Set go Cambridge Calgary
Where practical communications skills are applied such as in a teaching session or a meeting with a client or patient a video of the meeting with full consent will allow review and discussion to further improve these skills
Ownership of the presentation, the issues that arise and possible solutions should always lie with the learner who has brought along the video. Every opportunity should be given to allow the learner to go first and offer observations and suggestions first.
It is the ultimate achievement of teaching for the learner to reach and fully own new ideas and skills themselves. Reaching new levels of understanding with help from a mentor is more effective than being told by a teacher without full engagement
Consider key points in the video consultation. Review what actually occurred and consider what alternative options there were in what was said or done. Consider a wide range then discuss the possible outcomes from each approach. As usual the learner goes first and the observe makes additional observations as needed
Ensure the options are handled neutrally. This is an alternative, what might have been the outcome then
Remember you are equals, with one person who has usually had more experience and is acting as a resource
- What went well
What areas develop
I feel I need
Observed might need
Pendleton put forward a simple model for discussing videos which hands back and forth discussion between the learner and teacher
There is an empahsis on what went well first because most people are very critical of themselves and do not appreciate how well they did. The learner presents first then the teacher should put forward as many positive points as possible.
“What areas to develop” should also be handled positively. Everyone has areas to develop and it is the reason for the whole meeting. The principle is to encourage the learner to put forward the issues and solutions first so they have ownership and understanding. The teacher may encourage reflection and make suggestions but must not impose their own beliefs by telling the learner of the “one way” to do it. Once all issues have been covered the teacher can make suggestions, usually by posing open questions that help the learner cover the issues noted by the teacher.
“I feel I need” refers to the summary by the learner of what they wish to do to address any issues arising. Observed might need allows the teacher to add in other possible options. An action summary by the learner clarifies what is to be done next and acts as a reference in the future.
Set go Cambridge Calgary
This is a more structured approach to video review. This suits some but not others. The best appraoch is to keep to the process but allow time for discussion. I have added the nemonic SEW before and after the original SET GO promoted by Cambridge Calgary
- SEW, SETGO, SEW
Saw watch? – Learner
Else see? – Observer(s)
Think? – Learner comment
Goal – Learners
Offers – Observers
After outlining the context of the video it is important to agree the process together at the start. The aim is to neutralise criticism and make objective observations which give the leaner new insights. Talking about the participants in their roles of learner or teacher helps neutrality.
The “SET” section starts with the learner observing what they actually saw on the video. “Else see” allows others to add comments. This allows the learner time to reflect on what was observed. The discussion is then handed back to the learner to comment on what they thought about the observations. There is opportunity for the others present to use open questions which help the learner move towards new insights, without imposing their beliefs on the solutions.
The learner then outlines any personal “goals” for development arising from the discussion. Others can then “offer” additional suggestions.
The second SEW starts with a summary of the next steps by the learner followed by feedback on the whole process. This is an opportunity to safety net. Have an issues been overlooked, how did everyone feel, has a strongly felt issue been overlooked? Writing down the summary helps to cement it in the memory and is a reminder and reference for future use.
Roger Neighbour outlined five key areas in each consultation and marked them off in turn against the thimb and fingers of the hand. This is useful to consider when loking at consultations with patients, but the principles apply in any meeting
- Connecting: have we got rapport?
- Summarising: could I demonstrate to the person that I’ve sufficiently understood why he’s come:
- the person’s reason for attending
- the person’s ideas and feelings, concerns and expectations are explored and acknowledged adequately
- listening and eliciting
- the clinical process – assess, diagnose, explain, negotiate and agree
- Handing over: has the person accepted the management plan we have agreed?
- Safetynetting: What if…? the art of managing uncertainty:
- predict what could happen if things go well
- allow for an unexpected turn of events plans and contingency plans
- Housekeeping: Am I in good condition for the next person? – stress, concentration and equanimity
- if not then look at ways to relieve stress such as a break, drink, stretch or think