Video Vignettes: Lab-in-the-Field Experiment in Burkina Faso

The video vignettes were applied within the context of a “lab-in-the-field experiment” in Burkina Faso that tests effects of various incentive measures on provider performance within the context of a “laboratory” setting. We designed video vignettes representing cases related to maternal and early childhood care. The cases followed symptom description and treatment protocols as defined by Burkina Faso’s national therapeutic guidelines as well as WHO IMCI guidelines. The cases were developed and tested with nurses at the two nursing schools in Ouagadougou in January 2014.

For ability measurement, we used 4 cases: a pregnant woman experiencing pre-term labor, a 6-month-old child with pneumonia, a lactating woman with mastitis and a 3-year-old child with measles. In order to capture the variety of ways in which patients present themselves to practitioners, each case consisted of a video lasting either 60 or 100 seconds. In all cases, the same actress was used to play the role of the patient, and always in the same setting (an average clinic). Two of the videos lasted 60 seconds each, and represented “simple” cases in which the actress used normal language and had a standard appearance. These cases were the pre-term labor and the mastitis cases. The 100 second videos represented cases with more symptoms and, in addition, the actress used rambling language and appeared to be poorer and less educated. This more disadvantaged socio-economic status was conveyed through the patient’s dress and the vocabulary and language she used to describe her illness history and symptoms. The two 100 second cases were the child with pneumonia and the child with measles. The videos were shot and edited by renowned director Boubakar Diallo.

Subjects viewed the video and were asked to select the correct (1) diagnosis, (2) treatment, (3) follow-up schedule, and (4) alternate treatment in case the patient did not respond well to the initial treatment course. For each question, they selected their answer from a multiple-choice list, which can be downloaded here.

Each answer set had one correct response, two nearly correct responses, and two wholly incorrect responses, yielding additional variation. “Wholly incorrect” responses would be inconsistent with the symptoms and data provided in the case while “nearly correct” responses would be consistent with most (but not all) of the symptoms provided to the health professional.  Correct responses were those that followed the national guidelines.

2E Preterm Labor: simple case

10E Mastitis: simple case

7E Child Pneumonia: complex case

19E Child Measles: complex case