An Intervention Study of Clinician-Patient Nonverbal Interactions and Patient Perceptions of Visits

Abstract

The aim of this study is to characterize the effects of specific clinician nonverbal behaviors on patient nonverbal interaction and perceptions of clinicians. A randomized controlled trial was conducted to evaluate the effects of clinician training on improving patient perceptions of the clinical visit. Two hundred and seventy one patients saw clinicians that they had no prior relationship with for cold symptoms. The clinicians were trained to interact with patients in either "standard" (type A) or "enhanced" (type B) mode as expressly defined by this study. They were randomly assigned to interact with the patient in one of these two conditions. In the enhanced condition, clinicians made efforts to create rapport by patient-oriented talk and positive nonverbal behaviors such as making eye contact. The encounters were videotaped and the nonverbal interactions were analyzed. The results of this study show that the training of enhanced behaviors was successful in increasing the clinicians' amount of specific positive nonverbal behaviors in the encounter. Additionally, when clinicians engaged in certain culturally recommended rapportbuilding nonverbal interactions such as, but not limited to, eye contact, they were able to positively influence patient nonverbal behaviors and patient perceptions of clinicians. Results of this study could be used to develop training for physicians and to determine how technologies should be designed to facilitate positive interpersonal interactions in health encounters. If eye contact is important to rapportbuilding and ultimately to improved health outcomes, then technologies should support and not impede such nonverbal cues.

Changes in posttraumatic growth, core belief disruption, and social support over the first year of the COVID-19 pandemic

“…Moreover, video communication precludes physical touch, a component that may play a key role in perceptions of social support. Indeed, physical touch has been found to increase perceptions of empathy (Montague et al, 2013 ), reduce anxiety (Gagne and Toye, 1994 ), and buffer against stress (Coan et al, 2006 ). Previous research on quarantines, which limit physical touch between humans, has found increased anxiety, anger, and post-traumatic stress symptoms because of the quarantine (Brooks et al, 2020 ).…”

Videoconferencing versus face‐to‐face psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance, empathy and treatment characteristics

“…Psychotherapy in an analogue setting might facilitate building a reliable therapeutic alliance and expressing empathy, which is reflected by the psychotherapists’ ratings within the online survey. They explicitly criticised the lack of nonverbal communication through facial expressions and gestures in VCT, which is a crucial factor for therapeutic alliance (Klasen et al, 2013) and empathy (Kraft‐Todd et al, 2017; Montague et al, 2014; Pettit et al, 2019; Riess & Kraft‐Todd, 2014; Timmermann et al, 2017). Furthermore, they speculated that dealing with crisis and suicidality might be a problem in VCT, which does not allow comparable support to a face‐to‐face encounter.…”

Strategies for effective patient care: Integrating quality communication with the patient‐centered approach

“…Regarding rapport, the PCCMC posits that clinicians' efforts to build a strong interpersonal relationship with patients are facilitated by approaching the encounter with the mindset of forming a therapeutic alliance and offering patients social and emotional support by demonstrating empathy and compassion for their unique illness experience. Attention to less obvious features of the medical interaction, such as the physical comfort of patients and where clinicians place themselves relative to the patient during the interaction, serve to create an atmosphere of warmth and reinforce effective communication through implicit and nonverbal behaviors, with evidence suggesting that eye gaze, nodding, and other cues of nonverbal attention are the strongest predictors of patient satisfaction (Arora, 2003; Frankel & Stein, 1999; Montague, 2018; Morse & Sweeny, 2020). Used together, robust evidence suggest these strategies serve to cultivate trust and strengthen patient–provider relationships, improving patient satisfaction, treatment adherence, and care continuity (Arora, 2003; Hillen et al, 2011; Rodriguez & Pellegrini, 2019; Sinaiko et al, 2019; Street, 2013; Street et al, 2013).…”