House staff nonverbal communication skills and standardized patient satisfaction.
OBJECTIVE
To examine the association of physician nonverbal communication with standardized patient (SP) satisfaction in the context of the "quality" of the interview (i.e., information provided and collected, communication skills).


METHODS
Observational.


METHODS
One university-based internal medicine residency program.


METHODS
Fifty-nine internal medicine residents. INTERVIEWING: The 59 residents were recruited to participate in 3 SP encounters. The scenarios included: 1) a straightforward, primarily "medical" problem (chest pain); 2) a patient with more psychosocial overlay (a depressed patient with a history of sexual abuse); and 3) a counseling encounter (HIV risk factor reduction counseling). Trained SPs rated physician nonverbal behaviors (body lean, open versus closed body posture, eye contact, smiling, tone of voice, nod, facial expressivity) in the 3 encounters. Multiple regression approaches were used to investigate the association of physician nonverbal behavior with patient satisfaction in the context of the "quality" of the interview (SP checklist performance, measures of verbal communication skills), controlling for physician characteristics (gender, postgraduate year).


RESULTS
Nonverbal communication skills was an independent predictor of standardized patient satisfaction for all 3 patient stations. The effect sizes were substantial, with nonverbal communication predicting 32% of the variance in patient satisfaction for the chest pain station, 23% of the variance for the depression-sexual abuse station, and 19% of the variance for the HIV counseling station.


CONCLUSIONS
Better nonverbal communication skills are associated with significantly greater patient satisfaction in a variety of different types of clinical encounters with standardized patients. Formal instruction in nonverbal communication may be an important addition to residency.
Griffith
Charles H
CH
Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, Ky 40536, USA. cgrif00@uky.edu
Wilson
John F
JF
Langer
Shelby
S
Haist
Steven A
SA
D005260:Female; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency; D008297:Male; D009633:Nonverbal Communication; D017060:Patient Satisfaction; D010372:Pediatrics; D010817:Physician-Patient Relations