Video-based feedback of oral clinical presentations reduces the anxiety of ICU medical students: a multicentre, prospective, randomized study

Abstract

Background: Oral presentations of clinical cases by medical students during medical rounds in hospital wards are a source of anxiety and little is known about how this anxiety can be alleviated. The objective of this study was to investigate whether video-based feedback of public oral presentations can reduce anxiety in 4th year medical students.

Methods: Multicentre randomized study conducted in six intensive care units (ICU) and emergency departments (ED) in France over a 9-month period in 2012. One hundred and forty two 4th year medical students were randomized to two groups: intervention and control. Students in the intervention group were recorded while making an oral presentation of a patient during morning ward rounds, followed by video-based feedback. Students in the control group conducted presented classical oral presentations without being filmed and with no formal feedback. Anxiety levels during a public oral presentation were assessed using the Spielberger State Anxiety Inventory (STAI-S). The primary outcome was the difference in STAI-S scores between groups at the beginning and at the end of a 3-month ICU or ED internship.

Results: Seventy four students were randomized to the 'video-based feedback' group and 68 were randomized to the control group. In both groups, STAI-S scores were significantly lower after 3 months of internship. However, the reduction in STAI-S scores was significantly greater in the "video-based feedback" group than in controls (-9.2 ± 9.3 vs. -4.6 ± 8.2, p = 0.024. Compared to the control group, significantly fewer students with high-level anxiety were observed in the "video-based feedback" group after 3 months of internship (68 vs. 28%, p <0.001).

Conclusions: Compared to "usual practice", video-assisted oral feedback reduced anxiety and significantly decreased the proportion of students experiencing severe anxiety.

Figure 1

Self-assessment of anxiety generated by oral presentation at the beginning and end of an intensive care unit or emergency department internship. STAI-S, Spielberger State Anxiety Inventory: scores from 20–80. The VBF group, with video-based feedback; the control group, with no video-based feedback; ICU, intensive care unit; ED, emergency department.