Clinicians' accuracy in perceiving patients: Its relevance for clinical practice and a narrative review of methods and correlates

Department of Psychology, Northeastern University, Boston, MA, USA.
Patient Education and Counseling (Impact Factor: 2.2). 05/2011; 84(3):319-24. DOI: 10.1016/j.pec.2011.03.006
Source: PubMed


A relatively unexplored aspect of clinicians' communication skill is their interpersonal sensitivity, or ability to perceive their patients accurately with regard to patients' feelings, desires, intentions, needs, physical states, personality, attitudes, beliefs, and values. The present article argues for the importance of this skill in clinical interactions and summarizes supportive research.
Reviews approaches to measuring interpersonal sensitivity and research on correlates of clinicians' and laypersons' interpersonal sensitivity.
Studies on clinicians' interpersonal sensitivity suggest that this skill could be improved. Furthermore, there are important correlates of clinicians' interpersonal sensitivity, including, on the patient's side, satisfaction, appointment-keeping adherence, and learning of conveyed information, and, on the clinician's side, awareness of patients' cues of anxiety and distress, commitment to patient-centered values, self-reported awareness of own emotions, and female gender. Furthermore, a very large non-clinical literature points to many other correlates of interpersonal sensitivity that are relevant to the clinical situation, including empathy, prosocial behavior, skill in negotiating, selling, teaching, and managing, better personal adjustment, and better interpersonal relationships. Research also suggests that interpersonal sensitivity is a trainable skill that could realistically be included in clinical education.
Clinicians' interpersonal sensitivity is an important component of quality of care and deserves further research.
This important skill should be incorporated into training programs to improve clinician-patient communication.

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    • "The latter is possible if the physician is interpersonally accurate. There is an increasing number of voices advocating physician training in interpersonal accuracy [34]. Research shows that interpersonal accuracy is effectively trainable [40] and we posit that this skill would enable physicians to infer automatically and accurately their patients' preferences which in turn would facilitate PBA and practical implementation of patient-centered care. "
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    ABSTRACT: Objective: Based on a literature review, we propose a model of physician behavioral adaptability (PBA) with the goal of inspiring new research. PBA means that the physician adapts his or her behavior according to patients’ different preferences. The PBA model shows how physicians infer patients’ preferences and adapt their interaction behavior from one patient to the other. We claim that patients will benefit from better outcomes if their physicians show behavioral adaptability rather than a “one size fits all” approach. Method: This literature review is based on a literature search of the PsycINFO® and MEDLINE® databases. Results: The literature review and first results stemming from the authors’ research support the validity and viability of parts of the PBA model. There is evidence suggesting that physicians are able to show behavioral flexibility when interacting with their different patients, that a match between patients’ preferences and physician behavior is related to better consultation outcomes, and that physician behavioral adaptability is related to better consultation outcomes. Practice Implications: Training of physicians’ behavioral flexibility and their ability to infer patients’ preferences can facilitate physician behavioral adaptability and positive patient outcomes.
    Patient Education and Counseling 10/2015; 98(10):1243–1247. DOI:10.1016/j.pec.2015.07.028 · 2.20 Impact Factor
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    • "Focusing on clinicians and medical settings, studies have shown that clinicians who are more accurate at judging the thoughts and feeling of their patients have more satisfied, adherent, and engaged patients [5] [8] [17] [18]. The stakes for accurate person perception in healthcare are particularly high. "
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    • "set out to investigate the correlates of physician EA on metastatic cancer patient distress. In fact, factors of EA have rarely been studied in a clinical setting, especially in oncology [10]. The theoretical framework of Norfolk et al. [14] guided our analyses. "
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    ABSTRACT: To examine the determinants of the accuracy with which physicians assess metastatic cancer patient distress, also referred to as their empathic accuracy (EA). Hypothesized determinants were physician empathic attitude, self-efficacy in empathic skills, physician-perceived rapport with the patient, patient distress and patient expressive suppression. Twenty-eight physicians assessed their patients' distress level on the distress thermometer, while patients (N=201) independently rated their distress level on the same tool. EA was the difference between both scores in absolute value. Hypothesized determinants were assessed using self-reported questionnaires. Multilevel analyses were carried out. Little of the variance in EA was explained by physician variables. EA was higher with higher levels of patient distress. Physician-perceived quality of rapport was positively associated with EA. However, for highly distressed patients, good rapport was associated with lower EA. Patient expressive suppression was also related to lower EA. This study adds to the understanding of EA in oncological settings, particularly in challenging the common assumption that EA depends largely on physician characteristics or that better rapport would always favor higher EA. Physicians should ask patients for feedback regarding their emotions. In parallel, patients should be prompted to express their concerns.
    Patient Education and Counseling 11/2013; 94(3). DOI:10.1016/j.pec.2013.10.029 · 2.20 Impact Factor
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