Telepresence: Self-Viewing in Telehealth Visual Communication

During traditional in-person conversations, individuals aren’t usually aware of their facial expressions, body language, or conduct. This changes with visual communication media, such as video chats, where one’s behavior is readily observable during the conversation. This aspect doesn’t seem to go unnoticed, as many video chat users admit they are drawn to watching their own images (O’Gieblyn, 2021). The potential impact of self-viewing during video chats, such as heightened concern about appearance, is receiving increasing scholarly attention (Pfund et al., 2020; Pikoos et al., 2021). The following article analyzes a workplace self-viewing study involving visual communication and suggests how to moderate its impact on telepresence. The term telepresence refers to the utilization of technology to establish a feeling of “presence” with another person in a three-dimensional space distinct from the physical location of the individuals involved. How to optimize telepresence is addressed for practitioners using video communication platforms that allow self-viewing.

New Research into the Effects of Self-Viewing

A research team led by Soo Yun Shin published a study in the Journal of Computer-Mediated Communication. The study aimed to address this gap in the research on the impact of self-viewing in video chats during challenging workplace conversations. Original hypotheses and research questions about the following themes were developed:

• Self and partner diagnostic ability
• Self-evaluation, partner evaluation
• Satisfaction with the solution and
• Conversational behaviors.

These investigative themes were grounded in self-perception theory (Bem, 1972) and objective self-awareness theory (Duval & Wicklund, 1972). Each prediction is discussed in more detail below.

Methods

Participants were recruited from an online paid participant pool connected to a Midwestern university in the US Accessible to university students and the general public, the pool offered a reasonably diverse participant base. A total of 88 individuals participated in the study and received $15 upon completion. However, eight participants were later excluded due to failing the attention check question or failing to follow the experiment’s instructions. 

The final participant count was 80 people (40 pairs) with the following characteristics:

• The average age of the final sample was 33, with a standard deviation of 14 and an age range of 19-69 years.
• Females constituted 67.5% of the participants.
• In terms of ethnicity:
• 71.3% identified as Caucasian
• 12.5% identified as Asian
• 5% identified as African American
• 2.5% identified as Middle Eastern
• 1.3% identified as Hispanic.

A lab-based experimental approach was used with a between-subjects design featuring two conditions: self-view and no self-view. The research process collected three types of data:

1. Real-time monitoring of participants’ physiological arousal and eye movements (gaze) during the conversation.
2. Post-conversation self-report data that included evaluations of oneself, the partner, and the proposed solution.
3. Transcriptions of all video chat conversations for subsequent text analysis.

Self-Viewing Study Summary

The study’s researchers offered the following conclusions: 

• Self-viewing during video chats can affect self-evaluation, particularly in difficult interactions.
• Self-viewing lowers self-evaluation and satisfaction with the discussion outcome, particularly for self-view-sensitive individuals.
• Self-viewing hampers accurate perception of a partner’s attitude but doesn’t affect self-assessment of physiological arousal.
• Self-viewing reduces negative emotional expressions, with “lower power” individuals showing more behavior change.

The adverse effects of self-viewing stem from its presence, not frequency or duration. The study underlines the importance of careful video chat participation and design. The information gathered in the workplace study enhances our understanding of self-viewing in workplace visual communication. As offered below, the everyday clinician may be interested in how such findings apply to a typical teletherapy interaction.

Telehealth Visual Communication

The study’s findings may have several relevant implications for the workplace and for establishing robust telehealth telepresence. Telehealth practitioners may want to consider the role of the following factors with each client or patient served rather than assuming that telehealth visual communication self-viewing is the same for everyone. Therapists may want to consider their individual needs as well.

1. Enhancing Self-Evaluation. With the ability to view oneself during a video consultation, clinicians might become more critical of their performance. This self-awareness could improve professional development, as they can observe and refine their communication skills and bedside manner. However, too much self-critique could also decrease confidence, impacting their interactions with patients.
2. Influence on Patient Satisfaction. The study suggests that self-viewing could decrease satisfaction with the conversation’s outcome. For telehealth clinicians, this could mean that their patients might be less satisfied with the consultation if the clinicians are visibly self-conscious or overly focused on their performance instead of the patient’s concerns.
3. Understanding Patient Perception. The presence of self-view might impair clinicians’ ability to accurately gauge patients’ feelings or attitudes, as their attention could be split between focusing on the patient and monitoring their appearance and behavior. This could potentially hinder the clinician-patient relationship and the effectiveness of the consultation.
4. Emotional Expression. The study found that self-viewing reduced the expression of negative emotions. For telehealth clinicians, this might mean they can control their emotional expressions better when viewing themselves during a consultation, leading to more professional and empathetic patient interactions.
5. Role-based Behavior. The study also found that behaviors changed based on the role of the individual in the conversation. For example, employees altered their tone to be more positive when self-viewing was enabled. In the context of telehealth, clinicians, who are in a position of authority, might not change their behavior significantly when self-viewing. However, clients or patients, who may feel in a lower power status, could experience an enhanced awareness of their tone and associated behavior.
6. Design of Virtual Consultations Using Visual Communication Channels. The study found that the mere presence of self-view in video chat influenced behavior and perceptions. This underscores the need for careful consideration of how telehealth platforms are designed. For instance, allowing clinicians and patients to disable self-view during consultations might be beneficial.

Overall, the findings suggest that self-viewing during video consultations in telehealth can significantly impact clinician self-evaluation, patient satisfaction, and the overall effectiveness of the consultation. Awareness of these factors could also help clinicians optimize their telepresence when using telehealth platforms and improve the quality of care they provide. Further research in different contexts and with diverse participants would help better understand these findings’ implications.

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