Improving feedback by using first-person video during the emergency medicine clerkship

Abstract

PurposeProviding feedback to students in the emergency department during their emergency medicine clerkship can be challenging due to time constraints, the logistics of direct observation, and limitations of privacy. The authors aimed to evaluate the effectiveness of first-person video, captured via Google Glass™, to enhance feedback quality in medical student education.Material and methodsAs a clerkship requirement, students asked patients and attending physicians to wear the Google Glass™ device to record patient encounters and patient presentations, respectively. Afterwards, students reviewed the recordings with faculty, who provided formative and summative feedback, during a private, one-on-one session. We introduced the intervention to 45, fourth-year medical students who completed their mandatory emergency medicine clerkships at a United States medical school during the 2015–2016 academic year.ResultsStudents assessed their performances before and after the review sessions using standardized medical school evaluation forms. We compared students’ self-assessment scores to faculty assessment scores in 14 categories using descriptive statistics and symmetric tests. The overall mean scores, for each of the 14 categories, ranged between 3 and 4 (out of 5) for the self-assessment forms. When evaluating the propensity of self-assessment scores toward the faculty assessment scores, we found no significant changes in all 14 categories. Although not statistically significant, one fifth of students changed perspectives of their clinical skills (history taking, performing physical exams, presenting cases, and developing differential diagnoses and plans) toward faculty assessments after reviewing the video recordings.ConclusionFirst-person video recording still initiated the feedback process, allocated specific time and space for feedback, and possibly substituted for the direct observation procedure. Additional studies, with different outcomes and larger sample sizes, are needed to understand the effectiveness of first-person video in improving feedback quality.

Direct Observation Tools in Emergency Medicine: A Systematic Review of the Literature

“…Twenty studies were conducted in the United States, 14–33 13 were performed in Canada, 34–46 three took place in Australia, 47–49 and two were conducted in Taiwan 50,51 . Thirty‐three studies involved resident physicians, 15,17–23,25–32,34–47,49,50 four studies involved medical students, 14,16,24,33 and one did not report the learner level 48 .…”

“…Twenty studies were conducted in the United States, 14–33 13 were performed in Canada, 34–46 three took place in Australia, 47–49 and two were conducted in Taiwan 50,51 . Thirty‐three studies involved resident physicians, 15,17–23,25–32,34–47,49,50 four studies involved medical students, 14,16,24,33 and one did not report the learner level 48 . Twenty‐two were prospective studies, 14,16,17,22–28,30,31,33,37,38,40–42,46–48,51 nine were retrospective, 18–20,32,35,39,44,45,50 five were qualitative studies, 21,29,34,43,49 and two were descriptive studies 15,36 .…”

“…Thirty‐three studies involved resident physicians, 15,17–23,25–32,34–47,49,50 four studies involved medical students, 14,16,24,33 and one did not report the learner level 48 . Twenty‐two were prospective studies, 14,16,17,22–28,30,31,33,37,38,40–42,46–48,51 nine were retrospective, 18–20,32,35,39,44,45,50 five were qualitative studies, 21,29,34,43,49 and two were descriptive studies 15,36 . Twenty‐five studies were performed in the clinical environment, 14,15,18–21,24,26–31,34–37,43–45,47–51 12 in the simulation lab, 16,17,22,25,32,33,38–42,46 and one used both simulation and the clinical environment 23 …”

“…Weersink et al 46 modified the QSAT to develop the RAT, which demonstrated a positive correlation with resident entrustment scores (r = 0.630, p < 0.01) and good inter‐rater reliability (ICC = 0.59 to 0.65). Hoonpongsimanont et al 24 described a locally developed workplace‐based assessment tool used on learner performances recorded with GoogleGlass and compared this with learner self‐assessments of that same recording. Donato et al 20 evaluated a Minicard that was able to identify struggling learners and also encouraged formative feedback with action plans.…”

“…Twenty studies were conducted in the United States, [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] 13 were performed in Canada, [34][35][36][37][38][39][40][41][42][43][44][45][46] three took place in Australia, [47][48][49] and two were conducted in Taiwan. 50,51 Thirty-three studies involved resident 1.…”