1. Flip Recorders An Alternative to Direct Observation
of Clerkship Students’ Interviewing Skills
Beat Steiner, MD MPH and Lisa Slatt, MEd

2. Rationale Explore ways to use new technology in an educational setting
Address institutional need - LCME Standard ED-27
“There must be ongoing assessment that assures students…can demonstrate on direct observation the core clinical skills…specified in the school’s educational objectives.”
Only 1/3 of clerkship students report being observed taking history or doing physical.

3. Agenda Record each other using a Flip
10 minutes
Critique student/patient interviews
12 minutes
Review six months of student feedback
3 minutes
Discuss HIPPA compliance issues
5 minutes
Brainstorm other ways of using Flip recorders
15 minutes

4. UNC Family Medicine Clerkship
Six weeks
Decentralized to seven AHECS across the state
Each week: one day of seminars; four days in preceptor’s office
Flip assignment is required, but not graded
Detailed instructions on clerkship website
Videos reviewed by AHEC faculty on seminar days

5. Anatomy of a Flip Recorder
Ultra 120 minutes, $149.00
Flip Ultra Camcorder
Two standard AA batteries
oft protective case
Wrist strap
TV connector (A/V) cable

6. Recording Practice – 10 minutes

7. Critiquing Student Interviews - 12 minutes

8. Student Written Feedback
N = 69 students [first six months of rotation]
How effective was the flip experience? 2.8 on 4 point scale
How did experience improve your interviewing technique?
55 open-ended comments
75% were positive

9. Student Comments
“I found the Flip Video Recorder to be VERY helpful in improving my interview technique…. Being able to see yourself as you interview and interact with a patient is indispensible to the learning process.”
“I was able to see how some things I purposefully did during an interview, believing that they would create a supportive environment, were actually annoying and disruptive.”
“It raised awareness…of my tendency to look away from the patient and to pause for too long….”

10. Ways to Improve Flip Experience
Clearer instructions: 5
Record an acute care patients: 3
Review assessment and management plans: 4
Inform about battery life: 3
Drop it: 3

11. Protocols to Comply with HIPPA
Protocols satisfy UNC HIPPA Office
Obtain signed consent from patient
While on Flip, videos are NOT encrypted
Students encrypt the recording after it is downloaded to their laptops from the Flip
Delete recording from Flip
Delete encrypted recording from laptop after it’s reviewed

12. Brainstorming Ideas – 15 minutes
Educational Blogs