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Analysing voice quality and pitch in interactions of emergency care simulation
  1. Frank Coffey1,
  2. Keiko Tsuchiya2,
  3. Stephen Timmons3,
  4. Bryn Baxendale4,
  5. Svenja Adolphs5,
  6. Sarah Atkins5
  1. 1 Department of Research and Education in Emergency Medicine, Acute Medicine and Major Trauma, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2 International College of Arts and Sciences, Yokohama City University, Yokohama, Kanagawa, Japan
  3. 3 Centre for Health Innovation, Leadership and Learning, University of Nottingham, Nottingham University Business School, Nottingham, UK
  4. 4 The Trent Simulation and Clinical Skills Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
  5. 5 School of English, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr Keiko Tsuchiya, International College of Arts and Sciences, Yokohama City University, 2360027, Yokohama, Japan; ktsuchiy{at}


Background/aims In emergency care, healthcare professionals (HCPs) interact with both a patient and their colleagues at the same time. How HCPs regulate the two distinct interactions is our central interest. Focusing on HCPs’ use of their voice quality and pitch, a multimodal analysis of the interaction in a simulation training session was conducted. Our aims are (1) to compare the use of HCPs’ voice quality and pitch in HCP–patient and HCP–HCP interactions, (2) to examine how different voice quality and pitch function in interaction, and (3) to develop the research methodology so as to integrate multimodal features in emergency care interaction for analysis.

Methods Three HCPs performed a scripted acute care scenario (chest pain) at the simulation centre. The multimodal corpus-based approach was applied to analyse the varying voice pitch and quality of the HCPs, in interactions with a simulated patient (SP) and with two other HCPs, in emergency care training.

Results The HCPs tended to use a clear voice when they talk to an SP and a ‘shattered’ voice to colleagues in the team. The pitch was raised to talk to an SP, by Helen (a nurse) and Mike (a doctor).

Conclusion This indicates that the HCPs strategically change their voice quality and pitch according to the addressees, regulating the interaction.

  • emergency care interaction
  • simulation training
  • voice quality
  • pitch
  • multimodal analysis

Statistics from


  • Contributors FC (emergency care consultant) and KT (linguist) have initiated the research project. FC planned the project, and arranged the data collection session and the scenarios. KT discussed the research plan with FC, attended the data collection and analysed the data. BB (consultant, director of the simulation centre) supported the data collection and provided valuable advice for collecting the data of the simulation training. ST (sociologist), SvA (linguist) and SaA (linguist) contributed to the data analysis and reviewed/improved the manuscript.

  • Funding This project was funded by the Great Britain Sasakawa Foundation (No. 4111). We thank the reviewers for their insightful comments.

  • Competing interests None declared.

  • Ethics approval The Ethics Committee of Nottingham University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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