Observation Skills - Healthcare Professionals

Becoming ContagiousMaximizing the impact we haveon those around us.

The Challenge• Maximal Impact (MI)• Setting• Limited Time• High Efficiency• Maximal Productivity• Charges and Documentation

The EquationKey elements of being a contagiousteacher(HP + CP) + CC =MI

(HP + CP) + CC =MIHigh Potency

(HP + CP) + CC =MIClose Proximity

(HP + CP) + CC =MIClear Communication

(HP + CP) + CC =MIMaximal Impact

Maximal Impact• Learner Learns• Gains new and usefulknowledge• Identifies areas of weakness• Inspired to be a self learner• Practices what is Learned

High Potency• Skill in Practice and Teaching1. Provides effective role modeling2. Demonstrates skillful interactions with patients3. Generates interest in the subject matter4. Presents information with organization andclarity5. Organizes and controls the learning experience6. Balances clinical and teaching responsibilities7. Give appropriate responsibility to the learner

High Potency• Motivating the Learner1. Emphasizes problem solving2. Translates specific cases into generalprinciples3. Promotes active involvement of the learner4. Demonstrates enjoyment and enthusiasm forpatient care and teaching5. Develops a supportive relationship with thelearner.

Close Proximity• Careful Analysis of the Learner1. Accurate assessment of learner's knowledgeattitudes and skills2.Uses direct observation of thelearner3. Provides effective feedback4. Performs fair and thoughtful evaluations

Clear Communication• Communication and the EffectivePreceptor1. Possesses and demonstrates broad knowledge2. Explains the basis for actions and decisions3. Answers learner questions clearly and precisely4. Open to conflicting ideas and opinions5. Connects information to broader concepts6. Communicates clear goals and expectation7. Captures learners attention8. Makes learning fun

Importance of Observation

Ocularcentrism• Plato and Aristotle closelyassociated vision and reason.• This has been a persistentbias in Western culture.• Students in one study wereasked to list the sense theywould least like to lose:75% listed sight

• Seeing is believing• Let me see, I seeOcularcentrism• I'll believe it when I see it with my own eyes• Seeing eye to eye• It's good to see you• Love at first sight• What does she see in him?• In the mind's eye• Draw your own conclusions• See what I mean?

Homo significans• Meaning Makers• This fundamental concern underlies theprocess of human visual perception.• Even when 'meaningless' patterns areobserved the mind restlessly strives tomake them meaningful.

What do you see first?

WhatDoYouSee?

Visual Perception• No Meaning Without - Context• historical• socio-cultural• individual• situational• structural

WHAT DO YOU SEE?

Koyukon Indians of the Subarctic Forest see• deep snowfalling snow• blowing snowsnow on the ground• hard drifted snowthinly crusted snow• granular snow beneath the surface• snow thawed previously and then frozen• earliest crusted snow in spring• snow cornice on a mountain• heavy drifting snow• slushy snow on the ground• snow caught on tree branches• fluffy or powder snow• snow drifted over a steep bank, making it steeper

Grouping

Grouping

Verbal labels may influence therecall of visual imagesred green blue green red yellow blueyellow red blue yellow green red blueblue yellow yellow blue red blue yellowred green green red green green greengreen blue blue yellow yellow yellowyellow red green yellow blue green redblue green red red green red green bluered yellow yellow red blue yellow blueyellow blue red blue green green yellowgreen red yellow blue yellow blue redblue red blue green red yellow bluegreen green red yellow blue yellow blue

Selective Perception• Unavoidable• We can’t see all there is to see• We focus on salient features and ignoredetails which are irrelevant to our currentpurposes or interests – Omission• Fill in gaps - Addition• Assisted by Redundancy and Frames ofReference

Perception Test• Read the sentence on thenext screen and follow theinstructions

Perception TestFINISHED FILES ARE THE RESULTOF YEARS OF SCIENTIFIC STUDYCOMBINED WITH THEEXPEIRENCE OF YEARS.Count aloud the number of F’s in thesentence above.

Perception Test• There are SIX F’s in thesentence.• 3 found = average• 4 found = above average• 5 found = exception• 6 found = genius

Perception TestFINISHED FILES ARE THE RESULTOF YEARS OF SCIENTIFIC STUDYCOMBINED WITH THEEXPEIRENCE OF YEARS.

Process of Assimilation• Assimilation by Condensation – fusingdetails• Assimilation to Expectation – one’s habitsof thought• Assimilation to Linguistic Habits – verbalcatergories• Assimilation to Interest – tellers bias• Assimilation to Prejudice – emotionalassimilation

Definition: Observe• To watch carefully especiallywith attention to details orbehavior for the purpose ofarriving at a judgment

Observation Skills and thePhysician• Clinician• Visual Diagnosis• Teacher• Evaluation and Feedback

Observation as a Teacher• Process of systematicallylooking at and recordingbehavior for the purpose ofmaking instructional decisions

Instructional Decisions• What to teach?• How to sequence objectives and teaching procedures?• How to teach?• What materials to use?• How to manage behavior?• How to organize time?• How to group students?• How to set up learning environment?• What and how to evaluate?• Whom to ask for help?

Selective Perception• Unavoidable• We can’t see all there is to see• We focus on salient features and ignoredetails which are irrelevant to our currentpurposes or interests – Omission• Fill in gaps - Addition• Assisted by Redundancy and Frames ofReference

Frames of ReferenceCompetency BasedLearning Objectives

General Competencies• The six general competenciesare:• Patient Care• Medical Knowledge• Professionalism• Interpersonal and Communication Skills• Practice-based Learning andImprovement• Systems-based Practice

Patient CareResidents must be able toprovide patient care that iscompassionate, appropriate,and effective for thetreatment of health problemsand the promotion of health.

Medical Knowledge• Residents must demonstrateknowledge about establishedand evolving biomedical,clinical, and cognate (e.g.epidemiological and socialbehavioral)sciences and theapplication of this knowledgeto patient care.

Practice-Based Learning andImprovement• Residents must be able toinvestigate and evaluatetheir patient care practices,appraise and assimilatescientific evidence, andimprove their patient carepractices.

Interpersonal and CommunicationSkills• Residents must be able todemonstrate interpersonal andcommunication skills that resultin effective informationexchange and teaming withpatients, their patients families,and professional associates.

Professionalism• Residents must demonstrate acommitment to carrying outprofessional responsibilities,adherence to ethical principles,and sensitivity to a diversepatient population.

Systems-Based Practice• Residents must demonstratean awareness of andresponsiveness to the largercontext and system of healthcare and the ability toeffectively call on systemresources to provide care thatis of optimal value.

Artwork can sharpenmedical diagnostic skills,Yale researchers reportJAMA 2001;286:1020

Yale Center for British ArtProject• All learners took a pretest, whichrequired them to describephotographs depicting peoplewith various medical conditions.• Learners were randomized toYCBA tutorial or traditionalclinical history taking

Yale Center for British ArtProject• 81 students received the YBCA tutorial. Inthe tutorial, students were assigned apainting, given time to study it, and thenasked to describe the painting to theirpeers based solely on what they hadseen.• 65 students in a control group received atutorial in clinical history taking andexamination.

Yale Center for British ArtProject• After the prescribed tutorial, bothgroups took a post-test consisting ofa new set of photographs.• The students who had received theYCBA tutorial improved theirdetection of details by 10%, while thecontrol group showed no significantimprovement.

In Summary•We should be aware of ourown culture, values, and beliefsystem, as our own biasesmay affect our observationsand interactions with learners

THE ENDPROCEED TO POST TEST

Post test question one• The formula for a contagious teacher to have maximumimpact on learners includes all of the following except:A. Good Self conceptB. High potencyC. Close proximityD. Clear Communication

Post test question twoWe seem as a species to be driven by a desireto make meanings"… out of life experiences.This statement describes the advantage ofgrading by:1. faculty observation2. grading conferences3. several evaluation tools4. multiple choice exams

Post test question threeIn recalling a learner situtation faculty use theprocess of assimilation. A problem withassimiliation is:A. Aspects of the event may be changed to make the event morecoherentB. Items relevant to the event may be importedC. Gaps in the event may be filled inD. Details may be changed to make them more consistent1. A, B only2. A, B,C only3. B, C,D only4. A, B,C,D

Post test question fourThe ACGME clinical competencies provide a frame ofreference for evaluating learners. The advantage ofhaving a frame of reference is:A. Minimizes student litigationB. Is required by accrediting bodiesC. Focuses faculty evaluation if studentsC. Supports faculty selective preception

The End• Download the test• Complete• Return to Dr. Sandra Oliver407I TAMU 2