title: Communication profiles of psychiatric residents and attending physicians in medication-management appointments: a quantitative pilot study.
abstract: OBJECTIVE
  The authors quantitatively examined differences in psychiatric residents' and attending physicians' communication profiles and voice tones.
  
  
  METHODS
  Audiotaped recordings of 49 resident-patient and 35 attending-patient medication-management appointments at four ambulatory sites were analyzed with the Roter Interaction Analysis System (RIAS). Nonparametric tests were used to compare differences in proportions of speech devoted to relationship-building, activating, and partnering in decision-making processes, and data-gathering/counseling/patient education. Differences in affect expressed by psychiatrists' voice tones were also examined.
  
  
  RESULTS
  Residents' visits were twice as long as Attendings' visits (28.2 versus 14.1 minutes), and residents devoted a significantly greater proportion of their talk to relationship-building (23% versus 20%) and activating/partnering (36% versus 28%) aspects of communication, whereas Attendings devoted a greater proportion to biomedically-related data-gathering/counseling/patient education (31% versus 20%). Analysis of voice tones revealed that residents were perceived as sounding significantly friendlier and more sympathetic, versus Attendings, who were rated as sounding more dominant and rushed.
  
  
  CONCLUSIONS
  These findings show distinct communication profiles and voice-tone differences. Future psychiatric communication research should address the influence of appointment length, psychiatrist/patient characteristics, and other potential confounders on psychiatrist-patient communication.
authors.affiliation: Dept. of Psychiatry, Univ. of Pittsburgh School of Medicine, PA, USA.
authors.forename: Enrico G
authors.initials: EG
authors.lastname: Castillo
authors.forename: Harold A
authors.initials: HA
authors.lastname: Pincus
authors.forename: Melissa
authors.initials: M
authors.lastname: Wieland
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.forename: Susan
authors.initials: S
authors.lastname: Larson
authors.forename: Patricia
authors.initials: P
authors.lastname: Houck
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
authors.forename: Mario
authors.initials: M
authors.lastname: Cruz
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D010820:Physicians; D010865:Pilot Projects; D011570:Psychiatry; D014831:Voice