Guidance for the recording of teaching activities off-campus

Video and audio recordings of teaching and learning activities over IP/networks have become a norm for activities that are being delivered both on-campus and off-campus (such as in clinical settings and GP Practices). Often, the recordings may involve third party individuals not associated with the University such as patients, and/or artefacts that contain sensitive¹ information such as photographs, investigation results or video resources².

Guidance for consent, storage and use of photographs and videos that are collected as part of routine clinical care³ is the responsibility of the NHS or other provider. Any sensitive information cannot be shared outside of the clinical provider organization without the explicit consent of the individual(s) in the recording, and of the organization who is responsible for the storage of that recording (the data controller).  Similarly, whether or not students can be invited to observe, or participate remotely in routine clinical activities using platforms in use by NHS or other providers is outside the scope of this guidance, and a matter for the provider. Such activities would not ordinarily be recorded and should not be so without explicit consent from all parties.

Digital (photographic, video or audio) recordings of clinical encounters, examination findings or procedures have long been in widespread use to support learning and assessment of healthcare students and professionals. These can be invaluable for:

• helping students ⁴ learn new techniques and procedures,

• helping students recognise different conditions,

• helping students understand the patient experience of disease and disability, and

• as part of assessing whether healthcare students have met the requirements to progress to the next stage of training, and ultimately qualify in their chosen area.

Where these can be fully anonymised, there is no barrier to their use for educational purposes. However, if that is not the case, this guidance applies.

This guidance deals specifically with recordings that are intended for educational purposes, with particular emphasis on maintaining patient confidentiality and respect of the patient during such sessions. This may be new material specifically recorded for this purpose, or material that has already been collected as part of clinical care, but where there is a desire to use that material for education or assessment outside of the clinical care environment, including in the development of remote learning resources.

This guidance provides broad guidance for the collection of recorded resources intended for educational purposes, and the recording of teaching activities in which either patient participate, or their recorded resources are utilized with links to the relevant regulatory framework.

It will be reviewed annually by the Information Governance Office and the Centre for Technology in Education (CTIE) for relevance and currency, and compliance with Data Protection Legislation. This will ensure emerging research into the student experience in the area is incorporated; that technological changes and enhancements are appropriately reflected, and that the impact of these changes can be considered.

A major consideration is a strict adherence to good practice regarding maintaining respect and confidentiality of the patient’s participation in the session, especially as it is not always known who the remote audience includes, beyond clinicians and healthcare workers involved in the patient’s treatment. This is especially pertinent during teaching, seminars, and experiential learning sessions.

1 In this context meaning where the individual is explicitly, or potentially identifiable

2 Including of cadaveric dissections. Whilst these are not generally identifiable, they are highly sensitive and inappropriate sharing which show a lack of respect for the donor and their families.

3 Including, but not limited to Video-EEG recordings, videos demonstrating clinical signs, photographs of rashes, audio or video recording of consultations (actual or simulated but with a “real” patient).

4 This may include undergraduate students or post-graduate trainees aspiring to be, or already registered as a healthcare professional

Recording of teaching and learning sessions have become vital to the learning process. It ensures that learners can join remotely where they can't be physically present while also allowing for the retrieval of associated recordings. These features extend its usefulness, enabling asynchronous use of the recordings for a variety of purposes. Recordings can be used for: 

• the benefit of learners to revisit relevant material, threshold concepts and discussion to help consolidate learning,

• the benefit of students not able to attend,

• students with disabilities who need to revisit the content covered, and

• staff in cases where tutorial visits have been agreed in advance of the recording for development and quality assurance purposes.

Below is a list of, and where relevant links to, guidance, policies and/or regulatory documents that are relevant to consent and recording of teaching activities in a field environment which must be adhered to:

1. The existing policy on consent and recording at the off-campus location e.g. Trust’s policy if in a Trust environment, or the Practice’s Policy if in a GP Practice environment.
2. St George’s, University of London’s Lecture Capture Policy which covers all lecture recordings at the University.
3. General Medical Council’s guidance on “Making and using visual and audio recordings of patients”
4. Jisc’s guidance on “Recording lectures: legal considerations”

This may include:

• Video, photographic, or audio recording of all, or part of selected patient encounters with a clinician⁵, in an outpatient, inpatient or primary care setting
• Video, a photographic or audio recording of patients in a community setting
• Video, photographic or audio recorded by the patient, or a member of their household or care team in the community setting
• Video, photographic or audio recorded by a clinician, teacher, or professional from media services

Where a third party to the University, such as a patient is involved in your recording, ensure that you have sought their consent in advance and that they have agreed to this. Refer to the following documents which accompany this guidance:

• Consent form for digital recordings (photographic, audio and video) of patients for educational purposes – Version 1 September 2020 (PDF)
• Patient Information Leaflet: digital recordings (photographic, audio and video) of patients for educational purposes – Version 1 September 2020 (PDF)

All those who will be captured and potentially identifiable on the recording must give consent. This may include not only the patient, but potentially the clinician or responsible teacher⁶, or sometimes family, friends or care staff supporting that individual.  

If recording in a clinical setting, ensure other patients or passing staff are not identifiable, e.g. by using a separate room if possible, or on a ward by closing the curtains and advising others in the vicinity that you will be recording or live streaming until completed.

If the patient is 16 or 17, they can be presumed to have capacity to consent. If the patient is under 16 they may give consent if they are deemed to have sufficient capacity and understanding to consent, but they should be encouraged to involve the person or people who have parental responsibility for them in the decision making, ensuring compliance in line with the guidance  in the Mental Capacity Act 2005 and General Medical Council’s guidance on “Making and using visual and audio recordings of patients” and that there is consent from parent/guardian.

5 Consent should be taken by the responsible clinician and include permission for use of that clinician’s contribution.

6 Consent should be taken by the responsible teacher and include permission for use of that teacher’s contribution. 

5.1 Preparation 

Always inform learner(s) before recording the event, ideally well in advance of the session, and again at the beginning of the session. The use of a slide emphasising this such as

Where photographs or recordings containing sensitive information made in advance of the session is being incorporated into the session, the session leader is responsible for the provenance of that material, including confirmation that the individual(s) had given consent for use of the material for this purpose.

Where a third party to the University, such as a patient is involved in your recording at the time of the learning event, ensure that you have sought their consent in advance and that they have agreed to this. Refer to the consent form and patient information leaflet which accompanies this guidance.

5.2 Storage

No clinical photographic images or video recordings should be stored on local ‘c’ drives or unencrypted portable storage devices such as memory sticks, CD/DVDs and laptops, etc. If images are being used, for example, in teaching on personal laptops, these laptops must have appropriate encryption and protection to meet both the University and NHS guidelines.

5.3 Events not suitable for recording and support for students with disabilities 

Some learning events may not be suitable for recording.

Within the University setting, including remote teaching to support teaching on placements, learning events that are primarily interactive, where knowledge and understanding are intended to be assimilated through practice or discussion rather than presented through a lecture-style presentation, may not be suitable. In these cases, the decision to record or not should take topic differences and sensitivities into account and be made in advance, in consultation with module teams, Cluster Managers and tutors:

• If it is decided that a learning event is not suitable for recording, adjustments or alternative versions should be made on request. In particular, if a recording is not made but a student with a disability requests (or has requested) a recording for disability reasons, a reasonable alternative should be provided, the nature of which should be discussed with the student. Possible alternatives include (but are not limited to):
  • a podcast or video blog containing the information shared
  • other alternatives, to be agreed with the student through the Reasonable Adjustment process, such as an additional session. 

If an event is recorded and sensitive issues (for example relating to commercial, medical or personal topics) are likely to be discussed:

• students can be allocated to breakout rooms which are not recorded to discuss such subjects. Within Microsoft Teams, sub-channels can be used as breakout rooms for this purpose. Within Big Blue Button, breakout rooms can be set up during teaching.
• students may report back key issues to the general group which can be recorded.
• lecturer/facilitator can stop recording at key points.

Students with disabilities have a legal right to a recording or alternative if they request one, as they are entitled to receive the learning content that their peers receive. The law protects their access to the learning content, not their experience of it; therefore, although a student may not be able, for disability reasons (e.g. anxiety), to have their participation recorded, they do not have the legal right, under the Equality Act, to prevent a recording being made. In this case, they are advised to request an alternative, such as a recording, one-to-one support or attendance without active (recorded) participation. 

Activities that ordinarily take place outside of the university, where the learning outcomes require students to practice and/or observe the application of knowledge and skills as part of apprentice-style learning would not ordinarily be recorded. Individual students should have reasonable adjustments to support their learning in a clinical environment, but the provision of an alternative would not be compatible with the learning outcomes of the course. For an individual student with disabilities precluding their meeting the course outcomes, despite reasonable adjustments, this will usually have been identified as part of admission and selection procedures. Questions about this, including further help and guidance on how to support students with disabilities should be directed to the disability advise team at disability@sgul.ac.uk. Where new concerns arise for a student who is already enrolled on a course, and occupational health assessment will usually also be required. 

There are some practical measures you may wish to consider when recording teaching activities to ensure that students attending the tutorial are fully aware of the values of recording and not put off by the purpose of recording. These might include some of the following measures:

• Reassuring students that breakout room or sub-channel discussions will not form part of the recording to encourage a ‘safe space’ for students to discuss and articulate ideas, concerns, and debate
• Recording part of the tutorial; focusing on recording any presentation parts of the event and making it clear which parts of the tutorial will not be recorded to allow for unrecorded discussion 

6.1 Equipment

Capturing high-quality video and audio can be challenging, and the use of certain equipment such as clip-on or close-up microphones represents an infection control risk. We, therefore, recommend contacting patientrecordings@sgul.ac.uk before filming for advice beforehand on how best to film and record your intended footage. 

Mobile phone cameras can capture high-quality visuals and are recommended for simple filming tasks, but these do not capture audio well. To support filming with phones, a small stock of equipment including stabilising gimbals and, if audio quality is important for the clip shotgun microphones suitable for isolating sound sources at a distance are available to borrow from the library. If you wish to borrow these, please contact patientrecordings@sgul.ac.uk in advance so that they can prearrange the loan and provide basic training. 

Where a personal device is being used for recording purposes, adequate steps must be taken to keep what is sensitive personal data secure.  This includes:

• ensuring where relevant that you are doing so in line with the process established by the Care/NHS provider e.g. St George’s Hospital Trust’s Mobile Device Management (MDM) solution. If unsure, please contact your Care/NHS provider IT department for details/support.
• the recording device (e.g. smartphone) being encrypted and password-protected, only known to that individual. This is now standard for smartphone/tablet devices.
• Device settings adjusted so that videos do not automatically synchronise with potentially insecure cloud-based services such as iCloud, Google Drive, OneDrive, and so on.
• After any recording has been made it should be transferred typically within 48-72 hours to the relevant expert for review and stored in a secured space in line with the relevant governance of the organisation responsible for securing the content e.g. NHS Trust, Surgery/Practice, or the University. See section 6.2 for details of how to do this.
• When it is known and verified that the video has been stored/successfully received elsewhere then the original must be deleted from the personal device (and any cloud services if applicable).

You are responsible for completing these steps – failure to do so risks a significant information breach. If you do not know how to do any of these steps, you must seek assistance and be guided to do so before any footage is recorded. 

A minimum specification for your mobile device to be used for filming is enforced to ensure that it meets security standards. An Apple iOS device must be running iOS 11.0 or later. An Android device must be running at least Android version 5.0 or later. 

6.2 Transfer to secure storage

Video files are often too big to email and attaching files to an email may of itself introduce a security risk (depending on the settings used). Video files should be transferred using the University's iDrop encrypted file exchange service. Until the files are received by the University, they remain the responsibility of the individual who has made the recording.

Dropping off the video file and consent form 

• Using the browser on your mobile device go to https://idrop.sgul.ac.uk.
• Follow the on-screen instructions to ‘Drop off’ files for a University user.
• You will be asked to input your details.
  • Put in the name and email address of the person that you are sending it to; the drop off should be sent to patientrecordings@sgul.ac.uk.
  • Add your video file(s) to the drop-off. Providing each video file is under 300MB in size, you should select the box ‘Encrypt every file’. If your video file is greater than that in size, please contact patientrecordings@sgul.ac.uk for further guidance.
  • Set a passphrase to encrypt the files. You must remember this passphrase as without it the file cannot be accessed. The passphrase must be shared separately, not via email,
  • You must also add any completed consent forms to the drop-off or send them immediately via email to patientrecordings@sgul.ac.uk.
  • Having completed the above steps, click ‘Drop-off Files’. You must then share the encryption passphrase, which you set in the above steps.

Sharing the encryption passphrase

You must share the encryption passphrase securely, and not put the passphrase itself directly into an email. To do this:

• Visit https://privnote.com in your web browser.
• Enter your passphrase where you see ‘Write your note here…’. Do not include any other information in the note.
• Click ‘Create Note’. The page will then say: ‘Note link ready’ and will show a web link.
• Copy this link and send it in an email to patientrecordings@sgul.ac.uk. This will allow the recordings team to see the passphrase and receive your dropped-off video file.

The drop off will be received to a shared inbox, and upon receipt, the video will be securely uploaded to the designated folder in Panopto by a member of staff. They will ensure that automatic captioning is enabled and will provide you with access and a link to the video so that you can use it in your teaching materials. Should you need any support with the embedding of video links, please email lts@sgul.ac.uk.

Usage for teaching or assessment 

All patient videos/audio will be stored into a database and managed by the records manager who will ensure that the videos are being used for their intended purposes (as per the signed consent form). 

When patient videos are captured and used for teaching, they are uploaded into Panopto and shared with students via our Virtual Learning Environment, Canvas. 

By using Panopto the video will be streamed and not usually made available for download. If you believe this will not work for your required purpose and need a downloaded copy please contact patientrecordings@sgul.ac.uk to discuss possible solutions. 

The video will remain on the University’s platform for the duration of the educational program in which it is being used. After the program ends the records will be held for a maximum of 6 years before been reviewed for disposal; following the University’s Lecture Capture Policy and Records Retention Schedules. 

Where a video/audio is being used for assessment purposes, it may be temporarily transferred into the assessment platform to make the material available for those being assessed. 

If there is a request to remove the consent to a video this should be done via an email to patientrecordings@sgul.ac.uk. This will then be reviewed via the Information Asset Owner (IAO) within the relevant institute and necessary steps should be taken to remove and delete the video from St George’s platforms.  

Accessibility 

Priority consideration has been given to support for students with disabilities when accessing teaching and learning online, through the provision of automatic live captioning within our primary technologies of Panopto, MS Teams and Big Blue Button. Automatic live captioning can benefit a range of students especially those who are deaf or hard of hearing, as well as students with an Autistic Spectrum Disorder (ASD), students with memory processing issues, and students for whom English is an additional language also find captions useful. 

Human-level captioning is also available where a need has been established through the Disability Advisory team. Human-level captioning requests are processed by the Learning Technology Services (LTS) section and can be requested by email to lts@sgul.ac.uk.                               

Students should not make any unofficial recording of any learning or assessment activity unless agreed with the tutor, and fellow students, and any others involved in the session. Where a recording has been made, it should be clear in the recording that consent had been sought and agreed to. 

Recordings shared with students are intended to support their learning and should only be used for this specific purpose. It should not be reproduced or shared with any individual or via any platform. Unauthorised sharing of recorded material may result in disciplinary under the relevant code of practice for that student. 

Students should consent to the recording of live teaching activity, although it is possible for St George’s, University of London to rely on other lawful bases to record (e.g. recording for students with disabilities as a reasonable adjustment under the Equality Act 2010). The facilitator must make this clear to students at the start of the activity, for example by providing a statement in the notes/slides that reads: 

‘This teaching activity is designated for recording and the recording will shortly start. If you do not consent to the recording, you should not attend this teaching activity.’

Students not wishing to consent to a designated tutorial being recorded can be directed to the other options for that learning event. The student has the right to withdraw consent by leaving the tutorial session should they not agree to the session being recorded.

Where a session will contain additional sensitive information relating to the individual patient(s), the facilitator should additionally make this clear to students at the start of the activity, for example providing a statement in the notes/slides such as follows (depending on the setting): 

Respecting patients and their families

• Families and patients have very kindly shared their stories
• We owe them and their families all due respect
• While it is legal to share pictures and films with permission in lectures/teaching sessions, they must never be photographed and shared on social media or the internet
• Please only use these pictures or videos in the context they were intended for
• Failure to do so will be treated as a serious disciplinary and fitness to practice issue.

Respecting our donors

• Our donors have generously donated their bodies for your benefit.
• We owe them, and their families, due respect.
• While it is legal to use photographs in teaching and research, images of donated bodies or body parts from the University must never appear on social media or the internet.
• Please only use these videos and images as they were intended.
• Failure to do so will be treated as a serious disciplinary and Fitness to Practise issue.

Recordings must be kept in accordance with the Data Protection Act 2018 (stored securely and destroyed at the end of the lifecycle), and only available to students whilst registered on the course at St George's, University of London. The University retains the right to withdraw any recording at any time due to potential data protection issues. 

Inappropriate use of recorded material is likely to result in a disciplinary matter. 

The Information Asset Owner (IAO) within the relevant Institute should own the process and ensure the correct consent is obtained and recorded for the video. 

All queries relating to this guidance should be directed to patientrecordings@sgul.ac.uk