Rapport expressed through nonverbal behavior

Family Medicine residents were videotaped in interviews with a new and a return-visit patient. Two coders recorded nonverbal behavior performed by the residents for two, one-minute segments of each interview. Categories of movement included: proxemic behaviors of distance, orientation, and trunk lean, and head, hand/arm, and leg/foot movement, facial expression, and direction of gaze.Each of the 36 video segments were rated by a group of psychiatric nurses using bipolar adjective scales assessing dimensions of rapport. Significant differences in nonverbal behavior were found between high and low rapport doctors. Physicians were rated more positively when they sat directly facing the patient, with uncrossed legs, and arms in symmetrical, side-by-side positions. High rapport doctors also engaged in moderate, but less extensive eye contact, with the patient than low rapport doctors. Discussion focuses on the impact of nonverbal behavior on physician-patient communication and the establishment of rapport.

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