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Conducting a Videotape Review

Establishing the Learning Environment

  • Introductions - Know your learners!
  • State the ground rules-time limits, confidentiality for patient/physician. If grading learners based on the tape, discuss this honestly.
  • Thank the person in the "hot seat", promise respectful feedback.

Setting Goals

  • Choose how to review tape: you may start at the beginning, have the learner pre-select a "trouble spot", watch the ending only.
  • Ask for a brief introduction to the tape, to orient the group to the encounter.
  • Everyone participating should articulate specific goals, which are behaviorally oriented-i.e. observing the use of open-ended questions, motivational interviewing techniques, nonverbal communication etc.

The Videotape Review
A. Give the person in the "hot seat" the remote.
B. View a segment of the tape.
      Stop when:

  • The learner wants to make a comment.
  • There is nervous laughter in the room.
  • You recognize a "nodal point" - a choice the learner makes in conducting the interview.
  • When a structural element is demonstrated i.e. after the opening statement, when the patient tells his story uninterrupted. No more than 2-3 minutes have elapsed.

C. Lead a brief interactive discussion for each segment (second side).

  • Let the person in the hot seat make the first comment.
  • Model effective feedback.
  • Make a limited number of teaching points building on previous segments.
  • Generate hypotheses - about the interview, patient, relationship.
  • Move on.

Ending

  • Acknowledge that there was much more that could have been explored.
  • Ask the learners what they have learned (remind them of their goals). Summarize the feedback.
  • Discuss next steps in practicing new behaviors.
  • Make plans for the next meeting.

Leading a Brief and Focused Discussion of a Videotape Segment

  • Feedback:
    Ask the person in the "hot seat" how she is doing so far.
    Expect a critique, be prepared to give positive feedback.
    Model effective feedback - about the behavior not the person,     nonjudgmental, relevant to the learner and the topic.
    Ask the group to comment (if doing it in a group).
  • Teaching Points: Point out basics using organizing structures:
    Three Functions of the Medical Interview
    1. Data gathering.
    2. Relationship building.
    3. Patient education.

    The Structural Elements of the Interview
    For instance-Opening, Introductions, Assessing and overcoming barriers to communication, Asking open-ended questions, Active listening to and facilitating of the patients opening statement, Using summary statements.


    The Diagnostic Process
    Hypothesis generating and refinement.
    What do we think is going on medically, psychosocially?
    What strategies are being employed to rule-in/rule-out?
    What are the visual cues?


    Specific Content Teaching
    Whatever medical issues arise.
    Be prepared to discuss common psychiatric illness (depression, anxiety, and somatization).



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Macy Initiative on Health Communication
Division of Primary Care
NYU School of Medicine
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