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PubMed1991

Effect of video feedback on the performance of a weight shifting controlled tracking task in subjects with parkinsonism and neurologically intact individuals.

This study compared the performance of a visual motor task, accomplished by standing weight shifting, of 34 people with Parkinson's disease (P.D.) and 34 neurologically intact (N.I.) subjects. Twenty of the P.D. subjects were in Stage 1 and 14 were in Stage 2. The performance of ten, 10-s trials was each examined under two feedback (FB) conditions: continuous video display of performance and end of trial position. Visual FB was composed of displaying a target and cursor on a video monitor, with the cursor controlled by the subject through weight shifting on a platform interfaced with a microprocessor. Once the cursor was centered, the computer then transferred the target to the upper right quadrant of the monitor, and the subject was required, through weight shifting, to relocate the cursor inside the target. ANOVA with repeated measures was used for data analysis. The visual motor performance of P.D. subjects was significantly worse than that of N.I. (P less than 0.01), as well as between FB conditions (P less than 0.01). The interaction of the FB condition by trial segment was significant (P less than 0.01), as was the interaction of group membership by the trial segment (P less than 0.01). FB condition and group membership did not significantly interact, confirming that performance was worse under end of trial position FB, regardless of group membership (P less than 0.01). Post hoc analysis yielded significant differences (P less than 0.05) in task performance between N.I. and P.D. subjects after the first second of the trials regardless of FB condition. In either group, significant differences between continuous visual FB and end of trial position FB (P less than 0.05) were verified after the fourth second. Performance between N.I., Stage 1, and Stage 2 P.D. subjects revealed significant differences (P less than 0.01) among all three groups, regardless of FB condition. One of the revealing aspects of this investigation was the establishment of significant differences in visual motor performance of individuals in the early stages of the disease compared to previous reports of extremity deficits in the later stages.

Adult↗
PubMed2000

[Use of video feedback in parent-infant counseling and psychotherapy].

Video-based observation and behavioral microanalyses have critically contributed to the international boom of infancy research in the early seventies. Video techniques have opened up a direct scientific access to the broad domains of intuitive behavior and thus to early integrative processes, self regulation, parenting, and preverbal communication. The exploratory potential of video based microanalyses may similarly promote innovative clinical approaches to preverbal processes and mechanisms of developmental psychopathology and disordered parent-infant relationships. The article review currently available video-based methods that are used in clinical diagnostics and parent-infant consultation and psychotherapy. The article is based on relevant international publications as well as on the Papouseks' use of behavioral microanalyses during three decades of joint basic research and almost ten years clinical experience from the Munich Interdisciplinary Research and Intervention Program for Fussy Baby's.

Adult↗
PubMed1989

Acquisition of self-control of a novel muscular activity with EMG and video feedback.

To examine the acquisition of voluntary control of a novel muscular activity from the initial stage to the self-control stage, the m. auricularis posterior, which had generally degenerated and had nearly lost its function of drawing an auricle backward in the human body, was selected as a target muscle to be studied. One female undergraduate student who could not move her auricles intentionally was required to activate her left m. auricularis posterior and underwent rest, pretest, training, and posttest sessions once a day for five days. At the subject's request, the electromyograph (EMG) from her left m. auricularis posterior on an oscillograph was provided for her as the feedback signal on each training trial. The picture of her left ear on television was handled in the same way. The EMG measures indicated that the subject could learn to activate her left m. auricularis posterior differentially. The number of training trials on which the subject requested the feedback signals suggested that EMG feedback signal was more useful to her than the video and that the usefulness of the feedback signals varied as the training sessions advanced. It was also concluded from analysis of the self-report data that the acquisition process of self-control of a novel muscular activity could be divided into at least four stages.

Adult↗
PubMed2002

The efficacy of video feedback for learning the golf swing.

This study was designed to examine the efficacy of video instruction relative to that of verbal and self-guided instruction. Before training, 30 golfers were assigned at random to one of three groups: video, verbal or self-guided instruction. Video instruction was defined as a practice session in which the teacher was aided by the use of video. Verbal instruction was defined as practising with the teacher providing verbal feedback. Self-guided practice was defined as practising without the aid of a teacher. The participants had a pre-test, four 90 min practice sessions, an immediate post-test and a 2 week delayed post-test. During the pre-test and post-tests, all participants were required to strike 15 golf balls, with a 7-iron, from an artificial turf mat for distance and accuracy. The results showed that all groups were equal on the pre-test. On the first post-test, the two instruction groups performed worse than the self-guided group. However, on the second post-test, the two instruction groups performed better than the self-guided group, with the video group performing best. We interpret these results to mean that video analysis is an effective means of practice, but that the positive effects may take some time to develop.

Adult↗
PubMed1995

The amobarbital sodium interview in conversion disorders: use of video feedback in therapy.

The prognosis in treating acute conversion disorder is good, but it demands considerable time in the form of an intensive, and often extensive, hospital stay. With the increasing trend to limiting hospital stays, the family practitioner working with a psychiatrist in the hospital setting is pressured to find new approaches in order to limit the use of inpatient units. The authors describe a case of classic conversion disorder and outline a successful approach that uses a video recording of the interview, during which the patient is under the influence of amobarbital sodium. The videotape then provides valuable feedback during future therapy sessions in the treatment of this persistent disorder.

Adult↗
PubMed1996

The effects of video feedback on the self-evaluation of performance in socially anxious subjects.

Previous research has demonstrated that socially anxious subjects appraise their own social performance as worse than it is seen by independent observers, but are able to appraise the performance of others accurately. Three studies are reported in which socially anxious subjects evaluated their own social performance after viewing it via video. In each study, ratings made following video were closer to those made by independent observers than were ratings made without the benefit of video. In addition, this effect was similar in both socially anxious and nonanxious people. A model is proposed in which self evaluation of one's social performance is based on a mental representation of one's external appearance which receives input from long term memory, internal cues, and external cues.

Adolescent↗
PubMed1996

Smoking-related knowledge and attitudes of senior Australian medical students.

OBJECTIVE: To assess the smoking-related knowledge and attitudes of senior medical students and to compare knowledge and attitude changes in students exposed to four different smoking cessation skills training interventions. DESIGN: A survey questionnaire, assessing knowledge and attitudes, was administered pre- and post-intervention for each of the four intervention conditions. SUBJECTS: A cohort of 219 fifth-year medical students at the University of Sydney. INTERVENTIONS: Students were randomised into one of four intervention conditions: (1) a traditional didactic lecture mode (control group); (2) the use of role plays and audiotaped feedback; (3) role plays with peer feedback; and (4) video feedback. MAIN OUTCOME MEASURES: Knowledge on morbidity and mortality associated with smoking, intervention strategies, intervention effectiveness, and cessation practices; anticipated clinical behaviour related to smoking; and attitudes towards medical practitioner involvement in smoking cessation. RESULTS: Smoking knowledge was significantly greater at post-test (mean unweighted scores of 69% before and 74% after intervention). All groups had improved knowledge levels at post-test. However, after controlling for pre-test differences, the control group, video feedback, and peer feedback groups were found to have improved significantly over the audio feedback group. Scores were higher on items related to morbidity and mortality and intervention effectiveness than for items on intervention strategies and cessation practices. Positive student attitudes towards their role in smoking cessation were also found. There was an almost universally held view that doctors can have a significant impact on reducing smoking levels. Although most students perceived smoking intervention to be a worthwhile activity, they remained pessimistic about the ease with which patients' smoking behaviour could be changed. CONCLUSIONS: Positive smoking cessation knowledge changes can be readily achieved through training. However, specific smoking cessation training is needed for medical trainees to develop appropriate skills and strategies. Attention to particular weaknesses related to specific intervention strategies and cessation practices is required to develop competence in this area and to maximise the chances of new medical graduates fully using the opportunities available to them.

Adult↗
PubMed2005

Tailoring communication in cancer genetic counseling through individual video-supported feedback: a controlled pretest-posttest design.

OBJECTIVES: To assess the influence of a 1-day individual video-feedback training for cancer genetic counselors on the interaction during initial visits. Feedback was intended to help counselors make counselees' needs more explicit and increase counselors' sensitivity to these. METHODS: In total 158 counselees, mainly referred for breast or colon cancer and visiting 1 of 10 counselors, received a pre- and post-visit questionnaire assessing needs (fulfillment). Visits were videotaped, counselor eye gaze was assessed, and verbal communication was analyzed by Roter Interaction Analysis System (RIAS) adapted to the genetic setting. Halfway the study, five counselors were trained. RESULTS: Trained counselors provided more psychosocial information, and with trained counselors emotional consequences of DNA-testing was more often discussed. Counselees seen by a trained counselor considered their need for explanations on (emotional) consequences of counseling as better fulfilled. Unexpectedly, counselees' contribution to the interaction was smaller with trained counselors. CONCLUSION: Feedback appeared to result in greater emphasis on psychosocial issues, without lengthening the visit. However, counselors did not become more verbally supportive in other ways than by providing information. PRACTICE IMPLICATIONS: A 1 day individual training appears effective to some extend; increased opportunities for watching and practicing behavioral alternatives and arranging consolidating sessions may improve training results.

Adult↗
PubMed2003

The role of video in facilitating perception and action of a novel coordination movement.

Two groups (n = 10 in each) practiced a novel, bimanual coordination pattern that was demonstrated on video. One of the groups received augmented video feedback of their own responses after each trial following a demonstration. The video-feedback group showed better performance in acquisition and retention than the no-feedback group. On error-detection tests, the video-feedback group was better able to distinguish between correct and incorrect movement patterns. The authors concluded that video feedback helps to make relative phase information salient by aiding the discrimination process. Prepractice ability on a scanning task revealed that individuals who persevered with in-phase-type movements, even though the task demands dictated otherwise, had the most difficulty determining and subsequently performing the required movement. Video feedback helped them to compensate for those difficulties.

Adult↗
PubMed2005

Feedback on video recorded consultations in medical teaching: why students loathe and love it - a focus-group based qualitative study.

BACKGROUND: Feedback on videotaped consultations is a useful way to enhance consultation skills among medical students. The method is becoming increasingly common, but is still not widely implemented in medical education. One obstacle might be that many students seem to consider this educational approach a stressful experience and are reluctant to participate. In order to improve the process and make it more acceptable to the participants, we wanted to identify possible problems experienced by students when making and receiving feedback on their video taped consultations. METHODS: Nineteen of 75 students at the University of Bergen, Norway, participating in a consultation course in their final term of medical school underwent focus group interviews immediately following a video-based feedback session. The material was audio-taped, transcribed, and analysed by phenomenological qualitative analysis. RESULTS: The study uncovered that some students experienced emotional distress before the start of the course. They were apprehensive and lacking in confidence, expressing fear about exposing lack of skills and competence in front of each other. The video evaluation session and feedback process were evaluated positively however, and they found that their worries had been exaggerated. The video evaluation process also seemed to help strengthen the students' self esteem and self-confidence, and they welcomed this. CONCLUSION: Our study provides insight regarding the vulnerability of students receiving feedback from videotaped consultations and their need for reassurance and support in the process, and demonstrates the importance of carefully considering the design and execution of such educational programs.

Adult↗
PubMed1977

A program for enhancing medical interviewing using video-tape feedback in the family practice residency.

In an effort to enhance the medical interviewing skills of family practice residents in the clinical setting, the Minnesota Communication Program was developed. The Program, which uses video-tape feedback as the primary teaching method, stresses the integration of biological and psychosocial data as well as the establishment of a therapeutic relationship. A description of the Program including goals, teaching strategies, and guidelines for implementing video-tape feedback is presented. The Medical Interview Skills Checklist (MISC) and its use as an assessment tool are described. Results of a survey eliciting residents' responses to the Program and the implications of video-tape feedback for medical education are also discussed.

Educational Measurement↗
PubMed2002

Teaching mental health skills to general practitioners and medical officers.

David Goldberg opened by describing the research that had led up to the present WPA teaching package. Early research had demonstrated that many psychological illnesses were not detected in primary care settings (Goldberg & Huxley 1980; ibid 1992), and these findings have been replicated in 14 centres round the world, with broadly similar results (Ustun & Sartorius 1995). We have found that in the UK the problem is not defects in factual knowledge, but not having clinical skills to assist in the management of mental disorders in general medical settings. The clinical skills needed in primary care are seldom taught in medical schools, and cannot be learned by listening to a lecture: it is necessary to practice them after they have been demonstrated. To do this it is convenient to break complex clinical skills down into their components: these are called "micro-skills", and we will deal later with the way in which these are taught. The most powerful method for improving mental health skills in this setting is to provide doctors with feedback--either video or audio--of their interview with real patients. The emphasis of such teaching must be on the interview techniques used by the doctor, rather than the clinical problems displayed by the particular patient being interviewed (Gask et al 1991). The problem with this is that video-feedback teaching of the necessary type is not always available, so we have developed videotapes that we can send out to distant locations, and which focus the attention of both local tutor and postgraduates on what should be learned. Because it is essential that most of the teaching is done by the live teacher rather than the videotape, there are always several "discussion points" so that postgraduates can ask questions, or describe their own way of dealing with particular situations. The videotapes are supplied together with teaching notes for the tutor, power points slides which can be adapted to suit local conditions, "role plays" to allow postgraduates to practice each skill they wish to learn, and other support materials. There is also a paper written by ourselves in association with Norman Sartorius, who has encouraged us to prepare the teaching package under the auspices of the WPA. Linda Gask described the process of teaching specific 'microskills', by working through how the skills necessary for the management of people who present in primary and general medical settings have been described and taught in the UK (see box 1). A model of the strategies and skills to be [figure: see text] taught was first developed utilizing the experience professionals and teachers from both primary care and mental health. A videotape was produced in which the skills to be acquired were demonstrated by real primary care doctors in role-played interviews with the addition of subtitles to label particular skills. The videotape is then utilised in a group teaching session to model the specific component skills of the model or 'microskills' to the participants in order to demonstrate exactly how the strategies of the model are applied in a real consultation. Watching the videotape will not however change behaviour. To do this, it is necessary to role-play brief scenarios so that the professional is able to practice the actual words he or she would use. This role-play work may be carried out in pairs, with one doctor playing the professional and the other playing the patient, or in threes, with the addition of an observer who ensures that the participants keep to the task. At the end of the role-play all participants provide feedback. These methods are described in much more detail in Gask (1999). Finally, there is also the possibility of videotaping one of these role-played interviews and teaching on this tape with the group as a whole. The specific skills and methods required to do this are described in much more detail along with the research evidence for these methods in Gask (1998). Our approach to facilitating the group in the exercise of videofeedback teaching is summarised in box 2.

Family Practice↗
PubMed2005

The importance of parenting in the development of disorganized attachment: evidence from a preventive intervention study in adoptive families.

BACKGROUND: As infant disorganized attachment is a serious risk factor for later child psychopathology, it is important to examine whether attachment disorganization can be prevented or reduced. METHOD: In a randomized intervention study involving 130 families with 6-month-old adopted infants, two attachment-based intervention programs were tested. In the first program, mothers were provided a personal book, and in the second program mothers received the same personal book and three home-based sessions of video feedback. The third group did not receive intervention (control group). RESULTS: The intervention with video feedback and the personal book resulted in enhanced maternal sensitive responsiveness (d=.65). Children of mothers who received this intervention were less likely to be classified as disorganized attached at the age of 12 months (d=.46), and received lower scores on the rating scale for disorganization than children in the control group (d=.62). In the book-only intervention group children showed lower disorganization ratings compared to the control group, but no effect on the number of infants with disorganized attachment classifications was found. CONCLUSION: Our short-term preventive intervention program with video feedback and a book lowered the rate of disorganized attachment. The effectiveness of our intervention documents the importance of parenting in the development of infant attachment disorganization.

Adoption↗
PubMedDate not supplied

Teaching smoking cessation skills to senior medical students: a block-randomized controlled trial of four different approaches.

BACKGROUND: Medical practitioners have considerable untapped potential to assist patients in stopping smoking. However, marked deficits have been found in the amount and type of training medical practitioners receive in smoking cessation counseling with little attention paid to determination of effective training methods. METHOD: A randomized controlled trial was conducted to examine the relative effectiveness of four different educational programs in teaching smoking cessation skills to 5th-year medical students in an Australian medical school. The four programs comprised: (a) a traditional didactic lecture mode (control group), (b) audio feedback through the use of audiotaped role plays, (c) role plays with peer feedback, and (d) video feedback. Students' smoking cessation intervention skills were assessed prior to training and at the end of term via videotaped interviews with simulated patients. RESULTS: Senior medical students demonstrated significantly improved skills in smoking intervention when exposed to any of the educational approaches other than traditional didactic teaching. No overall differences in smoking intervention skills were found between the three experimental training methods. CONCLUSIONS: Specific training in smoking cessation techniques is necessary to increase the intervention skills of medical students. Traditional teaching methods are ineffective in developing smoking cessation intervention skills. Enhanced teaching, of an appropriate nature, at undergraduate and postgraduate levels is needed.

Adult↗
PubMed1993

Teaching communication skills to clinical students.

Seven years' experience in teaching communication skills to first year clinical students at St Mary's Hospital School of Medicine is described. The first component consists of a day during the introductory clinical course; this is divided into a lecture and small seminar groups and involves behavioural scientists and clinicians from many departments. The second component uses simulated patients and video feedback and takes place in small groups later in the year. Participation of the students through active critical discussion, role play, and interactive video feedback are important aspects in the success of the course. The methods have been refined through evaluation by students and tutors. This article aims to allow others, already running or considering such a course, to develop effective courses within the practical constraints of their own institutions.

Clinical Competence↗