Clinical Trial Details
— Status: Recruiting
Administrative data
| NCT number |
NCT03374865 |
| Other study ID # |
2016-2822 |
| Secondary ID |
|
| Status |
Recruiting |
| Phase |
N/A
|
| First received |
June 15, 2017 |
| Last updated |
December 11, 2017 |
| Start date |
June 1, 2017 |
| Est. completion date |
December 1, 2018 |
Study information
| Verified date |
June 2017 |
| Source |
Radboud University |
| Contact |
Martijn Stommel |
| Phone |
024 361 1111 |
| Email |
Martijn.Stommel[@]radboudumc.nl |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Digital communication media like video‐interaction (cf. Skype) are increasingly being adopted
in institutional environments like hospitals for physician‐patient interactions. We may
expect that the use of a digital medium affects these interactions in various ways and on
various levels. In video‐interaction, eye contact for example is impossible due to the
position of the camera, which implies interactional behavior through gaze is impaired. This
may influence who speaks when, if and how the participants avoid/ solve misunderstandings,
etcetera. This project makes headway in our understanding of the impact of new communication
media on the role of language‐in‐use as a rich semiotic system, specifically in institutional
interaction. This type of contextualized research reveals which communicative aspects users
consider important, how they manage their institutional relationship through them and how
they go about solving communication problems.
The project compares the interaction of physicians and patients in video‐mediated
consultations to their traditional, face‐to‐face counterparts on both the verbal and the
nonverbal (gaze) level. The affordances of video‐consultations with relevance to
institutional goals and identities are analyzed through a comparison with the interaction in
face‐to‐face consultations. The approach used is Conversation Analysis, which involves
finding patterns on both the verbal and non‐verbal level (in sequences, turn design,
preference, etc.) in order to answer the question what goals and tasks the participants
achieve and what dilemma's or problems they aim to solve in their talk. This study will
provide insights in the limitations and advantages of both channels of communication. Best
practices will be generated and outcomes of the analyses will be used to develop reco
Description:
Research questions This project as a whole aims to understand the affordances of
video‐consultations. The general research question is: What are the interactional affordances
of video‐consultations compared to traditional consultations with respect to the goals and
tasks the participants achieve and the dilemma's or problems the participants (aim to) solve
in their talk?
Methodology The project involves a comparison of face‐to‐face and video‐mediated
consultations through the lens of affordances.
Data Baseline parameters, the Big Five survey, and details on experience and affinity with
video consultation and (social) media use are obtained by means of a questionnaire. The
patients are offered video‐consultation as an option, so all video‐consultation data involve
patients with a certain level of openness and willingness towards the medium. The first set
of data will consist of the recordings of 25 face‐to‐face and 25 videoconsultations of
physicians with patients who have had a cancer resection, were discharged from the hospital
and have a follow‐up 'visit' in which the pathology results of the resection are reported.
The reason for using video consultations for this group is that the patients would optimally
benefit from not having to travel to the hospital, because the patients recently underwent
surgery and are still recovering. These consultations solely consist of talk (no physical
examination), so video consultation is possible here. Other medical departments have already
implemented video consultations for similar reasons. All surgeons are in a similar stage of
their career and the patients are recorded only once during follow‐up consultation after
surgery. The video‐consultations are conducted through "Facetalk", video‐interaction
software. The physicians are trained to use this software and do about 3 to 4
videoconsultations per week. The face‐to‐face consultations are recorded with two camera's.
The video‐interaction data consist of recordings of the physician's screen during the
consultation and a video‐recording of the physician in the physical environment (sitting at a
desk), capturing the physician's body and head movement to and away from the
video‐interaction screen (e.g., towards a second computer screen with the patient's file).
The main applicant is already acquainted with the setting through the observation of
video‐consultations from within the physician's office.
In addition to the video‐recordings, brief surveys will be conducted with patients and
physicians after the consultation to measure satisfaction with the consultation. Informed
consent for the study and related education will be sought from both the patients and the
surgeons. The participants will also be asked for permission to archive the videorecordings
for future research on authentic communication. The recordings will be stored in a safe at
the Centre for Language Studies, Radboud University. Single episodes will be saved
occasionally on the researchers' computer for the benefit of the study (data session). These
episodes will be removed again as soon as possible. The participants will be anonymized in
the transcripts and any publication and conference presentation that may follow from this
study. Anonymization is achieved through functionalities in Windows Movie Maker (drawing
effect) and Audacity (tone adaptation). Rendering participant unrecognizable means that the
audience (of a presentation/ readers of an article) would not be able to recognize
participants without prior knowledge of the hospital, the department etc. These adaptations
do not affect the value of the material because non‐verbal behavior (head shakes, gestures)
and the talk are still understandable in combination. It is acceptable and common in the
academic domain that recordings shown at conferences and in publications are anonymized.
Before the patient is resigned from the hospital after surgery, the surgeon will ask the
patient whether the patient prefers a f2f or video consultation. Then, the patient will be
asked by the doctor whether the patient gives permission to be approached for participation
in the study. If yes, the patient information will be mailed to the patient to read and
consider at home. Permission (including signature) can be e‐mailed to the researcher or given
to the doctor in person prior to the consultation. After that, the doctor will also give
permission and sign. It is possible at any time for the participants to withdraw from the
study and have the video consultation interrupted. To withdraw from the study they should
e‐mail the main researcher of the project. This is explained in the patient information.
Method The analysis will be qualitative (micoanalytic) and iterative. The main method is
multimodal conversation analysis. Conversation analysis has a long tradition of research
based on the rendition of talk and interaction in terms of written transcripts of the audible
cues. The video mediated and face‐to‐face interactions will be compared. This means that
phenomena observed in the video‐mediated consultations will be compared to equivalent actions
and practices in the face‐to‐face consultations, both verbal and non‐verbal. Relevant
phenomena are likely to be the opening of the conversation (checking the technology), the
design of questions (use of more lexical tokens than deixis), particular gestures, specific
repair sequences due to technical trouble etc.). The analysis will be descriptive and will
result in recommendations for doing videoconsulting.
All talk will be transcribed according to CA conventions . Software like ELAN may be used for
the synchronization of multiple video data and for the annotation of (fragments of) the video
data.
