The Effectiveness of Health Care Teams in the National Health Service

Audio recording was done with two omni-directional PZM tabletop microphones
linked to different channels of a high quality audiotape recorder; the microphones
were set up so as to maximise channel differentiation but to be unobtrusive enough
that participants would not move them. A single static video camera on a tripod was
trained to record the gross movements of as many of the participants as possible;
this record was used only to aid speaker identification during transcription. Before
each meeting was opened all participants introduced themselves and their
occupation and upon the basis of this each was allocated a speaker number.
Therefore the first person to introduce him or herself became speaker 1, the second
speaker 2 and so on.
Meetings were transcribed from the audiotapes by an audio typist who had not
attended the meeting. Audio typists transcribed complete contributions in order,
according to when they began, labelling each contribution by speaker number, but
did not code finer timing information. Speaker identification was facilitated both by
the video recording and by a seating plan drawn up during the meeting by the person
recording the meeting. A contribution was defined as a period of speech from one
individual in which the only major pauses coincided with silence from the other
speakers, so that the pause was likely to be caused by the speaker thinking and not
by the speaker listening to someone else's contribution. Under this definition,
speakers cannot follow themselves in the speaking order. Overlapped speech was
transcribed, with the extent of the overlap roughly marked. Infrequently, parts of the
meetings were omitted because they were so badly overlapped that we could not
track individual contributions. After transcription, the transcripts were completely
anonymised taking out all staff, patient, place names, place and local authority
names or possible team or person identifiers.
An example transcription excerpt is given in Figure 2.13. Transcription proceeds one
contribution per row. Column one contains the speaker number. Column two
contains the words said, with coding information in a different font, and column three
contains any notes which the transcriber wished to make (for instance, about people
entering or leaving the room). 5
5 In previous work using these methods on four to twelve person meetings, transcribers were
able to agree very reliably who made any one contribution; using the kappa statistic, K=.93, k
= 2, N = 230, with an average of 2% and a maximum of 6% non-backchannel contributions
left as unidentified.