Observer-rated rapport in interactions between medical students and standardized patients.
OBJECTIVE
To measure rapport between medical students and standardized patients using observer ratings; to relate these ratings to students' emotional awareness and to behavior within the medical interaction; and to assess the relative validity of using excerpts of different lengths for the measurement of rapport.


METHODS
Third-year medical students (N=141) were videotaped during a 15-min interaction with a standardized patient, and rapport as well as other communication variables were measured using trained coders. Rapport was measured with good interrater reliability by trained coders who viewed three 1-min excerpts. Emotional awareness was measured by a test of recognizing facial expressions of emotion, self-ratings of emotional self-awareness, and peer ratings of interpersonal sensitivity. Finally, participants who viewed the videotapes while imagining themselves to be the patient (analogue patients) provided impressions of the students, including satisfaction.


RESULTS
Rapport based on all three minutes was positively correlated with accuracy in decoding facial expressions of emotion, self-reported attention to one's own emotions, peer ratings of sensitivity, communication behaviors of the medical student and standardized patient, and analogue patients' positive impressions and satisfaction. Rapport based on just the first minute of the interaction was significantly related to many of these variables.


CONCLUSIONS
Rating short excerpts of behavior is a valid and efficient methodology for capturing the concept of rapport.


CONCLUSIONS
Clinicians, researchers, and educators should focus on rapport building, even very early in the medical visit.
Hall
Judith A
JA
Department of Psychology, Northeastern University, Boston, MA, USA. j.hall@neu.edu
Roter
Debra L
DL
Blanch
Danielle C
DC
Frankel
Richard M
RM
D000328:Adult; D000704:Analysis of Variance; D001364:Awareness; D003142:Communication; D004644:Emotions; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D010379:Peer Group; D010817:Physician-Patient Relations; D011594:Psychometrics; D015203:Reproducibility of Results; D013223:Statistics as Topic; D013337:Students, Medical; D014743:Videotape Recording