Video-based feedback using real consultations for a formative assessment in communication skills

Background: Pre-recorded videotapes have become the standard approach when teaching clinical communication
skills (CCS). Furthermore, video-based feedback (VF) has proven to be beneficial in formative assessments. However,
VF in CCS with the use of pre-recorded videos from real-life settings is less commonly studied than the use of
simulated patients.
To explore: 1) perceptions about the potential benefits and challenges in this kind of VF; 2) differences in the CCC
scores in first-year medical residents in primary care, before and after a communication program using VF in a
curricular formative assessment.
Method: We conducted a pre/post study with a control group. The intervention consisted of VF sessions regarding
CCS, performed in a small group with peers and a facilitator. They reviewed clinical consultations pre-recorded in a
primary care setting with real patients. Before and after the intervention, 54 medical residents performed two
clinical examinations with simulated patients (SP), answered quantitative scales (Perception of Patient-Centeredness
and Jefferson Empathy Scale), and semi-structured qualitative questionnaires. The performances were scored by SP
(Perception of Patient-Centeredness and CARE scale) and by two blind raters (SPIKES protocol-based and CCOGbased scale). The quantitative data analysis employed repeated-measures ANOVA. The qualitative analysis used the
Braun and Clarke framework for thematic analysis.
Results: The quantitative analyses did not reveal any significant differences in the sum scores of the questionnaires,
except for the Jefferson Empathy Scale. In the qualitative questionnaires, the main potential benefits that emerged
from the thematic analysis of the VF method were self-perception, peer-feedback, patient-centered approach, and
incorporation of reflective practices. A challenging aspect that emerged from facilitators was the struggle to relate
the VF with theoretical references and the resident’s initial stress to record and watch oneself on video.
Conclusion: VF taken from real-life settings seems to be associated with a significant increase in self-perceived
empathy. The study of other quantitative outcomes related to this VF intervention needs larger sample sizes. VF
with clinical patients from real healthcare settings appears to be an opportunity for a deeper level of self-assessment,
peer-feedback, and reflective practices.
Keywords: Communication skills, Physician/patient relationship, Primary care education, Testing/assessment, Postgraduate
training