Evaluating verbal and non-verbal communication skills, in an ethnogeriatric OSCE.

OBJECTIVE Communication during medical interviews plays a large role in patient adherence, satisfaction with care, and health outcomes. Both verbal and non-verbal communication (NVC) skills are central to the development of rapport between patients and healthcare professionals. The purpose of this study was to assess the role of non-verbal and verbal communication skills on evaluations by standardized patients during an ethnogeriatric Objective Structured Clinical Examination (OSCE). METHODS Interviews from 19 medical students, residents, and fellows in an ethnogeriatric OSCE were analyzed. Each interview was videotaped and evaluated on a 14 item verbal and an 8 item non-verbal communication checklist. The relationship between verbal and non-verbal communication skills on interview evaluations by standardized patients were examined using correlational analyses. RESULTS Maintaining adequate facial expression (FE), using affirmative gestures (AG), and limiting both unpurposive movements (UM) and hand gestures (HG) had a significant positive effect on perception of interview quality during this OSCE. Non-verbal communication skills played a role in perception of overall interview quality as well as perception of culturally competent communication. CONCLUSION Incorporating formative and summative evaluation of both verbal and non-verbal communication skills may be a critical component of curricular innovations in ethnogeriatrics, such as the OSCE.

[1]  Judith A. Hall,et al.  Nonverbal behavior in clinician—patient interaction , 1995 .

[2]  H. Hashimoto,et al.  Evaluating medical students' non‐verbal communication during the objective structured clinical examination , 2006, Medical education.

[3]  M. Donnelly,et al.  Assessment of Residents' Interpersonal Skills by Faculty Proctors and Standardized Patients: A Psychometric Analysis , 2000, Academic medicine : journal of the Association of American Medical Colleges.

[4]  Stella M. Yu.  Healthy People 2010 , 1998, Maternal and Child Health Journal.

[5]  Robyn Tamblyn,et al.  Can standardized patients predict real‐patient satisfaction with the doctor‐patient relationship? , 1994 .

[6]  Judith A. Hall,et al.  Communication of affect between patient and physician. , 1981, Journal of health and social behavior.

[7]  E. Kachur,et al.  A culture OSCE: teaching residents to bridge different worlds. , 2001, Academic medicine : journal of the Association of American Medical Colleges.

[8]  P. Haidet,et al.  The patient-physician relationship. Teaching the human dimensions of care in clinical settings. , 2001, JAMA.

[9]  Mark D Schwartz,et al.  Effect of communications training on medical student performance. , 2003, JAMA.

[10]  R. Rosenthal,et al.  Rapport expressed through nonverbal behavior , 1985 .

[11]  Gregory Makoul,et al.  The value of assessing and addressing communication skills. , 2007, JAMA.

[12]  J. Betancourt.  Cross‐cultural Medical Education: Conceptual Approaches and Frameworks for Evaluation , 2003, Academic medicine : journal of the Association of American Medical Colleges.

[13]  Steven A. Haist,et al.  House staff nonverbal communication skills and standardized patient satisfaction , 2003, Journal of General Internal Medicine.

[14]  Judith A. Hall,et al.  The expression of emotion through nonverbal behavior in medical visits , 2006, Journal of General Internal Medicine.

[15]  R. Like,et al.  The ETHNIC(S) Mnemonic: A Clinical Tool for Ethnogeriatric Education , 2002, Journal of the American Geriatrics Society.

[16]  Thomas McGuire,et al.  Two‐Minute Mental Health Care for Elderly Patients: Inside Primary Care Visits , 2007, Journal of the American Geriatrics Society.

[17]  Larsen Km,et al.  Assessment of nonverbal communication in the patient-physician interview. , 1981 .

[18]  R. Frankel,et al.  Assessing Competence in Communication and Interpersonal Skills: The Kalamazoo II Report , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[19]  G. Makoul.  The SEGUE Framework for teaching and assessing communication skills. , 2001, Patient education and counseling.

[20]  A. Green,et al.  Student reflections on learning cross-cultural skills through a ‘cultural competence’ OSCE , 2007, Medical teacher.

[21]  J. Bensing,et al.  Non-verbal behaviour in nurse-elderly patient communication. , 1999, Journal of advanced nursing.

[22]  Ronald M Epstein,et al.  Assessing communication competence: a review of current tools. , 2005, Family medicine.

[23]  Rainer Beck,et al.  Behavioral Coding for Evaluation of Medical Student Communication: Clarification or Obfuscation? , 2004, Academic medicine : journal of the Association of American Medical Colleges.

[24]  H. Schaeffer,et al.  The "Culture OSCE"--introducing a formative assessment into a postgraduate program. , 2007, Education for health.

[25]  M. Dimatteo,et al.  Predicting Patient Satisfaction from Physicians’ Nonverbal Communication Skills , 1980, Medical care.

[26]  Edward Krupat,et al.  The Four Habits Coding Scheme: validation of an instrument to assess clinicians' communication behavior. , 2006, Patient education and counseling.

[27]  Rita Gorawara-Bhat,et al.  Nonverbal communication in doctor-elderly patient transactions (NDEPT): development of a tool. , 2007, Patient education and counseling.

[28]  David L Buckeridge,et al.  Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. , 2007, JAMA.

[29]  M. Doty,et al.  DIVERSE COMMUNITIES, COMMON CONCERNS: ASSESSING HEALTH CARE QUALITY FOR MINORITY AMERICANS FINDINGS FROM THE COMMONWEALTH FUND 2001 HEALTH CARE QUALITY SURVEY , 2002 .

[30]  Richard L Street,et al.  Racial differences in doctors' information‐giving and patients' participation , 2006, Cancer.

[31]  R. Epstein,et al.  The Patient-Physician Relationship , 2002 .

[32]  M. Stewart,et al.  Patient-physician communication assessment instruments: 1986 to 1996 in review. , 1998, Patient education and counseling.

[33]  P. Anderson,et al.  Educating medical students for work in culturally diverse societies. , 1999, JAMA.

[34]  L. Anderson,et al.  Improving patient and provider communication: A synthesis and review of communication interventions , 1991 .

[35]  Jasook Koo,et al.  Physical therapists' nonverbal communication predicts geriatric patients' health outcomes. , 2002, Psychology and aging.

[36]  M. Weinberger,et al.  The impact of clinical encounter events on patient and physician satisfaction. , 1981, Social science & medicine. Part E, Medical psychology.

[37]  Nancy R. Katz,et al.  Relations Between Physicians' Behaviors and Analogue Patients' Satisfaction, Recall, and Impressions , 1987, Medical care.

[38]  Stanford W Gregory,et al.  Further analysis of a doctor-patient nonverbal communication instrument. , 2005, Patient education and counseling.

[39]  D. Losh,et al.  Teaching Inpatient Communication Skills to Medical Students: An Innovative Strategy , 2005, Academic medicine : journal of the Association of American Medical Colleges.