Clinicians' accuracy in perceiving patients: its relevance for clinical practice and a narrative review of methods and correlates.
ABSTRACT 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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ABSTRACT: The goal was to explore the clinical relevance of accurate understanding of patients' thoughts and feelings. Between 2010 and 2012, four groups of participants (nursing students, medical students, internal medicine residents, and undergraduate students) took a test of accuracy in understanding the thoughts and feelings of patients who were videorecorded during their actual medical visits and who afterward reviewed their video to identify their thoughts and feelings as they occurred (Test of Accurate Perception of Patients' Affect, or TAPPA). Participants' accuracy scores were then correlated with participants' attitudes toward patient-centered care, clinical course background, recall of clinical conversation, evaluations of clinical performance made by preceptors, evaluations of interpersonal skill made by standardized patients in clinical encounters, and independent coding of behavior in a clinical encounter. Accuracy in understanding patients' thoughts and feelings was significantly correlated with nursing students' clinical course experience, clinicians' favorable attitudes to psychosocial discussion, standardized patients' evaluations of medical students' interpersonal skill, independent coding of medical students' patient-centered behavior while taking a social history, and undergraduates' more accurate recall of what an actor-physician said on video. Accuracy in perceiving patients' thoughts and feelings can be objectively measured and is a skill relevant to clinical performance.Health Communication 06/2014; · 0.97 Impact Factor
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ABSTRACT: 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.Academic medicine: journal of the Association of American Medical Colleges 05/2014; · 2.34 Impact Factor