Studying Medical Communication with Video Vignettes: a Randomized Study on How Variations in Video-vignette Introduction Format and Camera Focus Influence Analogue Patients' Engagement

Overview

Journal BMC Med Res Methodol

Publisher Biomed Central

Specialties General Medicine
Health Services

Date 2018 Jan 21

PMID 29351736

Citations 4

Authors

Leonie N C Visser

Nadine Bol

Marij A Hillen

Mathilde G E Verdam

Hanneke C J M de Haes

Julia C M van Weert

Ellen M A Smets

Affiliations

Soon will be listed here.

Abstract

Background: Video vignettes are used to test the effects of physicians' communication on patient outcomes. Methodological choices in video-vignette development may have far-stretching consequences for participants' engagement with the video, and thus the ecological validity of this design. To supplement the scant evidence in this field, this study tested how variations in video-vignette introduction format and camera focus influence participants' engagement with a video vignette showing a bad news consultation.

Methods: Introduction format (A = audiovisual vs. B = written) and camera focus (1 = the physician only, 2 = the physician and the patient at neutral moments alternately, 3 = the physician and the patient at emotional moments alternately) were varied in a randomized 2 × 3 between-subjects design. One hundred eighty-one students were randomly assigned to watch one of the six resulting video-vignette conditions as so-called analogue patients, i.e., they were instructed to imagine themselves being in the video patient's situation. Four dimensions of self-reported engagement were assessed retrospectively. Emotional engagement was additionally measured by recording participants' electrodermal and cardiovascular activity continuously while watching. Analyses of variance were used to test the effects of introduction format, camera focus and their interaction.

Results: The audiovisual introduction induced a stronger blood pressure response during watching the introduction (p = 0.048, [Formula: see text]= 0.05) and the consultation part of the vignette (p = 0.051, [Formula: see text]= 0.05), when compared to the written introduction. With respect to camera focus, results revealed that the variant focusing on the patient at emotional moments evoked a higher level of electrodermal activity (p = 0.003, [Formula: see text]= 0.06), when compared to the other two variants. Furthermore, an interaction effect was shown on self-reported emotional engagement (p = 0.045, [Formula: see text]= 0.04): the physician-only variant resulted in lower emotional engagement if the vignette was preceded by the audiovisual introduction. No effects were shown on the other dimensions of self-reported engagement.

Conclusions: Our findings imply that using an audiovisual introduction combined with alternating camera focus depicting patient's emotions results in the highest levels of emotional engagement in analogue patients. This evidence can inform methodological decisions during the development of video vignettes, and thereby enhance the ecological validity of future video-vignettes studies.

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References

Visser L, Tollenaar M, Bosch J, van Doornen L, de Haes H, Smets E . Are psychophysiological arousal and self-reported emotional stress during an oncological consultation related to memory of medical information? An experimental study. Stress. 2017; 20(1):86-94. DOI: 10.1080/10253890.2017.1286323. View

Vuilleumier P . How brains beware: neural mechanisms of emotional attention. Trends Cogn Sci. 2005; 9(12):585-94. DOI: 10.1016/j.tics.2005.10.011. View

Kreibig S . Autonomic nervous system activity in emotion: a review. Biol Psychol. 2010; 84(3):394-421. DOI: 10.1016/j.biopsycho.2010.03.010. View

Mauss I, Robinson M . Measures of emotion: A review. Cogn Emot. 2009; 23(2):209-237. PMC: 2756702. DOI: 10.1080/02699930802204677. View

Medendorp N, Visser L, Hillen M, de Haes J, Smets E . How oncologists' communication improves (analogue) patients' recall of information. A randomized video-vignettes study. Patient Educ Couns. 2017; 100(7):1338-1344. DOI: 10.1016/j.pec.2017.02.012. View

Blanch-Hartigan D, Hall J, Krupat E, Irish J . Can naive viewers put themselves in the patients' shoes?: reliability and validity of the analogue patient methodology. Med Care. 2012; 51(3):e16-21. DOI: 10.1097/MLR.0b013e31822945cc. View

van Vliet L, Hillen M, van der Wall E, Plum N, Bensing J . How to create and administer scripted video-vignettes in an experimental study on disclosure of a palliative breast cancer diagnosis. Patient Educ Couns. 2012; 91(1):56-64. DOI: 10.1016/j.pec.2012.10.017. View

Deng Y, Chang L, Yang M, Huo M, Zhou R . Gender Differences in Emotional Response: Inconsistency between Experience and Expressivity. PLoS One. 2016; 11(6):e0158666. PMC: 4928818. DOI: 10.1371/journal.pone.0158666. View

van Vliet L, van der Wall E, Albada A, Spreeuwenberg P, Verheul W, Bensing J . The validity of using analogue patients in practitioner-patient communication research: systematic review and meta-analysis. J Gen Intern Med. 2012; 27(11):1528-43. PMC: 3475831. DOI: 10.1007/s11606-012-2111-8. View

10.

Kreibig S, Wilhelm F, Roth W, Gross J . Cardiovascular, electrodermal, and respiratory response patterns to fear- and sadness-inducing films. Psychophysiology. 2007; 44(5):787-806. DOI: 10.1111/j.1469-8986.2007.00550.x. View

11.

Sep M, van Osch M, van Vliet L, Smets E, Bensing J . The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients. Patient Educ Couns. 2014; 95(1):45-52. DOI: 10.1016/j.pec.2013.12.022. View

12.

Visser L, Tollenaar M, Bosch J, van Doornen L, de Haes H, Smets E . Analogue patients' self-reported engagement and psychophysiological arousal in a video-vignettes design: Patients versus disease-naïve individuals. Patient Educ Couns. 2016; 99(10):1724-32. DOI: 10.1016/j.pec.2016.04.012. View

13.

Hillen M, van Vliet L, de Haes H, Smets E . Developing and administering scripted video vignettes for experimental research of patient-provider communication. Patient Educ Couns. 2013; 91(3):295-309. DOI: 10.1016/j.pec.2013.01.020. View

14.

Shapiro D, Boggs S, Melamed B . The effect of varied physician affect on recall, anxiety, and perceptions in women at risk for breast cancer: an analogue study. Health Psychol. 1992; 11(1):61-6. DOI: 10.1037//0278-6133.11.1.61. View

15.

de Haes H, Bensing J . Endpoints in medical communication research, proposing a framework of functions and outcomes. Patient Educ Couns. 2009; 74(3):287-94. DOI: 10.1016/j.pec.2008.12.006. View

16.

Baird A, Scheffer I, Wilson S . Mirror neuron system involvement in empathy: a critical look at the evidence. Soc Neurosci. 2011; 6(4):327-35. DOI: 10.1080/17470919.2010.547085. View

17.

Fernandez C, Pascual J, Soler J, Elices M, Portella M, Fernandez-Abascal E . Physiological responses induced by emotion-eliciting films. Appl Psychophysiol Biofeedback. 2012; 37(2):73-9. DOI: 10.1007/s10484-012-9180-7. View

18.

Visser L, Hillen M, Verdam M, Bol N, de Haes H, Smets E . Assessing engagement while viewing video vignettes; validation of the Video Engagement Scale (VES). Patient Educ Couns. 2015; 99(2):227-35. DOI: 10.1016/j.pec.2015.08.029. View

19.

Bradley M . Natural selective attention: orienting and emotion. Psychophysiology. 2008; 46(1):1-11. PMC: 3645482. DOI: 10.1111/j.1469-8986.2008.00702.x. View