Research paper on openings in optometric consultations

As part of the ESRC funded project The Practical Work of the Optometrist Helena Webb, Christian Heath, Dirk vom Lehn, Will Gibson and Bruce Evans have published an article concerned with the opening of optometric consultations in the journal Research on Language and Social Interaction. The paper particularly explored the sensitivity clients display to the use of the word ‘problem’ in the opening questions of the history taking.

The Problem With “Problems”: The Case of Openingsin Optometry Consultations

Abstract

This article contributes to conversation analytic understanding of openings in health-care consulta-tions. It focuses on the case of optometry: a form of health-care practice in which an optometristconducts checks of a patient’s vision and eye health. Patients are advised to attend regularly for rou-tine assessments and can also request a specific appointment at any time. Analysis of a corpus of 66 consultations shows what happens when the optometrist’s opening question solicits the client’s“problems” with their eyes. We find three types of patient response. Patients who have requested aspecific appointment (most often) report a problem with their eyes and establish a problem-purposeencounter. Patients attending for a routinely timed appointment either report no problems and estab-lish a routine-assessment purpose, or if they do have a problem, they delay reporting it or downplay it.We track through what happens subsequently. The findings have practical implications for diagnosisand treatment.

Advertisements

Research Methods paper on Video Transcription in published in the BSA journal Sociology

As part of the ESR funded project Will Gibson, Helena Webb and Dirk vom Lehn have published a paper that explores new ways in which a reflection on the use of transcript in the examination of video-recorded interaction can aid the analysis.

Analytic Affordance: Transcripts as Conventionalised Systems in Discourse Studies

Abstract

This article explores the role of transcripts in the analysis of social action. Drawing on a study of the interactional processes in optometry consultations, we show how our interest in the rhythm of reading letters from a chart arose serendipitously from our orientation to transcription conventions. We discuss our development of alternative transcription systems, and the affordances of each. We relate this example to constructivist debates in the area of transcription and argue that the issues have been largely characterised in political terms at the expense of a focus on the actual processes of transcription. We show here that analytic affordances emerge through an orientation to professional conventions. The article ends by suggesting that a close reflection on the design of transcripts and on transcription innovation can lead to more nuanced analysis as it puts the researcher in dialogue with the taken for granted ideas embedded in a system.

The article is on Early View at Sociology and with access can be downloaded here.

Would you like us to deliver a CET communication skills session at your practice?

As part of our research collaboration with the College of Optometrists we have designed two CET courses on communication skills. In addition to holding some courses in central London, we are able to travel to interested practices and run courses there. 

What do the courses involve?

Both courses are designed to further participants’ understanding of communication in the consultation and identify practical steps that can maximise the ways that optometrists communicate with their patients. The sessions are highly interactive and include the discussion of video extracts of real consultations as well as various opportunities for peer discussion. The sessions are available for small groups – ideally between 2 and 6 people – and are suitable for optometrists at any stage of their career. The two courses are:

Communication in the consultation: Understanding different approaches to communication and how they may be applied to activities and challenging scenarios across the optometric consultation. (1 CET point over one session).

Video-recording for communication skills development and peer review (3 CET points over two sessions).

Further details of each course can be found below.

Interested?

These courses are free of charge and we will provide the necessary materials. We can come over to your practice and deliver the sessions at a time that is convenient to you. A single session is generally planned to last between 2.5-3 hours although this may vary according to numbers of participants and the amount of discussion arising. We can bring along a projector and projector screen, if necessary – so all you need to do is supply the people and a room for us to meet in! 

If you are interested, please contact helena.webb@kcl.ac.uk for further details.

Single session seminar: 

Communication in the consultation: Understanding different approaches to communication and how they may be applied to activities and challenging scenarios across the optometric consultation. (1 CET point)

 A successful optometric consultation requires successful communication. The interactions that occur between optometrist and patient are crucial to clinical outcomes as well as patient adherence and satisfaction. Therefore it is highly beneficial to practitioners to maximise their communication skills.

This seminar provides an innovative opportunity for practitioners to deepen their understanding of communication in the consultation, reflect on their own communicative practices and consider a variety of ways to maximise their skills. The content of the seminar draws on video-footage and research findings and promotes peer discussion. Participants will have the opportunity to watch and discuss video footage of recorded encounters as well as to learn about research findings on communication in optometric consultations and discuss their practical implications. During the seminar participants will:

Discuss key challenges to successful communication in the consultation, including scenarios they personally find ‘difficult’;

Learn about and reflect on different patterns of communication and the consequences they can have for the accomplishment of consultation tasks;

Learn about and reflect on different communicative practices in relation to ‘difficult’ scenarios.

Discuss methods to maximise their communication skills.

The content of the seminar will focus on 1) obtaining information from the patient and 2) delivering information to the patient. It therefore directly relates to CET core competencies. Participants will be invited to contact the seminar facilitators before the session to let them know their specific areas of interest and this will help determine the particular content of the session. 

The seminar will be led by researchers from King’s College London, who have conducted a 2 year video-based study of communication in optometric consultations. These seminars form part of a broader collaboration between King’s College London and the College of Optometrists to deliver a communication skills development package for eye care practitioners.

Two session workshop:  

Video-recording for communication skills development and peer review (3 CET points)

Communication is central to the success of eye care consultations and it is therefore beneficial for practitioners to work to maximise their communication skills. Video recordings provide an excellent tool for communication skills development, enabling practitioners to observe and reflect on different communication behaviours and the consequences they have in the consultation. 

This 2 part workshop provides an innovative way for participants to experience the benefits of using video to deepen their understanding of communication and conduct peer reviews based on the discussion of video footage. The workshop draws on video footage of optometric consultations and research findings from a study of communication in eye care. It also promotes peer discussion.

In part 1 participants will:

Discuss key challenges to successful communication in the consultation, including scenarios they personally find ‘difficult’.

Learn about different communication behaviours and reflect on them as they relate to the consultation and their own practice.

Observe and discuss video footage of consultations in relation to key communication challenges.

Learn about video recording for the purposes of communication skills development.

Between parts 1 and 2 (a week) participants will video record some of their own practice and select a short clip (2-3 minutes) for discussion in part 2. The workshop facilitators will provide the necessary equipment and practical guidance on the recording process. 

In part 2 participants will:

Adopt a peer review format to discuss their selected clips, identifying and reflecting on the communication practices occurring.

Relate the discussion to understandings of communication behaviours from part 1 and use this to reflect on their own practice and communication skills development.

Discuss the video recording experience and how to incorporate video and peer discussion into long-term communication skills development. 

The workshop will provide a constructive, supportive environment in which practitioners will increase their knowledge of communication and identify ways to maximise their own communication skills. The content of the workshop directly relates to CET core competencies and requirements for peer discussion/review. 

The workshop will be led by researchers from King’s College London, who have conducted a 2 year video-based study of communication in optometric consultations. These workshops form part of a broader collaboration between King’s College London and the College of Optometrists to deliver a communication skills training package for eye care practitioners.

Helena Webb quoted in Optometry Today ‘Patients trust eye contact’

Optometry Today! currently runs an article that reports on a video-based study of GPs that highlights the importance of eye contact during consultations. Helena was contacted by OT to comment on the research findings. The article together with Helena’s comments can be found here:

http://www.optometry.co.uk/news-and-features/news/?article=5208

 

 

 

Optometry CET Communication Skills Workshop: Nov 11th, 4pm – 7pm at King’s College London

Single session seminar:

Communication in the consultation: Understanding different approaches to communication and how they may be applied to activities and challenging scenarios across the optometric consultation.

A successful optometric consultation requires successful communication. The interactions that occur between optometrist and patient are crucial to clinical outcomes as well as patient adherence and satisfaction. Therefore it is highly beneficial to practitioners to maximise their communication skills.

This seminar provides an innovative opportunity for practitioners to deepen their understanding of communication in the consultation, reflect on their own communicative practices and consider a variety of ways to maximise their skills. The content of the seminar draws on video-footage and research findings and promotes peer discussion. Participants will have the opportunity to watch and discuss video footage of recorded encounters as well as to learn about research findings on communication in optometric consultations and discuss their practical implications. During the seminar participants will:

–          Discuss key challenges to successful communication in the consultation, including scenarios they personally find ‘difficult’;

– Learn about and reflect on different patterns of communication and the consequences they can have for the accomplishment of consultation tasks;

– Learn about and reflect on different communicative practices in relation to ‘difficult’ scenarios.

– Discuss methods to maximise their communication skills.

The content of the seminar will focus on 1) obtaining information from the patient and 2) delivering information to the patient. It therefore directly relates to CET core competencies. Participants will be invited to contact the seminar facilitators before the session to let them know their specific areas of interest and this will help determine the particular content of the session. The seminar will be led by researchers from King’s College London, who have conducted a 2 year video-based study of communication in optometric consultations. These seminars form part of a broader collaboration between King’s College London and the College of Optometrists to deliver a communication skills development package for eye care practitioners.

If you are interested in attending the session, please contact helena.webb@kcl.ac.uk.

Coming soon: communication training skills courses with CET points!

We will soon be starting our CET accredited communication training skills courses. These are suitable for optometrists at all stages of their career and will cover topics connected to the GOC’s core competencies on communication. We will use our research data and findings to promote discussion of key issues in communication and consider ways to maximise communication between optometrists and patients. Two kinds of course are available – a single session and a double session. We plan to hold sessions in central London in addition to travelling over to interested optometric practices. The two course outlines are below. If you are interested in attending one (or two!) please contact helena.webb@kcl.ac.uk for further details.

Single session seminar:

Communication in the consultation: Understanding different approaches to communication and how they may be applied to activities and challenging scenarios across the optometric consultation.

A successful optometric consultation requires successful communication. The interactions that occur between optometrist and patient are crucial to clinical outcomes as well as patient adherence and satisfaction. Therefore it is highly beneficial to practitioners to maximise their communication skills.

This seminar provides an innovative opportunity for practitioners to deepen their understanding of communication in the consultation, reflect on their own communicative practices and consider a variety of ways to maximise their skills. The content of the seminar draws on video-footage and research findings and promotes peer discussion. Participants will have the opportunity to watch and discuss video footage of recorded encounters as well as to learn about research findings on communication in optometric consultations and discuss their practical implications. During the seminar participants will:

–        Discuss key challenges to successful communication in the consultation, including scenarios they personally find ‘difficult’;

–        Learn about and reflect on different patterns of communication and the consequences they can have for the accomplishment of consultation tasks;

–        Learn about and reflect on different communicative practices in relation to ‘difficult’ scenarios.

–        Discuss methods to maximise their communication skills.

The content of the seminar will focus on 1) obtaining information from the patient and 2) delivering information to the patient. It therefore directly relates to CET core competencies. Participants will be invited to contact the seminar facilitators before the session to let them know their specific areas of interest and this will help determine the particular content of the session. The seminar will be led by researchers from King’s College London, who have conducted a 2 year video-based study of communication in optometric consultations. These seminars form part of a broader collaboration between King’s College London and the College of Optometrists to deliver a communication skills development package for eye care practitioners.

Two session workshop

Video-recording for communication skills development and peer review

 

Communication is central to the success of eye care consultations and it is therefore beneficial for practitioners to work to maximise their communication skills. Video recordings provide an excellent tool for communication skills development, enabling practitioners to observe and reflect on different communication behaviours and the consequences they have in the consultation.

This 2 part workshop provides an innovative way for participants to experience the benefits of using video to deepen their understanding of communication and conduct peer reviews based on the discussion of video footage. The workshop draws on video footage of optometric consultations and research findings from a study of communication in eye care. It also promotes peer discussion.

In part 1 participants will:

–        Discuss key challenges to successful communication in the consultation, including scenarios they personally find ‘difficult’.

–        Learn about different communication behaviours and reflect on them as they relate to the consultation and their own practice.

–        Observe and discuss video footage of consultations in relation to key communication challenges.

–        Learn about video recording for the purposes of communication skills development.

Between parts 1 and 2 (a week) participants will video record some of their own practice and select a short clip (2-3 minutes) for discussion in part 2. The workshop facilitators will provide the necessary equipment and practical guidance on the recording process.

In part 2 participants will:

–        Adopt a peer review format to discuss their selected clips, identifying and reflecting on the communication practices occurring.

–        Relate the discussion to understandings of communication behaviours from part 1 and use this to reflect on their own practice and communication skills development.

–        Discuss the video recording experience and how to incorporate video and peer discussion into long-term communication skills development.

The workshop will provide a constructive, supportive environment in which practitioners will increase their knowledge of communication and identify ways to maximise their own communication skills. The content of the workshop directly relates to CET core competencies and requirements for peer discussion/review. The workshop will be led by researchers from King’s College London, who have conducted a 2 year video-based study of communication in optometric consultations. These workshops form part of a broader collaboration between King’s College London and the College of Optometrists to deliver a communication skills training package for eye care practitioners.

Scoping Exercise

Over the past two months, we’ve been conducting a scoping exercise with eye care practitioners, student practitioners and members of the pubic to find out what they feel about communication in eye care consultations and how communication skills should be taught. We are very grateful to everyone who has participated so far and for anyone who would like to part you can do so by clicking the student survey or practitioner survey link at the top of this page, or by contacting helena.webb@kcl.ac.uk.

IMG_2604

So far a number of clear themes are emerging from the scoping exercises. Practitioners and student practitioners frequently rate communication as a very important or the most important element of their work. They describe it as central to patient satisfaction and adherence, the accuracy of clinical tests, and guaranteeing return business for the practice. They also report a number of challenges in ensuring good communication in the consultation – for instance, dealing with time constraints, delivering bad news and talking to patients with learning difficulties or limited English.

Quotes 3

Meanwhile speaking to members of the public (such as our focus group with the Public-Patient Involvement group at the College of Optometrists, pictured) reveals that a chief concern amongst patients is to feel listened to by eye care practitioners. They want to have the opportunity to explain their concerns in full and to feel that their practitioner has understood them.

Quote 2

We are going to use the results of this scoping exercise to help us develop the focus and content of our communication skills package for eye care practitioners. We are particularly interested to see the learning techniques that our respondents feel are most suitable for maximising communication skills: learning from experience and watching your own and others’ practice. Peer discussion can provide a very constructive and support environment to consider different approaches to communication and, as the results of our first ‘Practical work of the optometrist’ study have shown, video recordings of consultations provide an excellent means to reflect on the adoption of various communication techniques and the consequences they can have in the consultation.

Quotes 1