Conversation analysis of video consultations vs face-to-face consultations

19 December 2019

A video consultation is often about the benefits of a digital connection. But what does it mean for the conversation itself? Surgeon Martijn Stommel and his sister Wyke Stommel (assistant professor of Language and Communication, Radboud University) conducted research into specific parts of the conversations, including: the opening.

In this article, we explore potential extra interactional work conducted by participants in video-mediated consultations. We focus on the beginning of the consultation. Our data consist of 39 recorded, postoperative, oncological consultations, both face-to-face and through video-mediated communication (VMC), which we analyzed using conversation analysis. Our analysis revealed small but important interactional and relational efforts that physicians employ to enable mediated health care. While in both video and face-to-face settings, the opening was usually followed by an announcement of the pathology report, we identified an alternative pattern of arriving at the reason for the consultation. Physicians may insert the question ‘how are you?’ (HAY?), being both pro-social and eliciting a patient report of the post-surgical state, in openings of medical consultations. The inserted HAY? was much more common in video consultations than in face-to-face consultations, suggesting that the other-attentiveness conveyed with the question was increasingly important in the video-setting. In response to HAY?, patients produced hedged responses, projecting the relevance of an elaboration of their initial answer. However, surgeons unilaterally closed the self-report with optimistic formulations or assessments in order to move on to the pathology results as the first and main reason for the consultation. This was a disaffiliative move, paradoxical to the prior pro-social HAY?. This indicates that inserting a particular move in a video consultation may pose consequences for the organization of rest of the consultation. It also shows that a detailed analysis can reveal aspects of mediated communication that remain under the surface when relying on contrived data (interviews, surveys).

Martijn Stommel is member of theme tumors of the digestive tract.