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Randomized Controlled Trial
. 2015 Jun;65(635):e351-6.
doi: 10.3399/bjgp15X685237.

Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations

Paul Little  1 , Peter White  2 , Joanne Kelly  1 , Hazel Everitt  1 , Stewart Mercer  3
Affiliations
Randomized Controlled Trial

Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations

Paul Little et al. Br J Gen Pract. 2015 Jun.

Abstract

Background: The impact of changing non-verbal consultation behaviours is unknown.

Aim: To assess brief physician training on improving predominantly non-verbal communication.

Design and setting: Cluster randomised parallel group trial among adults aged ≥16 years attending general practices close to the study coordinating centres in Southampton.

Method: 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.

Conclusion: 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.

Keywords: communication; consultation; general practice; nonverbal communication; patient satisfaction.

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Figures

Figure 1.
Figure 1.
CONSORT flow diagram. MISS = Medical Interview Satisfaction Scale. a Estimates based on reports from researchers approaching participants in the waiting room
See this image and copyright information in PMC

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