Video lessons: Be an exam room hero (Proceedings)

Take a moment and ask yourself these questions in regard to your veterinary practice:

• Are you certain that clients are being offered a consistent standard of care?

• Do team members have the tools and resources to meet the clients' needs?

• What future training do you see your team needing to best grow the business?

• How does your team best learn?

• What training have you specifically done in the past that has targeted client interaction on an individualized basis?

While there is little argument that costs are rising for training clinic team members, significant debate does exist over what methods of training will ensure consistency, enable the adoption of new skills, and create an environment that allows team members to coach themselves to achieve greater performance. When done correctly, recording employee/client interactions on video for one-on-one review can be one of the most valuable training tools available to change ineffective behavior into consistently productive client communication.

This article will cover a number of essential components that should be considered and implement in order to realise the full potential of video coaching in practice.

Communication

A 2005 survey of the American Management Association identified that more than half of employers use video surveillance as a way to decrease theft and violence1, while only 16 per cent of those businesses use that information for evaluating employee performance.2 While your practice may already be using video technology as a method of monitoring for theft-prevention or safety, video coaching differs in its ultimate aim, and these differences include how the information will be captured, what will be done with the video and how it can change your practice. 

The success of this process will hinge on clear communication with your team members, assuring them that this will not be a covert operation but rather an openly acknowledged training tool for reviewing staff and client interactions and subsequent coaching for future performance. This is not about looking for mistakes; it's about looking for ways to improve.

Each of us has had those moments when we replay a conversation with a client and wonder, ‘Could I have done something differently?' Seeing the entire interaction can provide clear answers – after all, a picture is worth a thousand words. So remember that the team will need to be reassured that the main goal of filming is for those images to help them choose just the right words in order to communicate more effectively with clients in the future.

Rules for everyone

Because there may be some initial resistance from the team about being recorded on video, it's important to establish clear, steadfast rules that will be outlined and followed so as to reassure the team that this is a training tool to be used in a positive manner. Recording an exam will proceed only after the client has been advised. A consultation could begin, for example, by saying, ‘Ms. Jones, we are videotaping today for training purposes. Is that okay with you?' Usually clients are glad to give consent, but if the client does not approve, then the camera is to be turned off. Signs must be posted to alert clients and remind team members that the practice is using video cameras, and that it is not a secret activity. While there may be a sense of natural apprehension at the onset of using video, over time, team members will likely have to be reminded that the video is running-it will become part of the landscape. Establish that the video will be used as a tool for training only, not as surveillance.

Setting up publicly

Implement a clear policy that outlines how the video will be recorded and evaluated to ensure maximum benefit to the employees as well as to the practice. To get the most out of the process, this should not be a one-time activity. Plan to evaluate it monthly and set goals with a timeline for each team member, then evaluate their success. A policy example can be found in Box 2.

One-on-one coaching

Be sure to have your team members assess themselves before their review with their supervisor. It is likely that the team members will readily pick up on how to improve and know what they need to do before the review. This will help them feel more confident ad supportive of your coaching over time. Reinforce this action; point out what they are doing on their own to improve and how that not only directly impacts the well-being of pets, client satisfaction and the health of the practice, but also enhances their skills. This is where an incentive program can accelerate results.

The rock star reel

Did you just watch Erin give a perfect explanation of why your pet needs to have a senior profile? Did you see how amazing Dr. Sanchez was in her response to an angry client? Videos are amazing tools for training new staff. Ask your team members if they would be comfortable sharing their expertise by showing how to perform at that star level in such special videos. Creating a collection of these interactions is incredibly instructive to new employees.

The benefits of using video for coaching in veterinary practice

• Team members can specifically review the actual interaction with each client, not simply go on what they remember about it.

• Video can be viewed and compared "back-to-back"? to see improvement over time.

• Team members can review an interaction multiple times focusing  on things such as their body language, word choice, speech volume and cadence and find something different upon each viewing.

• See a complete visit from the client's perspective, not just the team member's part. Set up the camera to show the entire exam room.

• Find out what clients do in your exam room when you are not present, then think of what you could do to make this a productive time for them and you.

Example policies for team video coaching

• The practice utilizes video as an individual staff coaching tool to evaluate interactions with clients exclusively in the exam room.

• Recording will take place in identified exam rooms on specified dates and times. All exam room assistants or technicians, receptionists, kennel assistants, and veterinarians will be expected to participate, as the entire visit in the exam room will be recorded. The video camera is to be set up correctly so the entire room will be visible.

• All staff who greet clients and guide them into the exam room are to state that the visit is being recorded and request the client's permission (for example, “Mrs. Jones, for training purposes we are recording this on video today-is that okay?”). If the client declines, the video camera is to be turned off.

• Team members will have opportunity to review their video and pick which of the clips they would like to review with their supervisor. Each team member will use an evaluation checklist and submit it to the supervisor prior to the review. (See checklist examples in figures 1 and 2.)

• The supervisor will review the clip one-on-one with the team member and complete the checklist for comparison with the team member's checklist. An agreed-upon goal will be established for the next videotape session.

• An incentive will be included, for example, all team members who complete four video reviews in a 12-month period will receive a $100 bonus and be entered into an annual drawing for a paid day off at a spa.

Positive and productive

Your team members will probably be concerned that this will be a negative experience that consists of looking for what they are doing wrong. Demonstrate that it's about building on their current skills and creating positive reinforcement. Start the discussion by asking them to identify what they did well and what they would do differently. Focus on the interaction, not the person. See Table 1 for additional recommendations to make coaching a positive experience.

Table 1: Positive coaching techniques

DON'T

DO

Use general feedback (“Good job” or “Nice work”) when reviewing video. Be specific: “Your use of the pet's name was just right in your introduction.” Believe that change isn't possible. Look for changes from one video to the next. Make a long list of mistakes.

Use a 3-to-1 ratio-identify three positive attributes for each negative feedback component. This will help keep you from sounding too negative and provide an overall tone that reinforces what the team is performing well.

Think you have nothing to learn. Get feedback from your team members. Ask them about the process, what is working, what they would change, and whether they like to mentor a team member in the future. Sugarcoat criticism and confuse your team members on what you want them to do. Stay specific to the example and not to the individual, then give a direct way to correct the issue (for example, “Next time, offer to review the medical care plan with the client prior to starting the services; this will prevent any issues with the bill after the services have been completed”). Fail to establish goals for the next video session. Mutually identify with the team member two areas to focus on in the next video.

Summary

To change ineffective behavior, the first step is to recognize that it is not working and clearly understand what will work. Video can dramatically depict how a team member is communicating with clients at that essential point: when they're in your exam room. Don't leave it up to chance; leave it up to training.