Challenges and opportunities of undertaking a video ethnographic study to understand medication communication.
OBJECTIVE
To examine the challenges and opportunities of undertaking a video ethnographic study on medication communication among nurses, doctors, pharmacists and patients.


BACKGROUND
Video ethnography has proved to be a dynamic and useful method to explore clinical communication activities. This approach involves filming actual behaviours and activities of clinicians to develop new knowledge and to stimulate reflections of clinicians on their behaviours and activities. However, there is limited information about the complex negotiations required to use video ethnography in actual clinical practice.


METHODS
Discursive paper.


METHODS
A video ethnographic approach was used to gain better understanding of medication communication processes in two general medical wards of a metropolitan hospital in Melbourne, Australia. This paper presents the arduous and delicate process of gaining access into hospital wards to video-record actual clinical practice and the methodological and ethical issues associated with video-recording.


CONCLUSIONS
Obtaining access to clinical settings and clinician consent are the first hurdles of conducting a video ethnographic study. Clinicians may still feel intimidated or self-conscious in being video recorded about their medication communication practices, which they could perceive as judgements being passed about their clinical competence. By thoughtful and strategic planning, video ethnography can provide in-depth understandings of medication communication in acute care hospital settings. Ethical issues of informed consent, patient safety and respect for the confidentiality of patients and clinicians need to be carefully addressed to build up and maintain trusting relationships between researchers and participants in the clinical environment.


CONCLUSIONS
By prudently considering the complex ethical and methodological concerns of using video ethnography, this approach can help to reveal the unpredictability and messiness of clinical practice. The visual data generated can stimulate clinicians' reflexivity about their norms of practice and bring about improved communication about managing medications.
College of Nursing and Public Health, Adelphi University, Garden City, NY, USA.
Wei
W
Liu
Melbourne School of Health Sciences, The University of Melbourne, Carlton, Vic., Australia.
Marie
M
Gerdtz
School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia.
Elizabeth
E
Manias
D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence; D003142:Communication; D006801:Humans; D061214:Patient Safety; D014741:Video Recording
ethical issues; hospital access; medication communication; video ethnography