Katherine Miles
ABSTRACT
Video Reflexive Ethnography for Social Sciences Research
Katherine Miles
Faculty of Medicine, Hashemite University, Jordan
Bernadette O’Neill
GKT School of Medical Education
Shuangyu Li
King’s Cultural Competency Unit
Background:
Humanistic approaches to healthcare are required to facilitate positive patient-healthcare provider relationships and health outcomes. Researching these humanistic approaches can be challenging as social interactions are complex by nature. Recognition of complexity in social interactions requires a move away from simple, linear methodologies towards methodologies that can embrace and harness complexity to answer research questions.
Video Reflexive Ethnography:
Video Reflexive Ethnography (VRE) is a novel and proactive research approach which recognises the complexity of everyday social situations. VRE aims to not only generate understanding but also improve practice. It does this by engaging participants and researchers in a collaborative process of reviewing video footage to gain new insights and interpretations about everyday practices. This process can empower participants to improve and change their practices.
VRE has not been widely used as a research approach in the Middle East and the acceptability of these techniques for participants in the Middle Eastern context is unknown. At The Hashemite University in Jordan, I used VRE to explore medical students’ practices of receiving feedback about their clinical communication. I will detail the principles of VRE using the research from Jordan as an illustrative example.
Principles of Video Reflexive Ethnography:
VRE does not have a prescriptive set of procedures but allows for flexible application of four VRE principles to guide the research process.
· Exnovation – using video-footage turned the attention of medical students and myself to the less visible, unconscious habits that structure behaviours during feedback interactions about clinical communication simulations.
· Collaboration – working collaboratively with medical students allowed for different perspectives to be fully explored in the research. This resulted in co-construction of the research and knowledge generating process. This approach was empowering and gave meaningful results to the medical students themselves.
· Reflexivity – video footage enables complex activities, such as feedback, to be re-played and viewed by myself and medical students. Familiar routine activities could be seen as unfamiliar activities of interest. Multiple meanings and interpretations were found as medical students viewed themselves as others might and discussed what was shown and what they saw. Reflexivity has the potential to improve feedback practices and to give medical students increased agency to change behaviours of which they were not previously aware.
· Care – maintaining respect and considering emotions and power dynamics for medical students and myself throughout the research process, to facilitate honest discussions about video footage.
Conclusion:
I found VRE to be a useful, acceptable research approach for healthcare education research in the Middle East context. Medical students engaged with the research process, consented to be video recorded and eagerly contributed to discussions when reviewing video footage. Notably, certain feedback practices were highlighted by reviewing video footage, that students mentioned that they would use in future feedback encounters. Using VRE in the Jordanian context generated new understanding and also facilitated learning, as students engaged with the process, and moved towards change in feedback practices.
BIOS
Dr Katherine Miles is a British medical doctor working as a lecturer in Clinical Communication and Clinical Skills at the Hashemite University Faculty of Medicine. She developed the Faculty of Medicine Clinical Skills curriculum and is the former Director of the Clinical Skills Education and Testing Center. With a specialization in Medical Education, she has a keen interest to improve the standard of teaching and learning of medicine. Dr Miles is the Lead for the iBMS-JO Advanced Medical Education and Ethics Module. Her research interests include advancements and innovation in medical education; methods for effective clinical communication; and cultural competency.
Dr. Bernadette O’Neill is Senior Lecturer, Head of Clinical Communication and Lead for Human Values in the GKT School of Medical Education. She has extensive experience in designing and delivering undergraduate and postgraduate clinical communication modules and training programmes within King’s Health Partners, external NHS Trusts and General Practices. Bernadette has an academic background in social science and qualitative research methods. She has a clinical background in adult general nursing and mental health care of older people. Her Doctorate in Education, awarded by King’s College London, focused on the pedagogy of clinical communication in relation to wider paradigms of clinical competency and human values in healthcare. Bernadette is a Senior Fellow of the Higher Education Academy.
Dr Shuangyu Li is a senior lecturer in clinical communication and cultural competence, and co-director of King’s Cultural Competency Unit. As a trained conversation analyst, he researches clinical consultations with language and cultural discordances. He is interested in using the ethnographic and multimodal approaches in the interactional analysis of diversity issues particularly around how inclusion and empowerment are manifested in communication. His current research is on student attainment (awarding) gaps in undergraduate healthcare programmes and cultural competency education. He is chair of the SIG on Language and Cultural Discordance in Healthcare Communication under the International Association of Healthcare Communication (EACH). He is also vice-chair of the UK Diversity in Medicine and Health.
Shuangyu is a dedicated educationist in medicine and cultural competency. He has developed several substantial modules and subjects in the MBBS curriculum, the MA in Clinical Education, and in College-wide innovation modules. He is working closely with academics, clinicians, patients, professional services staff, and students to develop inclusive and diversified curricula and culture to nourish innovation and improvement around diversity and inclusion.