Breaking Down the Skills: Designing and Pilot-Testing a Video-Based Microskills^® Training for Sexual Health Educators

Figures & data

Table 1. Key SkillFlix terms with examples.

Term with definition	Skill (Skill set) A set of Microskills that comprise a larger skill.	Microskill The natural “bite-sized” sub-skills that combine to create a skill. Microskills are the ideal size for quick learning via observation—they can be modeled in only 2–6 steps.	Microskill steps The specific steps (like steps in a recipe) that comprise a Microskill. Steps are modeled in each video with synchronized supporting text edited into the video.	Topic The content addressed in the Microskill video. "Topics are not inherent in the Microskill, but are a way to frame the skills of interest to educators.
Example	Answering Sensitive Questions	Answering an “Is it Normal?” Question Example: the anonymously submitted question, “Is it normal for my penis to be hard in the morning?” (See Table 3 for more examples.)	Provide definition of terms in the question. Address facts or values embedded in question. Match amount of detail to amount of time. Acknowledge range of experiences.	Anatomy and Physiology Erection Penis

Table 2. Summary of Phase I benchmarks of success (additional details in Tables 6 and 7).

Benchmarks	Phase I results
(1) Successful launch of SkillFlix website to prepare and support sex education teachers to use best practice Microskills.	The SkillFlix portal was successfully launched on October 28, 2017 with best practice video models for sex education educators in the pilot. The site continues to be available to key educators and trainers in the field.
(2) Satisfaction and usefulness results with mean ease-of-use scores of 5 or better on 7-point scales.	Mean scores from usability survey: Satisfaction = 6.9 Usefulness of Information = 6.36 Ease of Use = 6.27
(3) Increased knowledge and perceived skill level of educators using Microskills.	Reaction interviews revealed perceived increases in knowledge (in 100% of educators) and better skills in leading the lessons (83% teachers). Survey results showed a significant increase in perceived level of skill (p = .01).
(4) Increased demonstration of best practice Skills/Microskills as measured by comparing pre- and post-intervention assessment videos.	Observation data revealed significant and very large increases in Critical Skills Score in pre/post measures (p < .001) and the All Skills Scale (p < .001).

Table 3. Example of Microskills.

Answering Sensitive Questions is a skill set that includes 12+ Microskills, including:

Establishing group agreements Responding to “shock” questions (personal, angry, offensive language, technique questions) Responding to “am I normal?” questions Responding to “information-seeking” questions Responding to “permission-seeking” questions Introducing the anonymous question box Answering anonymous questions

Figure 1 Sample SkillFlix Video Web Page.

Table 4. Pilot evaluation protocol.

Pilot Session One: Educators come to site and:

Lead 30-min sex ed lesson with 10 teens while being videotaped (pre-assessment video) Complete brief in-person reaction interview Complete pre-survey (self-perception survey) Receive instructions (including private passwords) on how to use SkillFlix. Next 7 Days: Educators used SkillFlix at their own pace, with number, order and combination of videos/features entirely determined by the user.

Pilot Session Two: Educators come to site and: Lead a different 30-min sex education lesson with the same 10 teens while being videotaped (post-assessment video) Complete post-survey (self perception-survey) Complete brief in-person reaction and usability interviews (and receive stipend) Site use tracking data was retrieved and analyzed.

Table 5. Pilot study results (n = 11).

Scale	p	Effect size Cohen’s d
Critical Skills Scale	<.001	3.65
All Skills Scale	<.001	2.69
Answering Sensitive Questions, # of times correctly included	<.001	2.41
LGBTQ Inclusivity, # of times correctly included	<.001	1.65
Perceived Level of Skill	.01	1.19

Table 6. Usability survey results (n = 11) based on Likert scales with 1 = worst and 7 = best.

Question	Mean
Appearance of web site	5.18
Ease of use	6.27
How professional was the site	6.27
How informative was the site	6.18
How useful was the information presented	6.36
How much did you like the videos	6.09
How much did you like the educators in the videos	6.91
How much did you like the youth in the videos	7.00
Ease of navigation	6.11
Satisfaction, would recommend to colleague	6.90

Table 7. SkillFlix features.

First phase features

Robust search by skills or content Watch history allows users to track progress Trending videos allow users to access universally most watched videos Video ratings and comments Favorites button for user-created list of favorite videos Written Microskill steps. The Microskills modeled in the video are also described in text below the video for increased comprehension Certificates of completion are created for each skill set. Post viewing printable skill snapshots of all Microskill steps within a skill set User account settings including photo and profile Help functions include a video tutorial and frequently asked questions (FAQs) Optimized for use on mobile devices

Additional features for Phase II

500+ short video clips modeling Microskills User assessment tool to identify a customized learning path that addresses the user’s unique skill-building needs Links to relevant topical information presented in videos (as requested by educators in Phase I) A learning community that includes optional participation in:

Teacher Submitted Skill Videos (vetted before posting), with observation checklists for feedback; and Learning Groups for online discourse eCommerce functionality to charge users for subscriptions to the site