A framework for comparing video methods used to assess the clinical consultation: a qualitative study A. LEONG 1 , P. KOCZAN 2 , S. DE LUSIGNAN 3 & I. SHEELER 3 1 McGill University, Faculty of Medicine, 6th Floor McIntyre Medical Sciences Building, 3655 Promenade Sir William Osler, Montreal, Quebec H3G 1Y6, Canada 2 Churchill Medical Centre, London E4 8DG, UK and 3 Biomedical Informatics, Division of Community Health Sciences, St. George’s – University of London, London SW17 0RE, UK (Received March 2006; accepted August 2006) Abstract Background. Single-channel video is an established method for assessing clinical consultation in training general practitioners; however, it is hard to infer the body language of the doctor or how information in the consultation is being integrated into the medical record. A three-channel video was developed combining the conventional view with a camera looking at the doctor’s facial expression and copying the video output from the monitor. However, the choice of three channels and camera angles selected has not been critically appraised. Objective. To develop criteria for comparing single and multi-channel approaches to video recording of the consultation. Methods. Single channel and three-channel recordings of simulated consultations were shown to a panel of 12 health professionals and interviews were conducted to gather their opinions on the level of information presented, quality and assessment. The transcripts were analysed thematically. Results. It was found that in providing visual information the three-channel video was superior to the single channel video. The major elements needed for comparison of the two techniques would be the ability of the video to pick up quantifiable non-verbal communication of the doctor and the patient, and the ability to qualitatively and quantitatively reflect the use and impact of the computer on the consultation. The information provided by the three-channel video could be further classified to essential, desirable and redundant to guide the future development of the multi-channel video. Conclusions. Multi-channel methods should be able to capture the following information: body language and facial expression of doctor and patient; and how the doctor’s knowledge and information collected in the consultation are synthesized into the medical record. Keywords: General practice, family practice, medical record systems, computerized, computers 1. Introduction Video assessment of clinical consultation is a well established technique in the UK and a mandatory part of the GP assessment and the Membership of the Royal College of General Practitioners (MRCGP). While the benefits of the video used for assessment of Correspondence: S. De Lusignan, Biomedical Informatics, Division of Community Health Sciences, St. George’s – University of London, London SW17 0RE, UK. E-mail: slusigna@sgul.ac.uk Medical Informatics and the Internet in Medicine December 2006; 31(4): 255 – 265 ISSN 1463-9238 print/ISSN 1464-5238 online Ó 2006 Informa UK Ltd. DOI: 10.1080/14639230600991668