Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 368 Plantation St, Worcester, MA, 01605, USA.
National Board of Medical Examiners, Philadelphia, USA.
BMC Med Educ. 2022 Dec 28;22(1):899. doi: 10.1186/s12909-022-03984-6.
Physician delivered weight management counseling (WMC) occurs infrequently and physicians report lack of training and poor self-efficacy. The purpose of this study was to develop and test the Video-based Communication Assessment (VCA) for weight management counseling (WMC) training in medical residents.
This study was a mixed methods pilot conducted in 3 phases. First, we created five vignettes based on our prior data and expert feedback, then administered the vignettes via the VCA to Internal Medicine categorical residents (n = 16) from a University Medical School. Analog patients rated responses and also provided comments. We created individualized feedback reports which residents were able to view on the VCA. Lastly, we conducted debriefing interviews with the residents (n = 11) to obtain their feedback on the vignettes and personalized feedback. Interviews were transcribed, and we used thematic analysis to generate and apply codes, followed by identifying themes.
Descriptive statistics were calculated and learning points were created for the individualized feedback reports. In VCA debriefing interviews with residents, five themes emerged: 1) Overall the VCA was easy to use, helpful and more engaging than traditional learning and assessment modes, 2) Patient scenarios were similar to those encountered in the clinic, including diversity, health literacy and different stages of change, 3) The knowledge, skills, and reminders from the VCA can be transferred to practice, 4) Feedback reports were helpful, to the point and informative, including the exemplar response of how to best respond to the scenario, and 5) The VCA provide alternatives and practice scenarios to real-life patient situations when they aren't always accessible.
We demonstrated the feasibility and acceptability of the VCA, a technology delivered platform, for delivering WMC to residents. The VCA exposed residents to diverse patient experiences and provided potential opportunities to tailor providers responses to sociological and cultural factors in WMC scenarios. Future work will examine the effect of the VCA on WMC in actual clinical practice.
医生提供的体重管理咨询(WMC)很少发生,医生报告缺乏培训和自我效能感差。本研究的目的是为住院医师开发和测试基于视频的沟通评估(VCA)用于体重管理咨询(WMC)培训。
本研究是一项混合方法的试点研究,分为三个阶段进行。首先,我们根据先前的数据和专家反馈创建了五个病例,然后通过 VCA 向来自一所大学医学院的内科住院医师(n=16)进行了这些病例。模拟患者对反应进行评分,并提供评论。我们创建了个性化反馈报告,住院医师可以在 VCA 上查看。最后,我们对住院医师(n=11)进行了汇报访谈,以获取他们对病例和个性化反馈的反馈。访谈记录被转录,我们使用主题分析生成和应用代码,然后确定主题。
计算了描述性统计数据,并为个性化反馈报告创建了学习要点。在住院医师的 VCA 汇报访谈中,出现了五个主题:1)总体而言,VCA 使用方便、有帮助且比传统学习和评估模式更具吸引力,2)患者情况与诊所中遇到的情况相似,包括多样性、健康素养和不同的改变阶段,3)VCA 的知识、技能和提示可以转移到实践中,4)反馈报告有帮助、切中要害且信息丰富,包括如何最好地回应情景的示例响应,5)VCA 为现实生活中的患者情况提供了替代方案和实践情景,而这些情况并不总是可及的。
我们证明了 VCA 作为一种技术交付平台,用于向住院医师提供 WMC 的可行性和可接受性。VCA 使住院医师接触到不同的患者体验,并为在 WMC 情景中针对社会和文化因素调整提供者的反应提供了潜在机会。未来的工作将研究 VCA 在实际临床实践中对 WMC 的影响。