Video gives us an opportunity to slowly and methodically review consultations, to develop efficient and patient-centred consulting skills. When videos are analysed against RCGP consultation observation tool (COT) criteria, it is possible to identify what is done well and which aspects of our consulting could do with a bit more polish.
Videos are used for COT assessments to give evidence for several GP competencies: communication skills, practising holistically, data gathering and interpretation, making a diagnosis/making decisions and clinical management. - Set up a video clinic
Liaising with receptionists is vital. A receptionist who explains to patients why you are videoing, passes on the necessary consent forms, holds your telephone calls and warns other staff not to interrupt your video surgery is worth her weight in gold.
Putting up a large, smart sign on the door of your consulting room also signals to patients and clinicians the importance of the video surgery.
Be familiar with the video equipment. Ensure that the picture and sound quality is good.- Review the video
While videos tend to be used for COT assessments, they can also form the basis for discussions on disease management. Those difficult consultations we would like to erase often provide a wealth of information about our attitudes, particularly when analysed against Berne or Balint constructs.
It may be useful to limit the discussion to two or three learning points per video. By practising and reviewing these behaviours, you are also preparing for the clinical skills assessment. - Obtain feedback
Trainers tend to break the complex consultation competencies into bite-sized learning outcomes (knowledge, attitude, skills). Obtain specific feedback from your trainers on which require work. - Create an action plan
At the end of the discussion, write down a few strategies you wish to implement in your future consultations. Review the next set of videos to see if you have managed to action these learning needs. - Reflect on the teaching
Evaluate what has been useful and enjoyable about the videoing and subsequent discussion. A structured reflective account (SRA) about your attitudes to certain patients or ways of learning for your ePortfolio demonstrates awareness of your professional development.
- Contributed by Dr Prashini Naidoo, a GP trainer in Oxfordshire. She qualified as a GP in 2002
- Brief the receptionist.
- Check the video equipment.
- Review the video using COT criteria or a consultation model.
- Obtain feedback about your consulting knowledge, skills and attitudes.
- Identify communication techniques to try in your next consultation.
- Write an SRA summarising your professional insights.