title: Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations.
abstract: BACKGROUND
  The impact of changing non-verbal consultation behaviours is unknown.
  
  
  OBJECTIVE
  To assess brief physician training on improving predominantly non-verbal communication.
  
  
  METHODS
  Cluster randomised parallel group trial among adults aged ≥16 years attending general practices close to the study coordinating centres in Southampton.
  
  
  METHODS
  Sixteen GPs were randomised to no training, or training consisting of a brief presentation of behaviours identified from a prior study (acronym KEPe Warm: demonstrating Knowledge of the patient; Encouraging [back-channelling by saying 'hmm', for example]; Physically engaging [touch, gestures, slight lean]; Warm-up: cool/professional initially, warming up, avoiding distancing or non-verbal cut-offs at the end of the consultation); and encouragement to reflect on videos of their consultation. Outcomes were the Medical Interview Satisfaction Scale (MISS) mean item score (1-7) and patients' perceptions of other domains of communication.
  
  
  RESULTS
  Intervention participants scored higher MISS overall (0.23, 95% confidence interval [CI] = 0.06 to 0.41), with the largest changes in the distress-relief and perceived relationship subscales. Significant improvement occurred in perceived communication/partnership (0.29, 95% CI = 0.09 to 0.49) and health promotion (0.26, 95% CI = 0.05 to 0.46). Non-significant improvements occurred in perceptions of a personal relationship, a positive approach, and understanding the effects of the illness on life.
  
  
  CONCLUSIONS
  Brief training of GPs in predominantly non-verbal communication in the consultation and reflection on consultation videotapes improves patients' perceptions of satisfaction, distress, a partnership approach, and health promotion.
authors.affiliation: Primary Medical Care Group, Community Clinical Sciences Division, Faculty of Medicine, University of Southampton, Southampton.
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.affiliation: Nightingale Surgery, Romsey.
authors.forename: Peter
authors.initials: P
authors.lastname: White
authors.affiliation: Primary Medical Care Group, Community Clinical Sciences Division, Faculty of Medicine, University of Southampton, Southampton.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kelly
authors.affiliation: Primary Medical Care Group, Community Clinical Sciences Division, Faculty of Medicine, University of Southampton, Southampton.
authors.forename: Hazel
authors.initials: H
authors.lastname: Everitt
authors.affiliation: General Practice & Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow.
authors.forename: Stewart
authors.initials: S
authors.lastname: Mercer
mesh_terms: D000328:Adult; D004645:Empathy; D004739:England / Q000453:epidemiology; D005260:Female; D058006:General Practice; D058005:General Practitioners / Q000193:education* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009633:Nonverbal Communication; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000592:standards
keywords: communication; consultation; general practice; nonverbal communication; patient satisfaction