The Eardrum Made Simple Dr. Ramesh Mehay Programme Director, Bradford VTS.
Gask Video Analysis Dr. Ramesh Mehay Course Organiser (Bradford VTS) Dr. Ramesh Mehay Course...
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Transcript of Gask Video Analysis Dr. Ramesh Mehay Course Organiser (Bradford VTS) Dr. Ramesh Mehay Course...
Gask Video AnalysisGask Video AnalysisDr. Ramesh Mehay
Course Organiser (Bradford VTS)
Dr. Ramesh Mehay
Course Organiser (Bradford VTS)
AIMSAIMS
• To highlight the emotional issues that MUST be addressed in a consultation (GASK)
This slide show has slide notes that you may wish to refer to
• To highlight the emotional issues that MUST be addressed in a consultation (GASK)
This slide show has slide notes that you may wish to refer to
OBJECTIVESOBJECTIVES
GASK:• To improve your Problem Detection Skills
(beginning the consultation, picking up and responding to verbal and non verbal cues, demonstrating empathy, asking about health beliefs/concerns, ending the consultation)
• To Improve your Problem Management Skills(ventilating feelings, information giving/educating, making links, negotiating, motivating change, problem solving)
GASK:• To improve your Problem Detection Skills
(beginning the consultation, picking up and responding to verbal and non verbal cues, demonstrating empathy, asking about health beliefs/concerns, ending the consultation)
• To Improve your Problem Management Skills(ventilating feelings, information giving/educating, making links, negotiating, motivating change, problem solving)
Key Point 1Key Point 1
You will soon come to see yourself in a better light.You will soon come to see yourself in a better light.
A common first reaction to the sight of oneself on video is that you look professionally incompetent and
personally unattractive – don’t worry about this..
Why Do We Need Good Communication Skills?
Why Do We Need Good Communication Skills?
• Diagnosis• Giving Information• Giving Support
• Diagnosis• Giving Information• Giving Support
Sources of Information in the Consultation
Sources of Information in the Consultation
• What the patient says (verbal cues)• What the patient does (non-verbal cues)• What the doctor perceives• How the doctor feels• Other parties (eg in 3 way consultations)
• What the patient says (verbal cues)• What the patient does (non-verbal cues)• What the doctor perceives• How the doctor feels• Other parties (eg in 3 way consultations)
The Gask MethodThe Gask Method
After Linda Gask (Psychiatrist, Manchester)
Session 1 (til 3.15pm)
After Linda Gask (Psychiatrist, Manchester)
Session 1 (til 3.15pm)
The Gask MethodThe Gask Method
• Problem Orientated Analysis for demonstrating cues or emotional content
• Facilitator/Group members can stop the tape whenever they see a cue
• Can also use it to demonstrate the structure as well as skills in the consultation
• Problem Orientated Analysis for demonstrating cues or emotional content
• Facilitator/Group members can stop the tape whenever they see a cue
• Can also use it to demonstrate the structure as well as skills in the consultation
How the Gask Method WorksHow the Gask Method Works
• Learners select the consultation• Learners identify issues they want to focus on (agenda
setting)• Focus on the tape• Anyone can stop the tape• Focus on specific skills, not generalities• Focus on consultation skills, not clinical content• Can stop the tape to draw attention to a skill which was
demonstrated, or to something which could have been done differently
• In the latter case, the person who stops the tape must have a specific suggestion for an alternative way of doing it
• Learners select the consultation• Learners identify issues they want to focus on (agenda
setting)• Focus on the tape• Anyone can stop the tape• Focus on specific skills, not generalities• Focus on consultation skills, not clinical content• Can stop the tape to draw attention to a skill which was
demonstrated, or to something which could have been done differently
• In the latter case, the person who stops the tape must have a specific suggestion for an alternative way of doing it
Additional MethodsAdditional Methods
Consider role-playing certain issues
Can use a variety of methods
I. One acts as dr, one acts as pt
II. Whole group acts as dr, one acts as pt
Consider role-playing certain issues
Can use a variety of methods
I. One acts as dr, one acts as pt
II. Whole group acts as dr, one acts as pt
The Video TapeThe Video Tape
PLEASE REMEMBER:
• The doctor on the tape is offering his/her tape “as a gift for the group”
Respect that!
• Think of yourself in that situation before being critical
PLEASE REMEMBER:
• The doctor on the tape is offering his/her tape “as a gift for the group”
Respect that!
• Think of yourself in that situation before being critical
Giving FeedbackGiving Feedback
Your aim is not to destroy the other personA Balancing Act between
Being Too Critical Cosiness Zone
The Most Important Part of Feedback is Offering an Alternative to the Skill or Task Being Analysed
Your aim is not to destroy the other personA Balancing Act between
Being Too Critical Cosiness Zone
The Most Important Part of Feedback is Offering an Alternative to the Skill or Task Being Analysed
Giving FeedbackGiving Feedback
So, feedback requires:• Courage• Skill• Understanding• Self Respect• RESPECT FOR OTHERS
So, feedback requires:• Courage• Skill• Understanding• Self Respect• RESPECT FOR OTHERS
Feedback – general principles revisited
Feedback – general principles revisited
Focus on
• Behaviour which can be changed• Being accurate and clear• The behaviour, not the person• Observation, not inference• Description, not judgement• sharing ideas, not giving advice• Exploring alternatives, not providing answers
Focus on
• Behaviour which can be changed• Being accurate and clear• The behaviour, not the person• Observation, not inference• Description, not judgement• sharing ideas, not giving advice• Exploring alternatives, not providing answers
Feedback – general principlesFeedback – general principles
Also think about:
• How much to give• When to give it
Also think about:
• How much to give• When to give it
Feedback – Pendleton’s RulesFeedback – Pendleton’s Rules
• Clarify matters of fact
• Thing that went well • How they went well
• Things that could have been done differently
• How they could have been done differently
• The pair or group agree areas for development
• Clarify matters of fact
• Thing that went well • How they went well
• Things that could have been done differently
• How they could have been done differently
• The pair or group agree areas for development
Doctor first, then the group
Doctor first, then the group
What to look for in the VideoWhat to look for in the Video
• Look at (behaviour/skills)
Performance
Effects on Others
• Be Aware of (tasks)
What (s)he does
How (s)he does it
• Look at (behaviour/skills)
Performance
Effects on Others
• Be Aware of (tasks)
What (s)he does
How (s)he does it
FACILITATOR NOTESFACILITATOR NOTES
Facilitator Notes – Gask 1Facilitator Notes – Gask 1
Facilitator’s roles• Monitor and facilitate discussion at each tape stop, summaries if
appropriate. Make sure learner’s and group’s needs are both being attended to
• Label/Identify the behaviour of the doctor on the tape and the alternative behaviours suggested by the group
• Stop the tape when the patient clearly exhibits verbal and non verbal cues, if necessary prompt group to develop own skills in identifying these by asking a hierarchy of questions like:
1. “why do you think I stopped the tape there?”2. “Did you notice anything happening at that point?”3. “Did you notice anything about the patient’s voice?”4. “Did you notice her voice changed when she talked about her husband?”• Make sure the group gives constructive criticism : balance between
positive comments and alternative suggestions• Ask for feedback at the end from the doctor who brought the tape• Give them some praise to go home with
Facilitator’s roles• Monitor and facilitate discussion at each tape stop, summaries if
appropriate. Make sure learner’s and group’s needs are both being attended to
• Label/Identify the behaviour of the doctor on the tape and the alternative behaviours suggested by the group
• Stop the tape when the patient clearly exhibits verbal and non verbal cues, if necessary prompt group to develop own skills in identifying these by asking a hierarchy of questions like:
1. “why do you think I stopped the tape there?”2. “Did you notice anything happening at that point?”3. “Did you notice anything about the patient’s voice?”4. “Did you notice her voice changed when she talked about her husband?”• Make sure the group gives constructive criticism : balance between
positive comments and alternative suggestions• Ask for feedback at the end from the doctor who brought the tape• Give them some praise to go home with
Facilitator Notes – Gask 2Facilitator Notes – Gask 2
WHAT CAN YOU TEACH WITH GASK 1
Problem Detection Skills• Beginning the consultation• Picking up/responding to verbal cues• Picking up/responding to non verbal cues• Demonstrating empathy• Asking about Health Beliefs/Concerns• End the Consultation
WHAT CAN YOU TEACH WITH GASK 1
Problem Detection Skills• Beginning the consultation• Picking up/responding to verbal cues• Picking up/responding to non verbal cues• Demonstrating empathy• Asking about Health Beliefs/Concerns• End the Consultation
Facilitator Notes – Gask 3Facilitator Notes – Gask 3
WHAT CAN YOU TEACH WITH GASK 2
Problem Management Skills• Ventilate Feelings• Information/Education• Making Links• Negotiating• Motivating Change• Problem Solving
WHAT CAN YOU TEACH WITH GASK 2
Problem Management Skills• Ventilate Feelings• Information/Education• Making Links• Negotiating• Motivating Change• Problem Solving
Facilitator Notes – Gask 4Facilitator Notes – Gask 4
Possible Pitfalls• First time GPR’s may tend to go for content and
clinical mistakes• Encouraging role play can be difficult in both GPR1
and GPR2’s – don’t enforce it though, negotiate or let them decide
(we don’t want to frighten them off video analysis)• Think of methods of encouraging and motivating a
passive group
Possible Pitfalls• First time GPR’s may tend to go for content and
clinical mistakes• Encouraging role play can be difficult in both GPR1
and GPR2’s – don’t enforce it though, negotiate or let them decide
(we don’t want to frighten them off video analysis)• Think of methods of encouraging and motivating a
passive group