Midwife patient

Health care education and research

Friday, 7 November, 2014

The use of video feedback is well established and encouraged in the world of health care education and research. Clinical encounters, behavioral protocols, and doctor-patient interactions can be evaluated. Video recording also enables the assessment of communication in great detail.

Midwife-client interaction

Evelien Spelten and colleagues set forth to gain insight into the midwife-client interaction in relation to the quality of care provided by midwives. Focusing on the first antenatal consultation, their study describes the introduction of video recording in midwifery practices for research purposes, the coding process, and the resulting dataset.

Why is video recording so important?

Spelten and colleagues explain that complex interactions are ideally studied after the fact, in order to reduce biases on the parts of the health care provide and client. These videos can then be analyzed in depth using a well-known and proven protocol called RIAS (Roter Interaction Analysis System), a very extensive coding scheme for medical dialogue.

How to set up the video recording

The midwife positioned the unmanned camera to show her full face, in line with protocol instructions provided by the researchers. All interactions took place in an office environment. The client and her partner were usually only recorded from behind or from the side. The researchers aimed to record at least 15-20 client sessions per midwife, but the study produced anywhere from 7 to 23 recordings for each midwife. It has been recommended for future studies that vigilant monitoring of the participants will ensure more effective data collection, resulting in each health care professional reaching the 15-20 recordings mark.

Improving interactions

In Spelten’s experiment, the video recordings and coding of behaviors added great value to the study and improvement of interactions. Spelten et al. note that The Observer XT was used to code behavior directly from the digitized videotaped sessions. They explain, however, that there are a couple of challenges researchers need to tackle before starting with video recordings. For example, it is highly necessary to ensure commitment of health care providers to the research prior to enrolling the practice group as part of the study. This will prevent health care professionals from backing out of their initial consent. Another conclusion from this study is that the intrusive nature of video recordings did not appear to be a problem; client participation was high.

Video recordings provide valuable feedback

In both training and education, video recordings provide valuable feedback. By reviewing videos of real-life interactions, professionals can reflect on their communication methods and learn from each other. Researchers study interactions to evaluate protocols and improve their understanding of doctor-patient interaction processes.

Major labs like the Clinic for Health Services Research and Psychiatry, Akershus University Hospital, Norway, the W21C Healthcare Human Factors and Simulation Laboratory, Máxima Medical Center, and the Behling Simulation Center (The State University of New York) have already begun investing in high-tech equipment to facilitate education, training, and research, and more are expected to surface as health care providers’ knowledge in this field expands.

Observation lab

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  • Spelten, E.R.; Martin, L.; Gitsels, J.T.; Pereboom, M.T.R.; Hutton, E.K.; Dulmen, S. van (2014). Introducing video recording in primary care midwifery for research purposes: procedure, dataset, and use. Midwifery, article in press: http://dx.doi.org/10.1016/j.midw.2014.06.007