Category Archives: Guest Blogs

Studying Video Consultations: How do we record data ethically during COVID-19?

Lockdown in many countries has affected the way in which healthcare workers interact with their patients. In the UK, for example, a number of medical consultations have gone online, with doctors trying to deal with their patients over Zoom or Skype – and it has not been easy. Lucas Seuren has been working in Oxford in a team actively exploring the costs and benefits of online medical consultation, and I’m delighted that he has agreed to send in a report from the front line.

Screenshot 2020-07-16 at 19.44.19

Lucas Seuren, Oxford University

The outbreak of the COVID-19 pandemic has radically changed the organisation of healthcare services. Social distancing protocols mean that face-to-face contact between patients and health care professionals has to be limited as much as possible. Consultations are now mostly conducted by telephone or video. This provides a unique opportunity for EMCA research on healthcare interaction, but also a significant challenge. Little is still known about how communication works in these remote service models, and as experts on social interaction, we are in a prime position to develop evidence-based guidance. The problem is: how do we get data when we cannot go to places where the interaction take place?

Our research group in Oxford (Interdisciplinary Research in Health Sciences) has been studying video consultations for nearly a decade, and we recently secured funding from the UKRI to investigate the new Remote-by-Default service models in primary care. This project involves a small work package in which we will be investigating how health care professionals assess potential COVID-19 patients during video consultations, with a particular focus on how they assess breathlessness and fatigue. So how did we address the challenges involved in doing this research?


The first challenge in studying video consultations is figuring out how to record the data. This used to be relatively straightforward in the pre-COVID era. In previous research projects, we set up multiple cameras, both in the clinic and the patient’s homes [1, 2]. These would capture the participants as well as their screen and audio feeds (see for example figure 1). In this way, we could get a decent picture of what each participant was doing as well as what they could see and hear of their co-participant. In practice it was not always feasible to get all cameras set up and record in both locations, but we coped.

Screenshot 2020-07-16 at 19.56.45

Figure 1: Four angles during heart failure video consultation

For our new research project, we had to develop a protocol that would give us decent quality data that was also ethically sound. We essentially had to deal with two problems. First, we did not actually have access to the consultations, and second, since we are dealing with acute and potentially serious COVID-19 cases, we could not secure informed consent from patients before the consultation.


To even get data, we had to compromise on the quality. Many videoconferencing solutions like Zoom have built-in recording options, which would mean clinicians could simply record the consultation with the push of a button. Health care providers, however, frequently use specialised video consultation software, such as Attend Anywhere, in which recording is not possible. For these cases, we decided to opt for commercial screen and audio capture programmes that do the same job. In cases where this option is not available, we decided to opt for commercial screen and audio capture programmes that do the same job.

While fairly straightforward, the downside is that you get a very limited picture of the interaction. You only record what the clinician sees and hears on their computer, which is hardly the complete participants’ perspective. It provides few insights into how participants use the technology, the environment in which the interaction takes place, how lag and other technological disruptions shape participant behaviour, or how they use their bodies off-screen. We settled for this limited view, because given our research goals and the practicalities around social distancing, we think we can develop an adequate analysis with one-sided recordings.


The bigger problem was setting up a recording protocol that would meet ethical standards. Our first proposal was for the clinicians to initiate the recording at the start of the consultation, in order not to delay the clinical assessment, and to inform the patients and secure verbal consent at the end of the consultation.

Informed consent is, however, not taken lightly, and so we had to make some adjustments. While we can still get verbal consent after the consultation has taken place, clinicians have to ask patients at the start of the consultation if they can record it. They then have to store the recordings until the point we have been able to talk to the patient, explain the study, and record consent. After that, we use secure data transfer services to move the recordings from the clinician to the secure servers in Oxford. It’s a bit of a hassle, but workable enough.

Fortunately for us, because our research was urgent, both our local Research Governance department and the Research Ethics Committee prioritised the study. Normally this process would likely have taken many months, but in this case we actually had REC approval in the first week of the study! That means that in little over a month we went through the entire research ethics procedure. Well, almost the entire procedure, since we will still need to secure local approval from each clinical site. But clinicians have been very keen to work with us, and so moving forward has not been much of a problem.

Evidence-based Guidance

The goal of this project is of course not simply to investigate how clinicians assess breathlessness and other COVID symptoms by video. We aim to develop evidence-based guidance on how to do this effectively and efficiently. There are currently no established and empirically validated tools [3]. CA can make a vital contribution to addressing the pandemic, because we can show in details which practices clinicians use (not only which ones they report using), how these are understood or misunderstood by patients, and what that means the clinical assessment.

The only real issue now is that lockdown measures have largely been so effective, few patients still call their GP because they might have COVID. We are told a second wave is likely inevitable in the autumn when life moves back indoors. On the one hand, I’d be very happy if that turns out not to be the case. But looking at how the virus is re-emerging in parts of Australia, France, Germany, and with a growing infection rate in the UK, it seems likely that the peak of our work is still to come.


  1. Shaw S, Wherton J, Vijayaraghavan S, Morris J, Bhattacharya S, Hanson P, et al. Advantages and limitations of virtual online consultations in a NHS acute trust: the VOCAL mixed-methods study. Health Services and Delivery Research. 2018;6(21):1-136. doi: 10.3310/hsdr06210.
  2. Shaw SE, Seuren LM, Wherton J, Cameron D, A’Court C, Vijayaraghavan S, et al. Video Consultations Between Patients and Clinicians in Diabetes, Cancer, and Heart Failure Services: A Linguistic Ethnographic Study of Video-Mediated Interaction. J Med Internet Res. 2020;22(5):e18378. doi: 10.2196/18378.
  3. Greenhalgh T, Koh GCH, Car J. Covid-19: a remote assessment in primary care. Bmj. 2020. doi: 10.1136/bmj.m1182.


Guest blog: Why are Zoom meetings so exhausting and frustrating?

Lockdown has made us all very familiar with remote working – and that has meant a great deal of time on various kinds of online meeting platforms: Skype, Zoom, Microsoft Teams, and many more. Lifeline or burden? Andrea Bruun and Ditte Zachariassen report.

Andrea Bruun, University College London
Ditte Zachariassen, Aarhus University

When the pandemic hit, it forced us to stay home and limit social contact. We were told to work remotely and use online platforms such as Zoom, Microsoft Teams, and Skype for our meetings – for all kinds of meetings, even social gatherings such as family dinners, happy hour and pub quizzes happened online..

An abundance of guidelines to improve video meetings were put out by communication consultants, psychologists, and even researchers of workplace talk-in-interaction. But it felt like something was missing.

Why are online encounters so exhausting – not at all the same as talking and being together with people as in the actual world?

This question became acutely relevant to us when yet another DanTIN workshop in June was moved online. The workshop was planned as a team building-like camp stay, and now we were instead facing two full days of Zooming from home. Exhausted at the mere thought of this, we began talking about how hard managing turn-taking is in online meetings. As conversation analysts, we felt that we should be able to see from an interactional point of view why it is so difficult to adapt to online communication – or at least, we would be able describe some of the differences.

Teachers debriefing meeting in Zoom. 
Top left to the right: Mic, May and Jay. Front middle: May. 

Based on a single recording of a Zoom meeting between teachers (see image) and a couple of days of intense brainstorming, we began writing up all the differences between online and physical interaction we could think of. Right now, we are working on an article on five topics: openings; speaker selection; alignment and affiliation; delay of repair; and closings. We illustrate the analysis with examples of these in our transcribed recording of a teachers’ meeting.

For each of the five parts, we present relevant theory, show a couple of examples, and then discuss which interactional limitations video meetings have compared to face-to-face interaction. Relevant theory includes analyses of the usage of address terms, fractured ecologies, and gaze perception, as well as more traditional CA insights in turn-taking, sequentiality, alignment, affiliation, and repair. For example, have a look at this use of Mic’s name:

Using names is often recommended for video meetings where gaze is not available for speaker selection. However, this strategy does not come for free, since using people’s names in interaction can have marked functions as well such as disaligning and disaffiliating. In this example, Jay uses Mic’s name when saying that Mic was responsible for doing a specific activity: He was supposed to upload a recording. Mic hasn’t uploaded this recording, and he goes on providing a long and almost apologising account of why from line 4 and onwards, even extending the shown extract. The response includes several words marking a dispreferred response such as the nåmen ‘well’, altså ‘but’ and øhm ‘eh’ as well as several restarts and longer pauses. So the usage of address terms for speaker selection is one example of a practice, which might feel odd because we most often use address terms for other things in face-to-face interaction.  

Considerations on the format and the purpose of our work was clear from the beginning: We wanted to place ourselves between the guidelines from communication bureaus and the hardcore academic work being done on online interactions. Research on online interaction often focuses on institutional interaction, and instead we wanted to look at video used for less goal-oriented interaction.

Sympathy, not advice!

We did not want to produce or provide guidelines to all the frustrated pandemic-quarantined Zoomers. Instead, we wanted to sympathize with them (and with ourselves). It’s alright. If video happy hour with colleagues doesn’t do it for you, there is a reasonable explanation. You are simply doing overtime work because so many of your usual interactional resources are limited.

During the lockdown, people have used software originally designed for business meetings as platforms for family dinners, pub quizzes and after work-beers. We wonder if different degrees of formality result in different levels of exhaustion? Nurturing relationships with friends and family is probably even more difficult than work meetings when certain interactional resources are unavailable. Or, as psychologist Gianpiero Petriglieri (as quoted on puts it: ‘It doesn’t matter whether you call it a virtual happy hour, it’s a meeting, because mostly we are used to using these tools for work’. 

Guest Blog: A research visit to Helsinki during the pandemic

Sometimes a much-anticipated research visit to a centre of excellence coincides with an unforeseen set of circumstances. That’s what happened to Rachael Drewery, who turned up in Helsinki only to be caught up in the Finnish lockdown. She tells her tale…

Rachael Drewery

Rachael Drewery, Nottingham University

On 18th February, when reports about COVID were found in the middle of UK newspapers, I commenced a three month research visit with the Emotions in Interaction team at the University of Helsinki.  Little did I know that four weeks later I would be conducting a research visit, via online platforms, during a global pandemic.

There I was in Helsinki, seeing COVID rates going up and the numbers using public transport suddenly going down. But after talking it over with my Nottingham supervisors, and with my Helsinki host Anssi Peräkylä, I decided to stay on in this beautiful city and continue my research visit.  Like everyone else, I had to adapt rapidly – setting up a home office, learning how to use online platforms and reassessing the aims for my research visit.  No longer would I be visiting other universities and healthcare institutions, but I could engage in online data sessions and reading groups, and the opportunity to enrol in Helsinki University’s course ‘Goffman and social encounters’ presented itself.

helsinki uni

Helsinki University, Senate Square, pre-lockdown

The timing of that course on Goffman was especially lucky for me.  Selecting and analysing online videos created opportunities for light relief e.g. the widely viewed You Tube video ‘children interrupting a news interview’.  Daily news briefings and outings became resources for considering Goffman’s theories in a pandemic e.g. how health care leaders maintain ‘face’ while admitting that they broke social distancing rules.

Data sessions online

Helsinki has a rich tradition of work utilising conversation analysis and both the Emotions in Interaction and the Intersubjectivity in Interaction groups quickly moved data sessions online.   While online sessions involved new challenges for everyone, including concurrently managing transcripts and video, and turn-taking during discussions, sessions were attended by a large number of participants from different disciplinary backgrounds (perhaps more than if the data session had been in a building).  For a visiting researcher, the opportunity to present data on nurse-patient interaction and to participate in a wide variety of data sessions, including empathy in a book club (Liisa Voutilainen), physiotherapy in mental health settings (Katja Mustonen) and dog walking (Mika Simenon), provided opportunities to develop my analytic skills and gain knowledge from colleagues working in different disciplines.

In addition to data sessions, the Emotions in Interaction team offered a regular reading group and a weekly online coffee break.   Weekly coffee breaks were supportive, breaking the isolation of working and living in one room.  They were also an opportunity to discuss how work including the project Facing Narcissism was progressing during COVID and, being a group of sociologists studying interaction, lots of discussion about observations from people’s daily lives – especially whether people ‘swerve’ to maintain social distancing.   In Helsinki wide pavements, quiet streets and a recommendation to maintain one metre distance from others appeared to allow social distancing without having to actively swerve.

The pandemic in the public sphere

While conducting a research visit during a pandemic was at times difficult, focusing on social interaction presented lots of opportunities to think and apply my learning to what was happening around me.  Observing how people interacted in public spaces as COVID rates increased, how people maintained one metre distance when out cycling or walking, and how people navigated the new rules about travel on public transport during my return to the UK all provided opportunities to think about interaction in an era of social distancing.

Empty departure halls, Helsinki airport, 16th May 2020

Empty departure hall, Helsinki Airport, May 16th 2020

Thank you to my supervisors and everyone at the University of Helsinki who facilitated my staying in Helsinki during a pandemic.  Special thanks to Anssi Peräkylä who took the time to supervise me, and to and the Emotions in Interaction Team (Mariel Wuolio, Aurora Guxholli, Maarit Lehtinen, Katja Mustonen, Liisa Voutilainen, Emmi Koskinen, Pentti Henttonen,) who welcomed me into their team.


Guest blog: The death of George Floyd – should we analyse the tape?

Magnus Hamann is a CA researcher with long experience of analysing the kind of police/citizen encounters that are available on YouTube,  especially those that end in violence. In this guest blog, he wrestles with the many dilemmas facing the academic researcher when something is incendiary, and very much in the public eye: How may an interactional researcher approach a case like the police killing of George Floyd? Should they abstain? Take sides?


Magnus Hamann, Loughborough University

Right now (early June 2020), the story of African-American George Floyd’s death at the hands of a US police force circulates the world. The graphic images in those recordings have caused a collective sadness and anger. Emotions that have led to disturbances, to put it mildly, in many US cities. One recording, especially, has gone viral[1].

It shows one of the officers kneeling on his neck until Floyd dies from asphyxiation. That officer was eventually arrested and charged with murder. I’ve studied video clips of police violence before. This time, I started to do so, but stopped. Here’s why.

Emotionally invested

Watching the videos, I ended up feeling what I imagine so many other people who watched the video felt: Anger, shame, sadness and helplessness. Instead of the usual analytical distance, I felt they got to me emotionally. This experience, initially, made me give up watching the recordings, but also made me think about the practice of working on disturbing data at all.

The fact that the data arguably disturbing to watch, should not dismiss it as something we could or should work on. While thinking about this, I realised that there’s lots of work on distressing episodes in life. For example, Shaw (et al. 2016) analyse the conversational strategies employed by doctors who have to tell parent that their new-born child is going to die.

Still, the difference is that in Shaw (et al.)’s case, no-one is going to argue that the parties are in actual conflict. Even less so, a situation where one is physically hurting the other. With a police killing, it is different.

How to see the video?

When I returned to the recordings, I had the idea of trying to see it the same way that Chuck and Candy Goodwin, two of EM/CA’s pioneers, saw the film of the African-American Rodney King being beaten repeatedly and heavily by members of the Los Angeles police department (1997). Here’s part of their comments on the subsequent trial, commenting on how the clip was being discussed in in court:

”By deploying an array of systematic discursive practices, including talk, ethnography, category systems articulated by expert witnesses, and various ways of highlighting the images provided by the tape, the lawyers for the policemen were able to restructure the complex perceptual field visible on the TV screen so that minute body movements of Mr King, rather than the actions of the policemen hitting him, became the focus of the jury’s attention.”

The Goodwins show how an expert witness, defending the police, was able to make the jury see things from the police’s point of view, by introducing an official coding scheme for the jury to see the incident as it played out. In this scheme, what Rodney King did at each moment was codable as a deliberate action – constructing him as an active agent, responsible for the police striking him 47 times with metal clubs. While the case had been described in the media as a very violent beating, the defence manged to get the jury to see that the police-officers had used reasonable and justified force in the situation. So, while their analysis was, to the liberal mind perhaps, revelatory, and could be seen as a form of protest, the analysis itself was not taking sides as it was simply displaying the practices that lead to the emergence of another way to see the recordings in a different way to the public.

Maybe I could follow the Goodwins’ lead, and just be “analytic” and let the chips fall where they may?

Analysis in whose interests?

Previously when I have presented data of police-officers using force that results in a person dying, I have (rightly) been questioned about whether it is even ethical to scrutinize and investigate these situations. I usually argue that we can and should investigate the practices that lead to a person’s death if we do so in a way that is in the interest of the person who died. This does not mean that our analysis should try and clear the person of guilt or try and place a guilt on someone in the interaction. My argument is that if we wish to approach data of other people’s death in an ethical manner, we must do so with an honest curiosity in the practices that led up to the moment where that person loses their life. Our own identities – here, our ethnicities and perhaps our nationalities – should be irrelevant.

As George Floyd’s death is currently a topic of public discussion, I, as a social scientist, stand in a dilemma. I could participate in the public discourse – help shape it or steer it in another direction. The reason that I have chosen not to engage is actually due to the potentially political grounds such an analysis would have to manoeuvre through. While it is both the reason for doing research that we can help inform the public discourse, we also risk that analytical contributions can become political in a way that constitutes an ethical problem:

“The way in which professional coding schemes for constituting control and asymmetry in interaction are used by the police to justify the way that they beat someone alerts us to ethical problems that can arise when, as social scientists we put our professional skills at the service of another profession, and amplify its voice and the power it can enforce over those who become the objects of its scrutiny. “ (C. Goodwin & M H Goodwin, 1997)

So what should we do?

I believe that we should indeed work on recordings such as the one of George Floyd’s death. Not only do they represent disturbing events of human life. They also represent events that shape a society’s collective understanding. These events should be studied. And, I argue, especially within the EM/CA approach. As Chuck and Candy (1997) formulated it back then:

”…, rather than situating such phenomena entirely in a rather general notion of ‘discourse’, it is necessary to investigate in detail the situated practices through which socially relevant talk and vision are accomplished, something made possible by the resources of fields such as conversation analysis.”

I will return to the recording. Writing this blog post has made me realise that I should. But I will not do it now. I think the public interpretation of the recordings is generally the accepted interpretation of what happened. I have not yet seen interpretations/analyses that are being weaponised in order to change the narrative. I fear that introducing an analysis might muddy these waters. At the same time, I fear that by actually thinking like this, I am also politicising my research.

[1] I won’t link to the video here; it can easily be found.


Goodwin, C., & Goodwin, M. H. (1997). Contested vision: The discursive constitution of Rodney King. The construction of professional discourse, 292-316.

Shaw, C., Stokoe, E., Gallagher, K., Aladangady, N., & Marlow, N. (2016). Parental involvement in neonatal critical care decision‐making. Sociology of health & illness38(8), 1217-1242.


Guest blog: A philosopher looks at Conversation Analysis

Coming across an interview with Susan Notess on the excellent Generous Questions philosophy podcast, I was intrigued by her perspective, as an ethicist, on the dangers of language – and delighted that she used the work of conversation analysts Liz Stokoe and Nick Enfield, among others, to illustrate her argument. She very kindly agreed to write a guest blog,  introducing us to a wider horizon of scholarship about the human conversational contract.

Screenshot 2020-05-10 at 20.12.40

Susan Notess, Durham University

There’s something about language which resembles conductivity. Through it we connect with each other and transmit not just stories, but also fears; not just kindness, but also power. To be able to speak and say what one means is a kind of power, and to be robbed of this power is a kind of injustice. Continue reading

Guest blog: Walking in the time of COVID-19

Lockdown has been socially, professionally and personally challenging for lots if us; but it has also stimulated a great deal of new work in response to the very different landscape we currently live in. I’m delighted to host a guest blog by four wonderful analysts, Eric Laurier, Magnus Hamann, Saul Albert & Liz Stokoe, who’ve used some of their time for a fascinating analysis of just what  “social distancing” means in public spaces. It’s a longer than usual blog, but there’s a lot to pack in… Continue reading

Guest blog: Why didn’t people follow the government’s advice on COVID-19?  

March 25th, 2020: governments around the world require citizens to take increasingly stringent measures to combat COVID-19. In a rapid response to  how Governments are communicating with us about how to limit the spread of the virus, Saul Albert and Charlotte Albury have compiled a report, based on a systematic review by a team led Albury, by on what CA can tell us about how medical advice is given and received.  Continue reading

Guest blog: Elliott Hoey on sniffing

Issue 1 of volume 53 of the journal (the fist issue of 2020) is devoted to non-lexical things we do in interaction – whistling, clicking, moaning: things which are not language, but are deployed in language-like ways. From a wealth of fascinating articles, I’m delighted that Elliott Hoey has agreed to send in lively report of his investigation into the uses of the sniff. Continue reading

Guest blog: Who uses transcriptions of conversations as formal evidence?

Emma Richardson

Emma Richardson, Aston University

It’s not just researchers who go out with their taperecorders and bring back data to transcribe: formal transcripts are part and parcel of the work of Parliaments, law courts, the police, and many others. Emma Richardson has been looking into the reach and scope of official recordings, and asks us to compare officials’ practical interests with our more academic ones. Continue reading

Guest blog: Sharing CA with the public at a research festival

CA is blessed with some exceptionally able communicators, and there is a growing appetite to reach out to members of the public with a show of what CA can do (see the other blogs in this “CA Teaching” section). One now well-established tradition is for members of York’s Centre for Advanced Studies in Language and Communication (CASLC) to engage in York’s research festival (“Yornight“), and I’m delighted that Rose Rickford has sent in a report of what happened this year. Continue reading