beyond Get lots of RAM - at least 512; 1gig betterGet lots of RAM - at least 512; 1gig better
Consider buying extra hard drive for storage Consider buying extra hard drive for storage
and faster editing and faster editing
Using analog cameras requires purchase Using analog cameras requires purchase
of analog to digital converter, about $300of analog to digital converter, about $300
Cost of VCR, monitor and tapesCost of VCR, monitor and tapes
Logistical ConsiderationsLogistical Considerations Preceptors must be oriented, trained if Preceptors must be oriented, trained if
possiblepossible Great way to reinforce resident learning and Great way to reinforce resident learning and
educate facultyeducate faculty Distribute precepting across several senior Distribute precepting across several senior
residents and facultyresidents and faculty Nursing staff need to be included to make Nursing staff need to be included to make
sure patient flow is not adversely affectedsure patient flow is not adversely affected Protect time in the preceptor’s schedule Protect time in the preceptor’s schedule Distribute schedules ahead of time to all Distribute schedules ahead of time to all
involvedinvolved
Logistical Instructions for Logistical Instructions for StudentsStudents
Meet nursing staff and preceptors in Meet nursing staff and preceptors in
advance of each clinicadvance of each clinic Protect time for video review and loggingProtect time for video review and logging Never see two patients at the same time, Never see two patients at the same time,
especially with the same preceptorespecially with the same preceptor Protect time in advance for student video Protect time in advance for student video
presentationpresentation
POVE DISSEMINATION POVE DISSEMINATION PROJECTPROJECT
Funded by Arthur Vining Davis Funded by Arthur Vining Davis FoundationsFoundations
Three year program to create a Three year program to create a learning community with 9 medical learning community with 9 medical schoolsschools
GoalsGoals
To disseminate the POVE modelTo disseminate the POVE model To stimulate faculty exploration of To stimulate faculty exploration of
how to teach and how students learnhow to teach and how students learn To provide an in-house resource for To provide an in-house resource for
the creation of training tapesthe creation of training tapes To study the learning process of To study the learning process of
medical students and their teachersmedical students and their teachers
Participants ReceiveParticipants Receive
Three day training in Seattle (winter, 07’)Three day training in Seattle (winter, 07’)
Computer with video editing softwareComputer with video editing software
Curriculum and site visitCurriculum and site visit
Three day learning & evaluation conference in Three day learning & evaluation conference in
Seattle for one faculty and two students (fall, Seattle for one faculty and two students (fall,
08’)08’)
POVE Research POVE Research
Web surveys of faculty and studentsWeb surveys of faculty and students Qualitative and QuantitativeQualitative and Quantitative
Learning and Evaluation conference Learning and Evaluation conference Focus groupsFocus groups
FacultyFaculty StudentsStudents
Video essay reviewsVideo essay reviews Teaching tape reviewsTeaching tape reviews
Pre-post tape comparisonPre-post tape comparison
www.fammed.washington.edu/pove