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Journal of General Internal Medicine
Erschienen in: Journal of General Internal Medicine 11/2009

01.11.2009 | Original Article

Nonverbal Sensitivity in Medical Students: Implications for Clinical Interactions

verfasst von: Judith A. Hall, PhD, Debra L. Roter, DrPH, Danielle C. Blanch, MA, Richard M. Frankel, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 11/2009

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Abstract

BACKGROUND

Clinicians’ accuracy in perceiving nonverbal cues has potentially important consequences, but has received insufficient research.

OBJECTIVE

To examine the relation of medical students’ nonverbal sensitivity to their gender and personal traits, as well as to their communication and impressions made during a standardized patient (SP) visit.

DESIGN

Psychometric testing, questionnaire, and observation.

SETTING

One US medical school.

PARTICIPANTS

Two-hundred seventy-five third-year medical students.

MEASUREMENTS

Nonverbal sensitivity and attitudes were measured using standard instruments. Communication during the SP visit was measured using trained coders and analogue patients who viewed the videotapes and rated the favorability of their impressions of the student.

RESULTS

Nonverbal sensitivity was higher in female than male students (P < 0.001) and was positively correlated with self-reported patient-centered attitudes (P < 0.01) and ability to name one’s own emotions (P < 0.05). It was also associated with less distressed (P < 0.05), more dominant (P < 0.001), and more engaged (P < 0.01) behavior by the SP, and with more liking of the medical student (P < 0.05) and higher ratings of compassion (P < 0.05) by the analogue patients. Correlations between nonverbal sensitivity and other variables were generally stronger and different for male than female students, but nonverbal sensitivity predicted analogue patients’ impressions similarly for male and female students.

CONCLUSION

Medical students’ nonverbal sensitivity was related to clinically relevant attitudes and behavioral style in a clinical simulation.
Literatur
1.
Roter DL, Hall JA. Doctors talking with patients/patients talking with doctors: improving communication in medical visits. 2nd ed. Westport, CT: Praeger; 2006.
2.
Griffin SJ, Kinmonth AL, Veltman MW, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2:595–608.CrossRefPubMed
3.
Mead N, Bower P. Measuring patient-centredness: a comparison of three observation-based instruments. Patient Educ Couns. 2000;39:71–80.CrossRefPubMed
4.
Roter DL, Hall JA. Physician gender and patient-centered communication: a critical review of empirical research. Ann Rev Public Health. 2004;25:497–519.CrossRef
5.
Hall JA, Harrigan JA, Rosenthal R. Nonverbal behavior in clinician-patient interaction. Applied Prev Psychol. 1995;4:21–37.CrossRef
6.
Roter DL, Frankel RM, Hall JA, Sluyter D. The expression of emotion through nonverbal behavior in medical visits. J General Int Med. 2006;21:S28–34.CrossRef
7.
Schmid Mast M. On the importance of nonverbal communication in the physician-patient interaction. Pat Educ Couns. 2007;67:315–8.CrossRef
8.
Bridges K, Goldberg D. Somatic presentation of DSM-III psychiatric disorders in primary care. J Psychosom Res. 1985;29:563–9.CrossRefPubMed
9.
Ormel J, Giel R. Medical effects of nonrecognition of affective disorders in primary care. In: Sartorious N, et al, ed. Psychological disorders in general medical settings. Lewiston, NY: CJ Hogrefe; 1990:146–58.
10.
Schulberg HC, Burns BJ. Mental disorders in primary care: epidemiologic, diagnostic and treatment research directions. General Hosp Psychiat. 1988;10:79–87.CrossRef
11.
Hall JA, Stein TS, Roter DL, Rieser N. Inaccuracies in physicians’ perceptions of their patients. Med Care. 1999;37:1164–8.CrossRefPubMed
12.
Hall JA, Horgan TG, Stein TS, Roter DL. Liking in the physician-patient relationship. Patient Educ Couns. 2002;48:69–77.CrossRefPubMed
13.
Merkel WT. Physician perception of patient satisfaction: do doctors know which patients are satisfied? Med Care. 1984;22:453–9.CrossRefPubMed
14.
DiMatteo MR, Taranta A, Friedman HS, Prince LM. Predicting patient satisfaction from physicians’ nonverbal communication skill. Med Care. 1980;18:376–87.CrossRefPubMed
15.
DiMatteo MR, Hays RD, Prince LM. Relationship of physicians’ nonverbal communication skill to patient satisfaction, appointment non-compliance, and physician workload. Health Psychol. 1986;5:581–94.CrossRefPubMed
16.
Robbins JM, Kirmayer LJ, Cathébras P, Yaffe MJ, Dworkind M. Physician characteristics and the recognition of depression and anxiety in primary care. Med Care. 1994;32:795–812.CrossRefPubMed
17.
Tickle-Degnen L. Working well with others: the prediction of students’ clinical performance. Amer J Occup Ther. 1998;52:133–42.
18.
Roter DL, Erby LH, Hall JA, Larson S, Ellington L, Dudley W. Nonverbal sensitivity: consequences for learning and satisfaction in genetic counseling. Health Educ. 2008;108:397–410.CrossRef
19.
Hall JA, Bernieri FJ, eds. Interpersonal sensitivity: theory and measurement. Mahwah, NJ: Lawrence Erlbaum Associates; 2001.
20.
Nowicki S, Duke MP. Individual differences in the nonverbal communication of affect: the Diagnostic Analysis of Nonverbal Accuracy Scale. J Nonv Behav. 1994;18:9–34.CrossRef
21.
Nowicki S Jr, Duke MP. Nonverbal receptivity: the Diagnostic Analysis of Nonverbal Accuracy (DANVA). In: Hall JA, Bernieri FJ, eds. Interpersonal sensitivity: theory and measurement. Mahwah, NJ: Lawrence Erlbaum Associates; 2001:183–98.
22.
Rosenthal R, Hall JA, DiMatteo MR, Rogers PL, Archer D. Sensitivity to nonverbal communication: the PONS test. Baltimore: The Johns Hopkins University Press; 1979.
23.
Hall JA, Andrzejewski SA, Yopchick JE. Psychosocial correlates of interpersonal sensitivity: a meta-analysis. J Nonverbal Behav. 2009;33:149–80.CrossRef
24.
Elfenbein HA, Foo MD, White J, Tan HH, Aik VC. Reading your counterpart: the benefit of emotion recognition accuracy for effectiveness in negotiation. J Nonv Behav. 2007;31:205–23.CrossRef
25.
Byron K, Terranova S, Nowicki S Jr. Nonverbal emotion recognition and salespersons: linking ability to perceived and actual success. J Applied Social Psychol. 2007;37:2600–19.CrossRef
26.
Marsh AA, Kozak MN, Ambady N. Accurate identification of fear facial expressions predicts prosocial behavior. Emotion. 2007;7:239–51.CrossRefPubMed
27.
Byron K. Male and female managers’ ability to ‘read’ emotions: relationships with supervisor’s performance ratings and subordinates’ satisfaction ratings. J Occup Org Psychol. 2007;80:713–33.CrossRef
28.
Hall JA. Gender effects in decoding nonverbal cues. Psychol Bull. 1978;85:845–57.CrossRef
29.
Hall JA. Nonverbal sex differences: communication accuracy and expressive style. Baltimore: The Johns Hopkins University Press; 1984.
30.
McClure EB. A meta-analytic review of sex differences in facial expression processing and their development in infants, children, and adolescents. Psychol Bull. 2000;126:424–53.CrossRefPubMed
31.
Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA. 2002;288:756–64.CrossRefPubMed
32.
Van Zanten M, Boulet JR, McKinley D. Using standardized patients to assess the interpersonal skills of physicians: six years’ experience with a high-stakes certification examination. Health Communic. 2007;22:195–205.
33.
Krupat E, Rosenkranz SL, Yeager CM, Barnard K, Putnam SM, Inui TS. The practice orientations of physicians and patients: the effect of doctor-patient congruence on satisfaction. Patient Educ Couns. 2000;39:49–59.CrossRefPubMed
34.
Salovey P, Mayer JD, Goldman SL, Turvey C, Palfai TP. In: Pennebaker JW, ed. Emotion, disclosure, and health. Washington, DC: American Psychological Association; 1995:125–54.CrossRef
35.
Krupat E, Frankel R, Stein T, Irish J. The Four Habits Coding Scheme: validation of an instrument to assess clinicians’ communication behavior. Patient Educ Couns. 2006;62:38–45.CrossRefPubMed
36.
Ambady N, Bernieri FJ, Richeson JA. Toward a histology of social behavior: judgmental accuracy from thin slices of the behavioral stream. Adv Experim Social Psychol. 2000;32:201–71.CrossRef
37.
Ambady N, LaPlante D, Nguyen T, Rosenthal R, Chaumeton N, Levinson W. Surgeons’ tone of voice: a clue to malpractice. Surgery. 2002;132:5–9.CrossRefPubMed
38.
Haskard KB, Williams SL, DiMatteo MR, Heritage J, Rosenthal R. The provider’s voice: patient satisfaction and the content-filtered speech of nurses and physicians in primary medical care. J Nonv Behav. 2008;32:1–20.CrossRef
39.
Hall JA, Roter DL, Blanch DC, Frankel RM. Observer-rated rapport in interactions between medical students and standardized patients. Patient Educ Couns. 2009;76:323–327.CrossRef
40.
Roter DL, Larson S. The Roter Interaction Analysis System (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns. 2002;46:243–51.CrossRefPubMed
41.
Roter DL, Hall JA, Katz NR. Relations of physicians’ task and socioemotional behaviors to analogue patients’ satisfaction, recall, and impressions. Med Care. 1987;25:437–50.CrossRefPubMed
42.
Schmid Mast M, Klockner C, Hall JA. Physician gender affects how physician nonverbal behavior is related to patient satisfaction. Med Care. 2008;46:1212–8.CrossRef
43.
Nowicki S. DANVA 2: instruction manual for the receptive tests of the Diagnostic Analysis of Nonverbal Accuracy 2. Atlanta: Department of Psychology, Emory University: no date.
44.
Evans BJ, Stanley RO, Burrows GD, Sweet B. Comparison of skills related to effectiveness of consultations: an Australian sample of medical students. Psychol Reports. 1987;61:419–22.
45.
Evans BJ, Coman GJ, Stanley RO. Scores on the Profile of Nonverbal Sensitivity: a sample of Australian medical students. Psychol Reports. 1988;62:903–6.
46.
Mechanic D, McAlpine DD, Rosenthal M. Are patients’ office visits with physicians getting shorter? NEJM. 2001;344:198–204.CrossRefPubMed
47.
Bensing JM, van den Brink-Muinen A, de Bakker DH. Gender differences in practice style: a Dutch study of general practitioners. Med Care. 1993;31:219–29.CrossRefPubMed
48.
DHHS. Publication No. (PHS) 80–1710. Characteristics of visits to female and male physicians. The National Ambulatory Medical Care Survey, United States, 1977, Series 13, Number 39, June 1980.
49.
Hall JA, Roter DL, Rand CS. Communication of affect between patient and physician. J Health Social Behav. 1981;22:18–30.CrossRef
50.
Roter DL. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction, and compliance. Health Educ Monog. 1977;50:281–315.
51.
Kaplan SH, Greenfield S, Ware JE. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989;27:S110–27.CrossRefPubMed
52.
Richard FD, Bond CF Jr, Stokes-Zoota JJ. One hundred years of social psychology quantitatively described. Rev Gen Psychol. 2003;7:331–63.CrossRef
53.
Hall JA. The PONS test and the psychometric approach to measuring interpersonal sensitivity. In: Hall JA, Bernieri FJ, eds. Interpersonal sensitivity: theory and measurement. Mahwah, NJ: Lawrence Erlbaum Associates; 2001:143–60.
54.
Costanzo M. Training students to decode verbal and nonverbal cues: effects of confidence and performance. J Educ Psychol. 1992;84:308–13.CrossRef
55.
Gillis JS, Bernieri FJ, Wooten E. The effects of stimulus medium and feedback on the judgment of rapport. Org Behav Hum Decis Processes. 1995;63:33–45.CrossRef
56.
Satterfield JM, Hughes E. Emotion skills training for medical students: a systematic review. Med Educ. 2007;41:935–41.CrossRefPubMed
Metadaten
Titel
Nonverbal Sensitivity in Medical Students: Implications for Clinical Interactions
verfasst von
Judith A. Hall, PhD
Debra L. Roter, DrPH
Danielle C. Blanch, MA
Richard M. Frankel, PhD
Publikationsdatum
01.11.2009
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 11/2009
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-1107-5

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