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Adaptive Physician-Patient Communication: Physician Interpersonal Sensitivity, Physician Behavioral Variability, and Patient Outcomes

English title Adaptive Physician-Patient Communication: Physician Interpersonal Sensitivity, Physician Behavioral Variability, and Patient Outcomes
Applicant Schmid Mast Marianne
Number 141737
Funding scheme ProDoc
Research institution Department of Strategy HEC Lausanne University of Lausanne
Institution of higher education University of Lausanne - LA
Main discipline Psychology
Start/End 01.10.2012 - 30.09.2016
Approved amount 327'427.00
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All Disciplines (2)

Discipline
Psychology
Health Education

Keywords (4)

interpersonal sensitivity; patient-centered communication; verbal and nonverbal behavior; health communication

Lay Summary (English)

Lead
Lay summary

There is widespread consensus about the fact that a patient-centered physician communication style is beneficial for the patient as well as for the doctor. In order to be patient-centered, the physician communication needs to be flexible or adaptive to the characteristics, needs, and preferences of the patient. For this, the physician needs to be able to sense and infer those characteristics, needs, and preferences from the patient. This physician skill is call interpersonal sensitivity, defined as the ability to correctly infer the patient’s states (e.g., emotions) and traits (e.g., personality characteristics). There is initial evidence from the literature that physician interpersonal sensitivity is related to positive consultation outcomes. However, what we do not know is through which verbal and nonverbal physician behavior a doctor’s interpersonal sensitivity translates into positive patient outcomes. We believe that the interpersonally sensitive physician adapts his or her interaction style to the patients’ need and preferences and that this is what explains the positive patient outcomes. In other words, for an optimal outcome, the doctor first needs to be able to correctly assess a patient’s characteristics, needs, and preferences; he or she needs to be skilled in interpersonal sensitivity. Second, the doctor needs to be able and willing to adapt his or her verbal and nonverbal communication behavior according to the identified patient characteristics, needs, and preferences. As an example, the interpersonally sensitive doctor will correctly assess that a patient is angry after receiving bad news whereas another patient is sad. Based on these assessments, the physician will show accommodating behavior towards the first patient and encouraging behavior towards the second patient. The extent to which the physician behavior varies among different patients is what we call behavioral variability.

The goal of the present research is to assess the physician’s individual level of interpersonal sensitivity, to investigate with which physician nonverbal cues it is associated and whether these associations differ depending on the patient’s needs, and how interpersonal sensitivity and physician behavioral variability relate to patient outcomes. We hypothesize that the more interpersonally sensitive a physician is, the more positive the patient outcomes are. We further hypothesize that more interpersonally sensitive physicians show more variability in their verbal and nonverbal behavior among different patients. Also, we predict that interpersonally sensitive physicians have patients who report better consultation outcomes  because physicians show adaptivity in their behavior.

When physician communication is tailored to patients’ needs and expectations, patients are satisfied and satisfied patients benefit from better health outcomes. Our results will inform to what extent physician training should emphasize the acquisition of different communication styles and the improvement of physician interpersonal sensitivity.

Direct link to Lay Summary Last update: 21.02.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
Individual training at the undergraduate level to promote competence in breaking bad news in oncology
Berney Alexandre, Carrard Valérie, Schmid Mast Marianne, Bonvin Raphael, Stiefel Friedrich, Bourquin Céline (2017), Individual training at the undergraduate level to promote competence in breaking bad news in oncology, in Psycho-Oncology, 26(12), 2232-2237.
Patient-Centeredness as Physician Behavioral Adaptability to Patient Preferences
Carrard Valérie, Schmid Mast Marianne, Jaunin-Stalder Nicole, Junod Perron Noëlle, Sommer Johanna (2017), Patient-Centeredness as Physician Behavioral Adaptability to Patient Preferences, in Health Communication, 33(5), 593-600.
Beyond “One Size Fits All”: Physician Nonverbal Adaptability to Patients’ Need for Paternalism and Its Positive Consultation Outcomes
Carrard Valérie, Schmid Mast Marianne, Cousin Gaëtan (2016), Beyond “One Size Fits All”: Physician Nonverbal Adaptability to Patients’ Need for Paternalism and Its Positive Consultation Outcomes, in Health Communication, 31(11), 1327-1333.
Physician behavioral adaptability: A model to outstrip a “one size fits all” approach
Carrard Valérie, Schmid Mast Marianne (2015), Physician behavioral adaptability: A model to outstrip a “one size fits all” approach, in Patient Education and Counseling, 98(10), 1243-1247.
Trait-agreeableness influences individual reactions to a physician’s affiliative behavior in a simulated bad news delivery
Cousin Gaëtan, Schmid Mast Marianne (2015), Trait-agreeableness influences individual reactions to a physician’s affiliative behavior in a simulated bad news delivery, in Health Communication, 31(3), 320-327.
Well, you have hepatic metastases: Use of technical language by medical students in simulated patient interviews
Bourquin Céline, Stiefel Friedrich, Mast Marianne Schmid, Bonvin Raphael, Berney Alexandre (2015), Well, you have hepatic metastases: Use of technical language by medical students in simulated patient interviews, in Patient Education and Counseling, 98(3), 323-330.
Gender in patient-physician interactions
Carrard Valérie, Schmid Mast Marianne (2015), Gender in patient-physician interactions, in Faniko Klea, Lorenzi-Cioldi O., Mayor Eric (ed.), Routledge, London, 58-71.
Hostile Sexist Male Patients and Female Doctors: A Challenging Encounter
Klöckner Cronauer Christina, Schmid Mast Marianne (2014), Hostile Sexist Male Patients and Female Doctors: A Challenging Encounter, in The Patient - Patient-Centered Outcomes Research, 7(1), 37-45.
Hostile sexist male patients and female doctors – A challenging encounter
Klöckner Cronauer C. & Schmid Mast M. (2014), Hostile sexist male patients and female doctors – A challenging encounter, in The Patient: Patient-Centered Outcomes Research., 7, 37-45.
Nonverbal communication in health settings
Cousin Gaetan, Schmid Mast Marianne (2014), Nonverbal communication in health settings, in Golson J.G., Thompson T.L. (ed.), Sage, Thousand Oaks, 946-950.
Beyond “one size fits all”: Physician nonverbal adaptability to each patient’s need for paternalism is related to positive consultation outcomes
Carrard V. Schmid Mast M. & Cousin G., Beyond “one size fits all”: Physician nonverbal adaptability to each patient’s need for paternalism is related to positive consultation outcomes, in Health Communication, advance online publication.
Gender, power, and nonverbal communication
Carrard Valérie, Schmid Mast, Hall Judith, Gender, power, and nonverbal communication, in Kissane D., Butow P., Bultz B. (ed.), Oxford University Press, New York.
Trait-agreeableness influences individual reactions to a physician's affiliative behavior in a simulated bad news delivery health communication
Cousin G. & Schmid Mast M., Trait-agreeableness influences individual reactions to a physician's affiliative behavior in a simulated bad news delivery health communication, in Health Communication.

Collaboration

Group / person Country
Types of collaboration
HUG Genève Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
UC Santa Barbara, Prof. Dr. Norah Dunbar United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
CHUV Lausanne Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
- Exchange of personnel
Northeastern University United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Johns Hopkins University, Baltimore United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
16th International Conference on Communication in Healthcare Individual talk Effectiveness of an undergraduate training in breaking bad news from an analogue patient perspective: A continuation study. 08.09.2018 Porto, Portugal Carrard Valérie; Schmid Mast Marianne;
International Conference on Communication in Healthcare Talk given at a conference What is it with female doctors? 10.09.2017 Baltimore, United States of America Schmid Mast Marianne;
conference of the Swiss Psychological Society Individual talk How physicians’ behavioral adaptability to each patient’s preferences is related to positive consultation outcomes 09.09.2017 Lausanne, Switzerland Schmid Mast Marianne; Carrard Valérie;
International Conference on Communication in Healthcare Talk given at a conference Physicians’ behavioral adaptability: Achieving patient-centeredness’ tailoring of care 07.09.2016 Heidelberg, Germany Carrard Valérie; Schmid Mast Marianne;
Interdisciplinary Conference on Communication, Medicine & Ethics (COMET) Talk given at a conference Patient-Centered Communication as Physician Adaptation to Patients’ Preferences 05.07.2016 Aalborg, Denmark Schmid Mast Marianne; Carrard Valérie;
Conference of the Society for Personality and Social Psychology Poster Behavioral adaptability and interaction outcomes 25.01.2016 San Diego, United States of America Carrard Valérie; Schmid Mast Marianne;
Nonverbal Behavior Preconference of the Conference of the Society for Personality and Social Psychology (SPSP) Talk given at a conference Physician Nonverbal Adaptability: What Enables it and What are the Consequences for the Patients? 21.01.2016 San Diego, United States of America Schmid Mast Marianne; Carrard Valérie;
Conference of the Swiss Psychological Society Poster Physicians’ empathy is related to verbal adaptability 12.09.2015 Genève, Switzerland Schmid Mast Marianne; Carrard Valérie;
Annual meeting of the Society for Personality and Social Psychology (SPSP) Talk given at a conference The Social Chameleon: The Link between Interpersonal Accuracy and Behavioral Adaptability 27.02.2015 Long Beach, CA, United States of America Schmid Mast Marianne; Carrard Valérie;
Annual meeting of the Society for Personality and Social Psychology (SPSP) Poster Interpersonal accuracy and positive interaction outcomes: When situation-specific accuracy skills are more efficient than a general emotion recognition skill 27.02.2015 Long Beach, CA, United States of America Schmid Mast Marianne; Carrard Valérie;
Annual meeting of the Society for Personality and Social Psychology (SPSP) Poster How interpersonal accuracy as a general emotion recognition skill and as a situation-specific skill affects interaction outcomes 27.02.2015 Long Beach, CA, United States of America Carrard Valérie; Schmid Mast Marianne;
Nonverbal behavior. Preconference of the annual meeting of the Society for Personality and Social Psychology (SPSP) Poster Interpersonal accuracy and positive interaction outcomes: When situation-specific accuracy skills are more efficient than a general emotion recognition skill 26.02.2015 Long Beach, CA, United States of America Carrard Valérie; Schmid Mast Marianne;
International Conference on Communication in Healthcare Poster Physicians' adaptation to patients' preferences concerning dominance is related to positive consultation outcomes 28.09.2014 Amsterdam, Netherlands Schmid Mast Marianne; Carrard Valérie;
Conference on Communication, Medicine and Ethics (COMET) Talk given at a conference Measuring physician behavioral adaptability and testing its relation to interaction outcomes 26.06.2014 Lugano, Switzerland Schmid Mast Marianne; Carrard Valérie;
Men and Women in Social Hierarchies workshop Talk given at a conference Gender in patient-physician interactions 27.03.2014 Genève, Switzerland Schmid Mast Marianne; Carrard Valérie;
Annual meeting of the Society for Personality and Social Psychology (SPSP) Poster Positive interaction outcomes through tailoring of interpersonal behavior 14.02.2014 Austin, TX, United States of America Schmid Mast Marianne; Carrard Valérie;
Nonverbal behavior. Preconference of the annual meeting of the Society for Personality and Social Psychology (SPSP) Talk given at a conference Physician nonverbal adaptability leads to positive outcomes 13.02.2014 Austin, TX, United States of America Carrard Valérie; Schmid Mast Marianne;
Conference of the Swiss Psychological Society Talk given at a conference Physician behavioral adaptability leads to patient satisfaction 08.09.2013 Basel, Switzerland Carrard Valérie; Schmid Mast Marianne;


Knowledge transfer events



Self-organised

Title Date Place
Recherche sur la communication médecin-patient 16.06.2016 Lausanne, Switzerland
La communication médecin-patient: apports de la recherche 16.06.2016 Genève, Switzerland

Communication with the public

Communication Title Media Place Year
New media (web, blogs, podcasts, news feeds etc.) How my physician could adapt his or her behaivors to my preferences? Atlas of Science International 2015

Awards

Title Year
"summa cum laude" distinction for the thesis of Valérie Carrard. 2016
Best poster award of the 12th International Conference on Communication in Healthcare (ICCH), Amsterdam, Netherlands. 2014

Associated projects

Number Title Start Funding scheme
159292 Interpersonal Accuracy of Leaders: Effects on Interpersonal Behavior and Interaction Outcomes 01.03.2016 Project funding (Div. I-III)
118632 Nonverbal communication in the medical encounter 01.05.2009 ProDoc
132615 Adaptivity in Communication and Health 01.02.2011 ProDoc

Abstract

There is widespread consensus about the fact that a patient-centered physician communication style is beneficial for the patient as well as for the doctor. In order to be patient-centered, the physician communication needs to be flexible or adaptive to the characteristics, needs, and preferences of the patient. For this, the physician needs to be able to sense and infer those characteristics, needs, and preferences from the patient. This physician skill is call interpersonal sensitivity, defined as the ability to correctly infer the patient’s states (e.g., emotions) and traits (e.g., personality characteristics). There is initial evidence from the literature that physician interpersonal sensitivity is related to positive consultation outcomes. However, what we do not know is through which verbal and nonverbal physician behavior a doctor’s interpersonal sensitivity translates into positive patient outcomes. We believe that the interpersonally sensitive physician adapts his or her interaction style to the patients’ need and preferences and that this is what explains the positive patient outcomes. In other words, for an optimal outcome, the doctor first needs to be able to correctly assess a patient’s characteristics, needs, and preferences; he or she needs to be skilled in interpersonal sensitivity. Second, the doctor needs to be able and willing to adapt his or her verbal and nonverbal communication behavior according to the identified patient characteristics, needs, and preferences. As an example, the interpersonally sensitive doctor will correctly assess that a patient is angry after receiving bad news whereas another patient is sad. Based on these assessments, the physician will show accommodating behavior towards the first patient and encouraging behavior towards the second patient. The extent to which the physician behavior varies among different patients is what we call behavioral variability.The goal of the present research is to assess the physician’s individual level of interpersonal sensitivity, to investigate with which physician nonverbal cues it is associated and whether these associations differ depending on the patient’s needs, and how interpersonal sensitivity and physician behavioral variability relate to patient outcomes. We hypothesize that the more interpersonally sensitive a physician is, the more positive the patient outcomes are. We further hypothesize that more interpersonally sensitive physicians show more variability in their verbal and nonverbal behavior among different patients. Also, we predict that interpersonally sensitive physicians have patients who report better consultation outcomes because physicians show adaptivity in their behavior. In order to test these assumptions, physicians’ interpersonal sensitivity will be assessed and they then will be videotaped while consulting with 4 of their patients (2 women and 2 men). The verbal and nonverbal behavior emitted by the physician during each consultation will be coded. Patients report the consultation outcomes after the consultation (e.g., satisfaction, trust in the physicians, intention to adhere to the treatment recommendation, recall of treatment recommendations). When physician communication is tailored to patients’ needs and expectations, patients are satisfied and satisfied patients benefit from better health outcomes. Our results will inform to what extent physician training should emphasize the acquisition of different communication styles and the improvement of physician interpersonal sensitivity.
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