Each participant gave either written or oral informed consent to participate in the study. All recordings and transcripts were de-identified and stored confidentially, and the recordings and transcripts were kept in a secure location. The study was approved by both the Research Ethics Board at the University Health Network in Toronto, Ontario, Canada (reference number 15–9030-AE) and by the Institutional Review Board at the University of Texas at Austin, Austin, Texas, USA (reference number 2015–05-0040).