Recording patients – what you should know

Teaching with patients is a crucial part of medical education, research has shown that recording patients and using videos facilitates discussions of clinical reasoning, communication and professionalism while actively engaging students as mentioned in Perron et al. (2016). This article focuses on the topic of recording patients, the benefits that can come from it as well as the ethical considerations and privacy concerns that need to be considered.

Why should you record patients?

Apart from the research mentioned in the introduction, recording patients comes with other benefits to medical education. Dohms et al. (2020) presents evidence that providing video-based feedback using real consultations appears to be associated with significant increases in self-perceived empathy. Moreover, this study points out that the use of video feedback appears to be an opportunity for a deeper level of self-assessment, peer-feedback, and reflective practices. Thus, recording patients and using video feedback in training can have positive effects in training communication skills.

Moreover, the results of Eeckhout et al. (2016) indicate that 70% of the GP trainees used in the study were positive about recording consultations and almost 90% noticed an improvement of their own communication skills. As well, it is mentioned that both students and teachers in the field of medicine acknowledge that the power of imaging is underestimated in the training of communicational and vocational skills.

Finally, Zhang et al. (2022) postulate the benefits of video-assisted debriefing by evidencing that it improved learners’ experience, attitude, and performance. This showed that this type of debriefing improved learning outcomes and offered comparable benefits as verbal debriefing.

Thus, from the studies mentioned above it appears that recording patients and using videos in training does help in improving communication skills and learning outcomes. Communicational skills are crucial for providing quality healthcare and patient safety. Being a good communicator can allow a doctor to obtain the required information more easily from patients, while at the same time ensuring the patient feels comfortable, correctly understands what the doctor says and increases the probability of correctly following treatments. If you want to learn more about the importance of communication skills in healthcare then I recommend you go to this article, for now, let us go back to the topic of recording patients.

When should you not record?

Although recording patients has its proven benefits for medical education it might have detrimental effects for patients if not done carefully. Eeckhout et al. (2016) showed that GP trainees believed that in 60% of cases patients felt uncomfortable during video-recorded encounters. Thus, this goes to show that recording patients needs to be done carefully and with consent to ensure their comfort.

Although recording patients does have its benefits for medical education, it is imperative that patient care is prioritized. Patients need to feel comfortable with their doctors. Thus, recordings should only be done in cases where patients are feeling fully comfortable with it and where they understand what the recordings will be used for.

This brings us into the legal and ethical considerations that need to be considered when recording patients.

ethics and legality of patient recording

In general, recording patients is legal if the patient has consented to it. In the European Union the rules around the use of data are stipulated in the General Data Protection Regulation (GDPR).

But what entails consent from a patient. According to the GDPR, consent from a data subject is tied to several rules, these are:

·        Consent must be “freely given, specific, informed and unambiguous”.

·        Requests for consent must be “clearly distinguishable from the other matters” and presented in “clear and plain language”

·        Data subjects can withdraw previously given consent whenever they want, and you have to honor their decision.

·        Children under 13 years of age can only give consent with permission of their parents or legal guardian.

·        You need to keep documentation of the consent.

If the rules mentioned above are followed and consent from a data subject is properly acquired, then recording of patients is legal. For more information about GDPR and what it entails about gathering and using data you can refer to the following article.

Moreover, when it comes to the ethicality of recording patients, consent is also a necessary part of it. Nevertheless, other factors should also be considered apart from obtaining a patient’s consent. For example, patients that are in a bad condition may not be able to fully understand what they are consenting to and therefore should not be recorded. Recording patients should be done mostly in cases where patients are in a good condition and are clearly fully aware of what they are consenting to.

If you record a patient you also have a legal and moral obligation to protect that video from unauthorized viewing. It is your obligation to implement privacy by design architecture in the system(s) you use for recording, sharing, and commenting.

Is it practical to record patients?

Now that we have covered the ethicality and legality of recording patients let us talk about the practicality. Recording patients can be a very practical tool for teaching. This allows students and trainees to go over the content afterwards. In turn, providing more opportunities for self-reflection as well as providing peer-to-peer feedback.

Moreover, unless super precise clinical procedures (like surgeries) want to be recorded for educational purposes, the equipment required to carry out recordings does not need to be advanced. When it comes to educating communicational skills, a simple smartphone or tablet camera will suffice to generate the required patient recordings. However, it is advisable to use an external microphone to make sure the audio is well recorded. Additionally, the research mentioned so far about the benefits of recording patients mostly focuses on the improvement of communicational skills that trainees experience. Thus, it is probable that recording patients is done mostly to improve communicational skills. Therefore, more expensive equipment will not be required. This all goes to say that recording patients can be a very practical tool.

Nevertheless, there can still be an impractical element to patient recording. Patients may feel uncomfortable about being recorded, even if they did consent to it, which could negatively affect their care. To avoid this, it is very important to check for changes in the way patients are interacting after the camera has been turned on. If it seems that they are becoming uncomfortable or if their behavior suddenly changes then it may be best to turn off the recording.

What are the best practices for recording patients?

Recording patients come with several privacy concerns that need to be considered before doing so. Recordings should only be used for educational purposes and any person that does not need to see the recording should not be able to see it. Thus, we believe the best practice to record patients is to use an application that immediately encrypts the video as they are recorded. This ensures the privacy and security of the content in the video. For this, we recommend using the Videolab Recorder.

recording patients app recording patients app

 

 

 

 

 

 

 

 

Additionally, recordings should only be able to be viewed in a secure platform, that ensures the privacy and security. This platform should have the highest standard in security and privacy by design architecture. Moreover, it should comply with the regulations stated in the GDPR. That is of course why Videolab exists, Videolab is a secure online platform that allows you to record, upload, share and comment on videos, while keeping the highest standard in security and privacy by design architecture and complying with the GDPR. Thus, Videolab will deal with the privacy concerns of recording patients, allowing all efforts to be focused on using the recordings to educate trainees and students in the best way possible. Would you like to read about how this was done at different leading university medical hospitals? Check out the success story of Maastricht University here.

Do you want to get started with recording? Or is it time to move your unsafe recordings to a safe system? Contact us!

Bibliography 

Dohms, M. C., Collares, C. F., & Tibério, I. C. (2020). Video-based feedback using real consultations for a formative assessment in communication skills. BMC Medical Education, 20(1), 1-9.

Eeckhout, T., Gerits, M., Bouquillon, D., & Schoenmakers, B. (2016). Video training with peer feedback in real-time consultation: Acceptability and feasibility in a general-practice setting. Postgraduate Medical Journal, 92(1090), 431-435.

Perron, N. J., Louis-Simonet, M., Cerutti, B., Pfarrwaller, E., Sommer, J., & Nendaz, M. (2016). Feedback in formative OSCEs: Comparison between direct observation and video-based formats. Medical Education Online, 21(1).

Zhang, H., Mörelius, E., Goh, S. H. L., & Wang, W. (2022). Effectiveness of Video-Assisted Debriefing in Simulation-Based Health Professions Education: A Systematic Review of Quantitative Evidence. Nurse Educator, 44(3), E1-E6.