Evaluating the Use of Video-Stimulated Recall to Research the Osteoarthritis Consultation in Primary Care: Reaching Parts Other Methods don't Reach

Background/Purpose Video-stimulated recall (VSR) is a method of enhancing participants’ accounts of a consultation using a video recording of the event to encourage and prompt participant recall in a post-consultation interview. VSR is used in education and education research, and to a lesser extent in medical and nursing research, although little is known about the validity, utility and acceptability of the method. This abstract describes an evaluation of the use of VSR in a study of the Osteoarthritis (OA) consultation in primary care in the UK. Methods With ethical approval and informed consent, 195 doctor-patient consultations were video-recorded with patients aged ≥ 45. Seventeen consultations in which OA was discussed were the subject of post-consultation interviews using VSR. VSR interviews were conducted with 17 patients and 13 General Practitioners (GPs). Evaluation of the method was achieved by thematic analysis of comments made during video playback, in addition to analysis of observations, field notes, consultation and interview transcripts. Empirical quotes will be presented to illustrate the findings. Results Validity There was evidence of the video altering both GPs’ and patients’ behaviour in the consultation with GPs particularly keen to demonstrate ‘desirable’ behaviours. However, GPs frequently expressed surprise that their actions did not reflect what they felt was best practice, and so we conclude that any altered behaviour would not bias study findings and would likely help interpretation of clinical behaviour during VSR. Utility The method was useful to explore meanings behind specific sections of talk in the consultation and both patients and clinicians often adopted a more critical stance to the consultation following playback. VSR resulted in subtly different ‘added value’ to interviews with patients and doctors. Patients were more empowered to reveal emotional narratives following video playback. VSR gently challenged GPs’ descriptions of their “normal” consultations. Acceptability Both GPs and patients reported finding the method broadly acceptable with some reporting enjoyment and educational value. However, occasional distress and anxiety occurred in interviews, to which the video playback may have contributed. Conclusion This study adds to the existing literature on VSR by describing specifically how this method enables a more critical, specific and in-depth response from participants to events of interest during clinical encounters, and in doing so, generates multiple perspectives on such encounters. The benefits of VSR for clinical and educational research need to be considered in conjunction with the important ethical considerations and the potential for this method to be intrusive