Table 2

Phases of video reflexive ethnography (VRE)

VRE phasesAnalysis process
Phase 1: video recordingFirst-level analysis
 1.1 Conducted a ‘dry run’ 1–2 days before video recording to understand logistical issues that may have created a challenge.
 1.2 During the ‘dry run’ we considered the positioning of videographer to minimise disruptions during video recording.
 1.3 Video-recorded patient care rounds in their entirety.
 1.4 Position of the videographer was adjusted if necessary.
 1.5 Each set of rounds was edited into separate clips, each clip containing one conversation between the physician and a nurse.
  • Members of the research team reviewed each video as soon as possible after recording to assure that the phenomenon of interest (communication between physicians and nurses) was being captured.

  • Research team voted on which clip contained the most interesting communication exchange to take forward to phase 2. Communication exchanges were deemed ‘interesting’ if there was lack of consensus or differing perspectives between nurses and physicians.

Phase 2: independent reviewSecond-level analysis
 2.1 Participants independently reviewed a copy of the video-recorded conversation on a laptop that we took to them.
 2.2 Participants were asked to stop the video at any point and comment on their thoughts or feelings, recalling their cognitive activity at the time.
 2.3 Specific questions were asked during the interview to prompt recall (eg, “What surprised you about the conversation, if anything?”).
 2.4 Comments from both nurse and physician participants of the same conversation were audio-recorded.
 2.5 Comments were edited into the video at the exact timestamp when the comment was made.
  • In research team meetings we watched videos with embedded comments and discussed what we were seeing.

  • Preliminary themes were identified through individual video reviews and discussed in team meetings.

Phase 3: joint reviewThird-level analysis
 3.1 In semistructured interviews conducted by the study team members, each physician–nurse dyad first watched the video together with both sets of comments embedded in it.
 3.2 To generate reflexivity, we asked participants to describe why—during the independent review—they paused the video at a particular juncture, to understand the interaction from their perspectives.
 3.3 To learn about the development of shared understanding, we asked if any independent review comments from the other participant revealed information that was unknown or misunderstood during the original conversation.
  • Using a constant comparative technique, the members of the research team independently reviewed the transcripts of both phase 2 and phase 3 reviews, looking for similarities as well as differences in themes between the phases.

  • Discussion of findings to reach consensus.