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BMC Medical Education Jul 2018Verbal and non-verbal aspects of communication as well as empathy are known to have an important impact on the medical encounter. The aim of the study was to analyze how...
BACKGROUND
Verbal and non-verbal aspects of communication as well as empathy are known to have an important impact on the medical encounter. The aim of the study was to analyze how well final year undergraduate medical students use skills of verbal and non-verbal communication during history-taking and whether these aspects of communication correlate with empathy and gender.
METHODS
During a three steps performance assessment simulating the first day of a resident 30 medical final year students took histories of five simulated patients resulting in 150 videos of physician-patient encounters. These videos were analyzed by external rating with a newly developed observation scale for the verbal and non-verbal communication and with the validated CARE-questionnaire for empathy. One-way ANOVA, t-tests and bivariate correlations were used for statistical analyses.
RESULTS
Female students showed signicantly higher scores for verbal communication in the case of a female patient with abdominal pain (p < 0.05), while male students started the conversations significantly more often with an open question (p < 0.05) and interrupted the patients significantly later in two cases than female students (p < 0.05). The number of W-questions asked by all students was significantly higher in the case of the female patient with abdominal pain (p < 0.05) and this patient was interrupted after the beginning of the interview significantly earlier than the patients in the other four cases (p < 0.001). Female students reached significantly higher scores for non-verbal communication in two cases (p < 0.05) and showed significantly more empathy than male students in the case of the female patient with abdominal pain (p < 0.05). In general, non-verbal communication correlated significantly with verbal communication and with empathy while verbal communication showed no significant correlation with empathy.
CONCLUSIONS
Undergraduate medical students display differentiated communication behaviour with respect to verbal and non-verbal aspects of communication and empathy in a performance assessment and special differences could be detected between male and female students. These results suggest that explicit communication training and feedback might be necessary to raise students' awareness for the different aspects of communication and their interaction.
Topics: Adult; Aged; Analysis of Variance; Child, Preschool; Clinical Competence; Communication; Education, Medical, Undergraduate; Empathy; Female; Humans; Male; Medical History Taking; Middle Aged; Nonverbal Communication; Patient Simulation; Physician-Patient Relations; Sex Factors; Students, Medical; Verbal Behavior; Video Recording
PubMed: 29970069
DOI: 10.1186/s12909-018-1260-9 -
Academic Medicine : Journal of the... Aug 2014There is a gap in the medical education literature on teaching nonverbal detection and expression of empathy. Many articles do not address nonverbal interactions,...
There is a gap in the medical education literature on teaching nonverbal detection and expression of empathy. Many articles do not address nonverbal interactions, instead focusing on "what to say" rather than "how to be." This focus on verbal communication overlooks the essential role nonverbal signals play in the communication of emotions, which has significant effects on patient satisfaction, health outcomes, and malpractice claims. This gap is addressed with a novel teaching tool for assessing nonverbal behavior using the acronym E.M.P.A.T.H.Y.-E: eye contact; M: muscles of facial expression; P: posture; A: affect; T: tone of voice; H: hearing the whole patient; Y: your response. This acronym was the cornerstone of a randomized controlled trial of empathy training at Massachusetts General Hospital, 2010-2012. Used as an easy-to-remember checklist, the acronym orients medical professionals to key aspects of perceiving and responding to nonverbal emotional cues. An urgent need exists to teach nonverbal aspects of communication as medical practices must be reoriented to the increasing cultural diversity represented by patients presenting for care. Where language proficiency may be limited, nonverbal communication becomes more crucial for understanding patients' communications. Furthermore, even in the absence of cultural differences, many patients are reluctant to disagree with their clinicians, and subtle nonverbal cues may be the critical entry point for discussions leading to shared medical decisions. A detailed description of the E.M.P.A.T.H.Y. acronym and a brief summary of the literature that supports each component of the teaching tool are provided.
Topics: Checklist; Cues; Education, Medical; Education, Medical, Continuing; Education, Medical, Undergraduate; Emotions; Empathy; Humans; Internship and Residency; Massachusetts; Nonverbal Communication; Physician-Patient Relations; Teaching
PubMed: 24826853
DOI: 10.1097/ACM.0000000000000287 -
Patient-centred communication is associated with positive therapeutic alliance: a systematic review.Journal of Physiotherapy 2012During the patient-therapist encounter, which communication factors correlate with constructs of therapeutic alliance? (Review)
Review
QUESTION
During the patient-therapist encounter, which communication factors correlate with constructs of therapeutic alliance?
DESIGN
Systematic review.
PARTICIPANTS
Clinicians and patients in primary, secondary or tertiary care settings.
MEASURES
Studies had to investigate the association between communication factors (interaction styles, verbal factors or non-verbal factors) and constructs of the therapeutic alliance (collaboration, affective bond, agreement, trust, or empathy), measured during encounters between health practitioners and patients.
RESULTS
Among the twelve studies that met the inclusion criteria, 67 communication factors were identified (36 interaction styles, 17 verbal factors and 14 non-verbal factors). The constructs of therapeutic alliance in the included studies were rapport, trust, communicative success and agreement. Interaction styles that showed positive large correlations with therapeutic alliance were those factors that help clinicians to engage more with patients by listening to what they have to say, asking questions and showing sensitivity to their emotional concerns. Studies of verbal and non-verbal factors were scarce and inconclusive.
CONCLUSIONS
The limited evidence suggests patient-centred interaction styles related to the provision of emotional support and allowing patient involvement in the consultation process enhance the therapeutic alliance. Clinicians can use this evidence to adjust their interactions with patients to include communication strategies that strengthen the therapeutic alliance.
Topics: Communication; Humans; Nonverbal Communication; Office Visits; Patient Compliance; Patient Satisfaction; Physical Therapy Specialty; Professional-Patient Relations
PubMed: 22613237
DOI: 10.1016/S1836-9553(12)70087-5 -
Perspectives on Psychological Science :... Nov 2023Research and theory in nonverbal communication have made great advances toward understanding the patterns and functions of nonverbal behavior in social settings....
Research and theory in nonverbal communication have made great advances toward understanding the patterns and functions of nonverbal behavior in social settings. Progress has been hindered, we argue, by presumptions about nonverbal behavior that follow from both received wisdom and faulty evidence. In this article, we document four persistent misconceptions about nonverbal communication-namely, that people communicate using decodable body language; that they have a stable personal space by which they regulate contact with others; that they express emotion using universal, evolved, iconic, categorical facial expressions; and that they can deceive and detect deception, using dependable telltale clues. We show how these misconceptions permeate research as well as the practices of popular behavior experts, with consequences that extend from intimate relationships to the boardroom and courtroom and even to the arena of international security. Notwithstanding these misconceptions, existing frameworks of nonverbal communication are being challenged by more comprehensive systems approaches and by virtual technologies that ambiguate the roles and identities of interactants and the contexts of interaction.
Topics: Humans; Nonverbal Communication; Facial Expression; Emotions; Sexual Behavior
PubMed: 36791676
DOI: 10.1177/17456916221148142 -
Progress in Neurobiology Apr 2021While humans have developed a sophisticated and unique system of verbal auditory communication, they also share a more common and evolutionarily important nonverbal... (Review)
Review
While humans have developed a sophisticated and unique system of verbal auditory communication, they also share a more common and evolutionarily important nonverbal channel of voice signaling with many other mammalian and vertebrate species. This nonverbal communication is mediated and modulated by the acoustic properties of a voice signal, and is a powerful - yet often neglected - means of sending and perceiving socially relevant information. From the viewpoint of dyadic (involving a sender and a signal receiver) voice signal communication, we discuss the integrated neural dynamics in primate nonverbal voice signal production and perception. Most previous neurobiological models of voice communication modelled these neural dynamics from the limited perspective of either voice production or perception, largely disregarding the neural and cognitive commonalities of both functions. Taking a dyadic perspective on nonverbal communication, however, it turns out that the neural systems for voice production and perception are surprisingly similar. Based on the interdependence of both production and perception functions in communication, we first propose a re-grouping of the neural mechanisms of communication into auditory, limbic, and paramotor systems, with special consideration for a subsidiary basal-ganglia-centered system. Second, we propose that the similarity in the neural systems involved in voice signal production and perception is the result of the co-evolution of nonverbal voice production and perception systems promoted by their strong interdependence in dyadic interactions.
Topics: Animals; Auditory Perception; Basal Ganglia; Nonverbal Communication; Perception; Primates; Voice
PubMed: 33189782
DOI: 10.1016/j.pneurobio.2020.101948 -
Developmental Medicine and Child... Aug 2020To investigate if communication ability and method were related to each other and to age, sex, gross motor function, or manual ability in children with cerebral palsy.
AIM
To investigate if communication ability and method were related to each other and to age, sex, gross motor function, or manual ability in children with cerebral palsy.
METHOD
This cross-sectional study used data registered in the Swedish Cerebral Palsy Surveillance Program registry, involving 3000 children aged 0 to 18 years. Pearson's χ test and Spearman's correlation were used to test associations between variables.
RESULTS
Communication ability and method were related to each other and to age, gross motor function, and manual ability. Aided communication methods were more frequently used among older children. The more functional the communication was, the less use of unaided communication occurred. Different communication methods were used across all Communication Function Classification System (CFCS) levels. Speech was most common in more functional levels, used by 72% of the children. Forty-five per cent were considered effective communicators in all environments. For classification of communication level and method, some recurring registration errors were made by the raters.
INTERPRETATION
Some raters may need clarification on interpretations of CFCS instructions. Results indicate that children should be presented to aided augmentative and alternative communication and manual signs earlier and to a greater extent.
Topics: Adolescent; Cerebral Palsy; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Male; Nonverbal Communication; Registries; Speech; Verbal Behavior
PubMed: 32281100
DOI: 10.1111/dmcn.14546 -
Philosophical Transactions of the Royal... Jun 2020Although anthropologists frequently report the centrality of odours in the daily lives and cultural beliefs of many small-scale communities, Western scholars have...
Although anthropologists frequently report the centrality of odours in the daily lives and cultural beliefs of many small-scale communities, Western scholars have historically considered the sense of smell as minimally involved in human communication. Here, we suggest that the origin and persistence of this latter view might be a consequence of the fact that most research is conducted on participants from Western societies who, collectively, were rather (adults), and (ODD) to various aspects of olfactory perception. The view is rapidly changing, however, and this themed issue provides a timely overview of the current state-of-the-art on human chemocommunication. Based on evolutionary models of communication, the papers cover both general mechanisms of odour production by 'senders' and odour perception by 'receivers'. Focus on specific functional contexts includes reciprocal impact of odours between infants and mothers, the role of odour in mate choice and how odours communicate emotion and disease. Finally, a position paper outlines pitfalls and opportunities for the future, against the context of the replication crisis in psychology. We believe a more nuanced view of human chemical communication is within our grasp if we can continue to develop inter-disciplinary insights and expand research activities beyond ODD people. This article is part of the Theo Murphy meeting issue 'Olfactory communication in humans'.
Topics: Humans; Nonverbal Communication; Odorants; Olfactory Perception
PubMed: 32306869
DOI: 10.1098/rstb.2019.0258 -
Developmental Medicine and Child... Nov 2019A scoping review was conducted to examine and evaluate empirical data on the communication profile of Angelman syndrome beyond the described dissociation between... (Review)
Review
AIM
A scoping review was conducted to examine and evaluate empirical data on the communication profile of Angelman syndrome beyond the described dissociation between receptive language and speech.
METHOD
Three databases (PsycINFO, Embase, and Web of Science) were searched to retrieve articles investigating communication in Angelman syndrome. Seventeen articles investigating the broader communication profile were found; their methodology was evaluated against quality criteria.
RESULTS
Despite the absence of speech, individuals with Angelman syndrome have a wide repertoire of non-verbal communicative behaviours, mainly characterized by gestures, although advanced forms such as symbolic communication are used by some individuals. The use of communicative forms differs between the genetic aetiologies of Angelman syndrome; individuals with non-deletion aetiologies typically have greater communicative abilities.
INTERPRETATION
The broader communication profile of Angelman syndrome is characterized by diverse and multimodal abilities, including some use of symbolic forms of communication that appears atypical given the absence of speech. This is suggestive of a probable dissociation between speech and other expressive forms of communication, indicating an isolated speech production impairment. This highlights a need in this population for alternative communication and specific input from services tailored to support the nuances of the communication profile of Angelman syndrome.
WHAT THIS PAPER ADDS
Although absent speech is near universal, a diverse profile of other communicative abilities has been reported. Parental reporting has been predominantly used to assess the communication profile of Angelman syndrome. Literature that investigates the specificities and possible dissociations in such a communication profile is limited.
Topics: Angelman Syndrome; Communication; Humans; Nonverbal Communication; Speech
PubMed: 31074506
DOI: 10.1111/dmcn.14257 -
Developmental Psychology Jan 2022Parent-child communication is a rich, multimodal process. Substantial research has documented the communicative strategies in certain (predominantly White) United States...
Parent-child communication is a rich, multimodal process. Substantial research has documented the communicative strategies in certain (predominantly White) United States families, yet we know little about these communicative strategies in Native American families. The current study addresses that gap by documenting the verbal and nonverbal behaviors used by parents and their 4-year-old children ( = 39, 25 boys) across two communities: Menominee families (low to middle income) living on tribal lands in rural Wisconsin, and non-Native, primarily White families (middle income) living in an urban area. Dyads participated in a free-play forest-diorama task designed to elicit talk and play about the natural world. Children from both communities incorporated actions and gestures freely in their talk, emphasizing the importance of considering nonverbal behaviors when evaluating what children know. In sharp contrast to the stereotype that Native American children talk very little, Menominee children talked than their non-Native counterparts, underlining the importance of taking into account cultural context in child assessments. For children and parents across both communities, gestures were more likely than actions to be related to the content of speech and were more likely than actions to be produced simultaneously with speech. This tight coupling between speech and gesture replicates and extends prior research with predominantly White (and adult) samples. These findings not only broaden our theories of communicative interaction and development, but also provide new evidence about the role of nonverbal behaviors in informal learning contexts. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Adult; Child, Preschool; Female; Gestures; Humans; Language; Male; Nonverbal Communication; Parent-Child Relations; Parents
PubMed: 34881968
DOI: 10.1037/dev0001279 -
Annual Review of Psychology Jan 2017As a highly social species, humans are equipped with a powerful tool for social communication-the face. Although seemingly simple, the human face can elicit multiple... (Review)
Review
As a highly social species, humans are equipped with a powerful tool for social communication-the face. Although seemingly simple, the human face can elicit multiple social perceptions due to the rich variations of its movements, morphology, and complexion. Consequently, identifying precisely what face information elicits different social perceptions is a complex empirical challenge that has largely remained beyond the reach of traditional methods. In the past decade, the emerging field of social psychophysics has developed new methods to address this challenge, with the potential to transfer psychophysical laws of social perception to the digital economy via avatars and social robots. At this exciting juncture, it is timely to review these new methodological developments. In this article, we introduce and review the foundational methodological developments of social psychophysics, present work done in the past decade that has advanced understanding of the face as a tool for social communication, and discuss the major challenges that lie ahead.
Topics: Facial Expression; Humans; Nonverbal Communication; Psychophysics; Social Perception
PubMed: 28051933
DOI: 10.1146/annurev-psych-010416-044242