is it possible to have two instances of Kinovea running to show 4 views at once?
Yes you can open multiple instances to have more players and cameras.
You can give names to the instances and recall them later (menu Window > Window properties…, Reopen window, Manage windows…). The general preferences are shared and synchronized between the windows, there is no "master" you can access the window manager or change the list of capture folders from any window. The concept of "workspace" is one level above that, it's for saving a whole set of windows and creating a shortcut to restart them all at once.
Ideally it would run like this:
1. Trigger recording with hotkey or pressing the red button.
2. Capture 5-20 seconds at around 60-120 fps
3. Hitting stop immediately saves the stream and the replay folder instantly renders the files into the side-by-side playback workspaces
Yes that should work. The hotkey or record button is in each window though, so if you want to start recording simultaneously in all windows it needs a different approach, easiest is via microphone trigger but there are other means.
Same for stopping the recording. The easiest is to set a predefined duration so you can't forget it and you will see a red bar reducing towards the left as a countdown.
20 second recordings is going to make large files, for your context where you'll likely have hundreds of videos it will be a concern and the NVMe will fill up. Next version will have a way to define more sensible compression settings (and improved performances to avoid frame drops). If you use USB webcam types they often have a stream that's already MJPEG encoded, this could work well for this.
The replay starts when a file is finalized in the observed folder. You have to tell it which folder to look at, it doesn't directly know about the capture windows. The linking is via the capture folder.
So in your case the first thing you want to do is define your capture folders. Then in the camera screens you tell each camera where it will save its files (using the drop down at the bottom). And for the replay screens you point them at the corresponding capture folder. Any time the capture side finalizes a recording it should be automatically loaded and played in the replay window.
Here is a tutorial that should be relevant, it was for golf but the setup is similar I think. Tutorial for golf swing automatic capture and replay.pdf
Or you could have each pair of camera + replay in its own window, if it's simpler.
For your use case there is maybe an extra layer of automation to investigate. You could have all the patients names in a CSV file, maybe exported from the main software that handles patient records. Then you import that into the "Context" (Options > Context > Import). In the capture screens you'll then get a drop down with all patient names and can specify who is being recorded. The capture folders and file name patterns can use that as variables to automatically put the files in a folder named according to the patient.