Background Communication is a cornerstone in nursing. Research on nurse–patient communication faces well-known challenges, as encounters are dynamic, context-dependent, and shaped by subtle verbal and non-verbal cues. Capturing this complexity requires rigorous observational approaches, of which audio and video recordings are key methods, enabling documentation of communication as it unfolds in practice. However, collecting such data in clinical settings involves significant methodological and ethical considerations. Objective The aim of this paper is to provide guidance for methodological rigor in data collection using audio or video recordings when observing clinical communication in patient encounters. Information sources This discussion paper draws on theory and previous empirical research on communication in clinical patient encounters using data collected with audio and video recordings. Results The practical guidance is structured into five key areas spanning the data collection process: (1) planning and preparation, (2) audio versus video recordings, (3) ethical and legal concerns, (4) information and recruitment, and (5) procedures for collecting recordings. Each area includes methodological considerations related to the design and conduct of data collection, as well as recommendations for transparent reporting to support rigor. Conclusions This guidance supports researchers in addressing key methodological challenges in data collection using audio and video recordings in studies of clinical communication. It highlights considerations relevant to the design and conduct of the research process, including issues of ecological validity and generalizability, and emphasizes the importance of transparent reporting of methodological decisions. In light of previous inconsistencies in reporting, such guidance is essential to strengthen methodological rigor. By adopting more robust methodological strategies, ethical and scientific standards in study design and data collection can be strengthened.