This study supports an individualized BBN teaching strategy and contributes to efforts to find the best way to train and reach the largest number of future physicians to improve communication competences in oncology.

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A physician who communicates in a patient-centered way is a physician who adapts his or her communication style to what each patient needs. In order to do so, the physician has to (1) accurately assess each patient's states and traits (interpersonal accuracy) and (2) possess a behavioral repertoire to choose from in order to actually adapt his or her behavior to different patients (behavioral adaptability). Physician behavioral adaptability describes the change in verbal or nonverbal behavior a physician shows when interacting with patients who have different preferences in terms of how the physician should interact with them. We hypothesized that physician behavioral adaptability to their patients' preferences would lead to better patient outcomes and that physician interpersonal accuracy was positively related to behavioral adaptability. To test these hypotheses, we recruited 61 physicians who completed an interpersonal accuracy test before being videotaped during four consultations with different patients. The 244 participating patients indicated their preferences for their physician's interaction style prior to the consultation and filled in a consultation outcomes questionnaire directly after the consultation. We coded the physician's verbal and nonverbal behavior for each of the consultations and compared it to the patients' preferences to obtain a measure of physician behavioral adaptability. Results partially confirmed our hypotheses in that female physicians who adapted their nonverbal (but not their verbal) behavior had patients who reported more positive consultation outcomes. Moreover, the more female physicians were accurate interpersonally, the more they showed verbal and nonverbal behavioral adaptability. For male physicians, more interpersonal accuracy was linked to less nonverbal adaptability.

Empathy is a well-defined active ingredient in clinical encounters. To measure empathy, the current gold standard is behavioral coding (i.e. trained coders attribute overall ratings of empathy to clinician behaviors within an encounter), which is labor intensive and subject to important reliability challenges. Recently, an alternative measurement has been proposed: capturing empathy as synchrony in vocally encoded arousal, which can be measured as the mean fundamental frequency of the voice (mean F0). This method has received preliminary support by one study . We aimed to replicate this study by using two large samples of clinical interactions (alcohol brief motivational interventions with young adults, N = 208; general practice consultations, N = 204). Audio files were segmented to identify respective speakers and mean F0 was measured using speech signal processing software. All sessions were independently rated by behavioral coders using two validated empathy scales. Synchrony between clinician and patient F0 was analyzed using multivariate multilevel models and compared to high and low levels of empathy derived from behavioral coding. Findings showed no support for our hypothesis that mean F0 synchrony between clinicians and patients would be higher in high-empathy sessions. This lack of replication was consistent for both clinical samples, both behavioral coding

Objective. The onset of a chronic health condition (CHC) can have a severe impact on an individual's life, affecting mental and physical health. This study's goal was to investigate psychological distress trajectories starting from one year before to four years after the onset of a physical CHC. The specific aims were to identify the number and shape of longitudinal psychological distress trajectories and to test health-related, psychological, social, and demographic factors predicting these trajectories.Methods. Two samples were drawn from the Swiss Household Panel dataset: a CHC sample (n = 361) and a 1 to 1 matched comparison sample of healthy individuals. Latent growth mixture modeling was used to identify psychological distress trajectories over six years. Factors predicting trajectories were then tested using multinomial logistic regression.Results. Four psychological distress trajectories were identified in the CHC sample: resilience (53.9%), chronic (22.2%), delayed (15.0%), and recovery (8.9%). In the comparison sample, two trajectories were identified: low psychological distress (90%) and elevated psychological distress (10%). Protective factors associated with resilient trajectory membership in the CHC sample are higher emotional stability, higher relationship satisfaction, and male gender.Conclusion. Individuals living with a CHC have an increased risk of vulnerability compared to a sample of healthy individuals. This advocates awareness of mental health issues following the onset of a CHC. In this regard, biopsychosocial factors (gender, emotional stability, and relationship satisfaction) offer prevention and intervention opportunities for more vulnerable individuals.

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