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Updated: Oct 15, 2025

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Three strategies when physicians provide complex information in interactions with patients: How to recognize and
J M Nordfalk1, J Menichetti2, O Thomas2
1Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway; University of Oslo, Norway.
Objective:
To define and operationalize three taught strategies for providing information in interactions with patients using videos collected in a randomized controlled trial (RCT).
Methods:
This was a qualitative exploratory study embedded in a randomized controlled design, using microanalysis of face-to-face dialogue as an inductive video analysis method to operationalize physicians' use of three information-provision strategies. Data were 34 video-recorded simulated (but unscripted) interactions between 17 physicians and 34 multiple sclerosis patients collected before and after a brief course on information provision. We operationalized (1) mapping the patient's preferences and (2) checking the patient's understanding, and pauses indicative of (3) portioning information.
Results:
Results are detailed analytical definitions, criteria, and assessable, quantifiable outcomes for each of the three strategies. Patients responded to portioning pauses as expected: whereas 91% of these pauses elicited an immediate patient response, only 23% of non-portioning pauses did so.
Conclusion:
Our methods revealed how to define and evaluate information sharing strategies physicians used within the contingencies of clinical interaction.
Practice Implications:
Findings provide applicable methods to teach, analyze, and evaluate information sharing strategies and indications for further training.
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