Reviewing Clinical Skills

Guest Blog Series: The Clinical Connection #2

Intelligent Video Solutions proudly presents a guest blog series by an experienced Clinical Educator, Professor and Communicative Disorders Clinic Director:  Ms. Angie Sterling-Orth.  Angie will be drawing on over 15 years of Clinical Education experience and 5+ years using software developed by the team at IVS to reflect on a variety of topics important to many Health Sciences Education stakeholders.

Using Evidence and Wisdom-of-Practice to Elevate Clinical Instruction Using a Networked Video Observation System

Video self-modeling” is a buzz word I started hearing only about five years ago. It sounded like a mouthful and I wasn’t even exactly sure what it meant. The context was two colleagues talking about how our new, online video capture system for clinical supervision was allowing him to utilize video self-modeling with his student clinicians on a regular basis and how delighted he was about this opportunity. I nodded along and made a mental note to research this term immediately. Was I doing “video self-modeling”? Was it really an evidence-based practice for clinical instruction and supervision? If so, where was the evidence? If I wasn’t doing it, what was it and should I start doing it? I had a mission to figure out the answers to these questions and make sure I was taking full advantage of our highly sophisticated supervision tool.

By definition, video self-modeling (VSM) is the use of video recording to analyze one’s own behavior. True VSM (Video self modeling) is where individuals observe themselves performing a skill or behavior SUCCESSFULLY on video and having this reflection guided or mediated so that they will be likely to continue more positive and accurate use of the targeted skills. I was relieved to discover that, yes, from the time our video capture system was installed in 2010, I had been using VSM with my student clinicians. I just didn’t know to call it “VSM.” In addition, I had been using it frequently with our clients (but more on that in a future blog). What I decided I needed to do after discovering this term that was new to me, was to make sure I was DELIBERATE and SYSTEMATIC about my use of VSM as a tool for clinical instruction. In doing this, I would be more certain that it would have the positive impact I desired as a tool for my student clinicians to hone their clinical skills and dispositions.

My first step in refining my use of VSM as a tool for clinical instruction was to create a one-page information handout for my student clinicians. Since VSM was a term that was new to me (even though the concept was something that I had already put into action), I figured it needed to be defined for my practicum students and I also wanted to provide them with some research citations on the use of the strategy. I hold a clinical instruction style that insists on being transparent with my supervisees, as I know that being on the same page as them allows for fewer communication breakdowns and greater achievement of clinical outcomes. Then, I put the VSM topic on a weekly agenda for a clinical meeting. I typically have two to four special topic meetings per month with my entire group of assigned clinicians, and VSM was perfect for one of our special topics. At that meeting, I reviewed the concept, showed it in action, and set a plan for all of us to move forward with the technique in a deliberate way. Finally, I developed a form and expectation for my clinicians’ use of VSM as a required component of our clinical experience together. A form to guide student reflections is critical to mediate the strategy in use. It will offer them a framework for reflecting, insist on the tallying of specific skills or behaviors (of their own, like specific use of feedback to the client or deployment of a visual cue, etc.), and keep them from straying towards all of the “oops” moments or mortifying behaviors they might think see in themselves. I assigned all clinicians to complete two detailed VSM reflections per semester (more, as desired and/or needed). For each required reflection, I directed my clinicians to complete the form I provided and then come to our following individual weekly feedback meeting ready to lead the discussion with their VSM reflection as our guide. We’d discuss the reflection and set goals for moving forward.

I’ve now been using VSM as an intentional and structured clinical tool for over four years. Student reporting confirms for me that they are wedded to this strategy for making gains as clinicians. My own observations and evaluations of student clinicians over the past fifteen years assures me that video self-modeling makes a considerable positive difference on a student clinician’s refinement of clinical skills and achievement of overall confidence. My best advice in adopting this as a strategy is to have a format in place, TEACH the technique overtly, keep students focused on POSITIVE clinical skills and behaviors (which creates a situation where the increased use of positive skills replaces any undesirable behaviors), and use VSM reflections as the basis of goal-setting with students. This comprehensive approach with VSM will surely allow you to maximize the use of a video capture system on a daily basis.

Coming soon in a future blog, specific evidence-based practice research associated with use of VSM with specific client types, such as autism, traumatic brain injury, and people who stutter!