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Investigating the use of video-recorded consultations as a training tool

In partnership with Health Education England, North Bristol NHS Trust has improved training in consultation skills by using video recordings of specialty trainee consultations as a training tool in the outpatients department.


Related themes

  • Improving training programmes and pathways

Background

This project sought to redesign the current model for training junior doctors in outpatient consultation skills by using audio-visual recordings of outpatient consultations and feedback. The main reason for doing so was to enhance the quality of trainer-trainee interaction using the video recordings to identify opportunities to improve consultation skills and to add value when completing supervised learning events (SLEs[i]). It also aimed to develop the skills of trainers learning from general practitioner colleagues who regularly use these techniques and most importantly, to improve the experience and quality of patient consultations.

How they did it

Specialty trainees in the outpatients department were able to record any number of sessions and were asked to select two recordings to receive feedback on from their supervisor. From this, a total of 34 recordings from 17 trainees were collected. Recordings were made using Trust computer-mounted webcams saved onto encrypted pin-protected USB drives. This method was inexpensive and ensured compliance with NHS security standards.

What they achieved

  • An increase in the number of workplace based assessments (WBAs) implemented? in an outpatient area
  • 85% of feedback sessions have helped trainees to identify areas that will help them to improve their consultation style
  • 85% of feedback sessions helped trainees identify something that they would do differently to improve future consultations
  • 90% of trainees involved felt that feedback on video-recorded consultations should become a routine component of the specialty training process
  • 100% of feedback sessions helped the consultant trainer to learn about their registrar’s consultation style
  • 70% of trainees in involved departments have now received training in outpatient consultation skills.

What they’ve said

“I hated role play at medical school. It would be easy to be put off having a go at this sort of thing by previous bad experiences. Recording yourself in real consultations is very different. It is a bit embarrassing at first, but it is not phoney. I think it is the perfect way to complete a case based discussion or mini-CEX.” Trainee

“Watching the videos back is often encouraging, challenging, embarrassing, moving, and amusing! I notice something new each time I see a new recording, and I hope to use on-going video training to experiment with changes to my consultation style to become the best doctor I can be!” Trainee

“Training based on videotaped consultations has the potential to add real and lasting value to training of all hospital doctors. I wish I had been offered such training earlier in my career.” Trainer

Toolkit

Please look at the toolkit materials in the documents section below. The top tips and business cases have been developed by the BTBC team to support organisations to implement these changes and the case studies and project resources have been developed and approved by the project teams.

The top tips include lessons learnt that have been identified throughout the project. The business case will guide you through the management principles and communications and engagement activities. The case studies provide a detailed overview of the project. Feel free to adapt these resources to suit your projects. Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

[i] Higher specialist trainees collect evidence of learning and formative feedback in the form of Supervised Learning Events (SLEs). These electronic forms encourage active teaching from consultants; and whilst not individually summative, outcomes from these forms are used to inform decision making at Annual Review of Competence Progression (ARCP). This requires consultants to have both the time and skills to school trainees alongside their clinical commitments. The legitimacy and variable application of SLEs has been attributed to lack of preparation of assessors and insufficient time in which to undertake the assessments properly.

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