The Potential of Video as a Learning Tool in Psychiatry: Etnographic focus on pre-graduate training

Author(s):

Cecilie Fog-Petersen(presenting / submitting)Karen Borgnakke Sidse Arnfred

Conference:

ECER 2017

Network:

19. Ethnography

Format:

Paper

Session Information

19 SES 08 A, Ethnography and New Tools for Teaching and Learning

Paper/Poster Session

Time:

2017-08-24

09:00-10:30

Room:

K4.12

Chair:

Catarina Player-Koro

Contribution

This paper is based on a study of medical students’ possibilities of learning in a psychiatry hospital. The study is a part of an ongoing Ph.D. Project about the education of medical students and doctors in psychiatry and the use of video as a supplementary learning tool to the traditional training at the ward. The Ph.D. Project is founded on ethnographic methods and runs from spring 2016 to spring 2019.

The focus of this paper is apprenticeship, situated learning and the use of video as a supplementary tool for during medical students’ placement at the psychiatry hospital.

Research question

How does the video library work in the real life setting of clinical psychiatry and how does the video library supplement the training of medical students at the psychiatric hospital? How will the implementation of the video library affect the overall context of learning in psychiatry?

Background

A decrease in numbers of inpatients, a growing conflict of time and demands and a shortage of doctors have become a challenge to the quality and the possibility of learning in the health sector. This is also the case in the field of psychiatry ( Holm-Petersen et al., 2006, Varma et al., 2012), in which the core concepts are known to be highly complicated, hard to understand and less tangible, than many somatic syndromes (Chur-Hansen, 2005, Parnas, 2013).

Psychiatry is a mandatory part of the medical education at the University of Copenhagen and the psychiatry module runs for four weeks. One week is structured as traditional academic lectures and three weeks are structured as a placement at a psychiatric hospital varying between apprenticeship and group lessons. The shortage of senior doctors in psychiatry and a management focus on efficiency challenges the apprenticeship. For some students it means idle time waiting for doctors to take the student along or to give the student feedback.

Studies shows that videos used in learning situations at hospitals have a great potential, that videos can fixate non-verbal communication and can help to break down the complex to less complicated parts and to take a closer look at signs and symptoms(Hammoud, 2012¸Muench, 2013, Roeske, 1979). We have earlier tested videos with medical students while they were at their placement in psychiatry (Fog-Petersen, 2014). The students requested video clips of symptoms, interview situations ect. To meet these requests we created a library with videos of patients and a short description of the patient as well as a mental status examination. We are using the same video library for both medical students and doctors in psychiatry.

In the study the definition of apprenticeship is inspired by the theory by Lave and Wenger, who define the main elements of learning in apprenticeship as social interaction and collaboration. With the concept, situated learning, Lave and Wenger points out social relations as the essentials components for learning (Nielsen,2003, Lave, 1999, Lave 2003). Lave and Wenger’s thoughts will be related to Dewey’s ideas about learning by doing. Furthermore understanding of the principle of progression of apprenticeship in the project is based on Dreyfus’ concepts and models for skill acquisition(Borgnakke 2005, Borgnakke 2013). Dreyfus’ models describe the progression of learning through a series of levels from the stages of a novice to the stage of an expert. Though Dreyfus´ models are useful for basic descriptions, the reality is expected to be far more complex and learning progression to be what is happening in oscillation between the planned goal for learning and the practice of real life.

Method

The study is inspired by the methodology of ethnography. The fieldwork will represent close-up studies of the challenges of the apprenticeship practice and is focusing on the learning practices at the ward and the experimental use of video. The main empirical material will be field notes and formal and informal transcribed interviews. Inspired by the methodical strategy of Karen Borgnakke, the goal of the observations is to capture the original articulated sentences word by word and to describe the acted practice. Though the aim of the study is about use of a video library the clinical placement, the medical students’ lectures in the week before the placement, was observed one time, to understand the context of placement. Also before adding the video library in the clinical placement two groups of medical students were followed on and off in their three weeks placement in psychiatry, this to understand the setting in which the video library was applied. The observations focused on the apprenticeship in daily practice. The second group also tested a pilot version of the video library while being observed and, at the end of their placement, the second group was interviewed about how they had used the video tool. The three groups were observed at introduction to psychiatry at their first day at the placement. The groups were then observed at a video library session at the placement and each group of students were interviewed about their use of the video library at the end of their placement. One key informant from each of the three groups where followed every day(as participation observations) at the ward at their three week placement. Field notes where written down, interviews are transcribed and analyzed with support from theories of learning.

Expected Outcomes

There are no results or analyses to be presented yet. Though analyses are still to be done, the empirical material about the medical students seem to be important to understand the foundation of the learning context, pointing at the field of psychiatry to be different and strange to the students. Hereby, the observations supports the research question and provide a deeper understanding of the learning environment within a busy psychiatric ward. The observations also show a variation of unexpected ways in which the video library is used and will inform us what the use of video as a learning tool in this context can offer. The study serves an important descriptive purpose identifying challenges in the learning context and identifying the potential of video as a learning tool in this context.

References

Borgnakke, K., Læringsdiskurser og praktikker. 2005, Kbh.: Akademisk Forlag. 263 sider. Borgnakke, K. and Københavns Universitet. Institut for Medier Erkendelse og Formidling., Etnografiske metoder i uddannelsesforskningen : mellem klassiske traditioner og senmoderne udfordringer. 2013, Kbh.: Institut for Medier, Erkendelse og Formidling, Københavns Universitet. 116 sider. Nielsen, K. and S. Kvale, Praktikkens læringslandskab : at lære gennem arbejde. 2003, Kbh.: Akademisk. 367 sider. Muench, J., D. Sanchez, and R. Garvin, A review of video review: new processes for the 21st century. Int J Psychiatry Med, 2013. 45(4): p. 413-22. Roeske, N.C., The medium and the message: development of videotapes for teaching psychiatry. Am J Psychiatry, 1979. 136(11): p. 1391-7. Fog-Petersen, C., Arnfred, S. Bedside iPad videooptagelser som læringsredskab i klinisk psykiatri. 2014. Chur-Hansen, A. and D. Parker, Is psychiatry an art or a science? The views of psychiatrists and trainees. Australas Psychiatry, 2005. 13(4): p. 415-8. En psykiatri i verdensklasse - regionernes visioner for fremtidens psykiatri. 2009 [cited 2016 05.02.]; Available from: http://www.regioner.dk/publikationer/psykiatri/en+psykiatri+i+verdensklasse+-+regionernes+visioner+for+fremtidens+psykiatri. Benchmarking af psykiatrien 2014. 2015 [cited 2016 05.02.]; Available from: http://www.regioner.dk/psykiatri/tal+og+fakta/~/media/9D9F5532FDF24246A09DF9C29BE69197.ashx. Hammoud, M.M., et al., Is video review of patient encounters an effective tool for medical student learning? A review of the literature. Adv Med Educ Pract, 2012. 3: p. 19-30. Holm-Petersen, C., Hansen, J.; Vinge, S., Medicinstuderende og yngre lægers valg af speciale. Udfordringer og muligheder i psykiatrien. 2006, DSI Institut for Sundhedsvæsen. Varma, A., Bonde, J.P. og Esbensen, L. Yngre Lægers Arbejdsvilkår 2012. En spørgeskemaundersøgelse af medlemmer i Foreningen af Yngre Læger. 2012 [cited 2016 05.02.]; Available from: http://www.laeger.dk/portal/pls/portal/!PORTAL.wwpob_page.show?_docname=10072978.PDF. Parnas, J., L.A. Sass, and D. Zahavi, Rediscovering psychopathology: The epistemology and phenomenology of the psychiatric object. Schizophrenia Bulletin, 2013. .39(2): p. pp. Lave, J., Læring, mesterlære, social praksis, in Mesterlære. Læring som social praksis., K. Nielsen and S. Kvale, Editors. 1999, Hans Reitzels Forlag: København. p. 35-53. Lave, J.o.W., Etienne, Situeret læring - og andre tekster. 2003, Kbh.: Hans Reitzel. 247 sider.

Author Information

Cecilie Fog-Petersen (presenting / submitting)

Region Sealand

Psykiatrien Vest, Region Sjælland

København N

Karen Borgnakke

University of Copenhagen

Sidse Arnfred

Psychiatry West , Region Sealand, Denmark; University of Copenhagen

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