4.6 Article

Acceptability and feasibility of video-based coaching to enhance clinicians' communication skills with patients

Journal

BMC MEDICAL EDUCATION
Volume 22, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12909-021-02976-2

Keywords

Patient-clinician communication; Feedback; Video coaching

Funding

  1. National Institutes of Health, National Institute of Mental Health [R21 MH115756-02]
  2. Michael E. DeBakey VA Medical Center

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The program proposing real-time observation and video-based coaching to teach clinician communication skills showed high feasibility and acceptability ratings among clinicians. Clinicians found the coaches credible and supportive, feedback useful, video-clips helpful for self-reflection, same-day feedback beneficial, and real patient interactions preferred over standardized patients. Video-based coaching is an effective and timely way for clinicians to learn new communication skills.
Background Despite a growing call to train clinicians in interpersonal communication skills, communication training is either not offered or is minimally effective, if at all. A critical need exists to develop new ways of teaching communication skills that are effective and mindful of clinician time pressures. We propose a program that includes real-time observation and video-based coaching to teach clinician communication skills. In this study, we assess acceptability and feasibility of the program using clinician interviews and surveys. Methods The video-based coaching intervention targets five patient-centered communication behaviors. It uses trained communication coaches and live feed technology to provide coaching that is brief (less than 15 min), timely (same day) and theory-informed. Two coaches were trained to set up webcams and observe live video feeds of clinician visits in rooms nearby. As coaches watched and recorded the visit, they time stamped illustrative clips in real time. Video clips were a critical element of the program. During feedback sessions, coaches used video clips to promote discussion and self-reflection. They also used role play and guided practice techniques to enforce new tips. Clinicians included residents (n = 15), fellows (n = 4), attending physicians (n = 3), and a nurse practitioner (n = 1) at two primary care clinics in Houston, Texas. We administered surveys to clinicians participating in the program. The survey included questions on quality and delivery of feedback, and credibility of the coaches. We also interviewed clinicians following the intervention. We used rapid analysis to identify themes within the interviews. Results Survey measures showed high feasibility and acceptability ratings from clinicians, with mean item scores ranging from 6.4 to 6.8 out of 7 points. Qualitative analysis revealed that clinicians found that 1) coaches were credible and supportive, 2) feedback was useful, 3) video-clips allowed for self-reflection, 4) getting feedback on the same day was useful, and 5) use of real patients preferred over standardized patients. Conclusions Video-based coaching can help clinicians learn new communication skills in a way that is clinician-centered, brief and timely. Our study demonstrates that real-time coaching using live feed and video technology is an acceptable and feasible way of teaching communication skills.

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