Roberts, Lisa, Whittle, Christopher, Cleland, Jennifer and Wald, Mike
Measuring communication in physical therapy consultations: a novel approach
Physical Therapy, 93, (4), Spring Issue
Background & objective: Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician. The purpose of this methodological paper was to measure verbal communication between physical therapists and patients with back pain during their initial consultation, and trial management of the resultant data using a novel, web-based application.
Design: Observational, cross-sectional study.
Methods. Nine musculoskeletal physical therapists and 27 patients with back pain participated in this study. Twenty-five initial consultations were observed, audio-recorded and analysed using The Medical Communications Behavior System. Data were managed using Synote, a freely-available application enabling synchronization of audio-recordings with transcripts and coded notes. Semi-structured interviews were undertaken with all participants, to elicit their perceptions of the consultation.
Results: This method of data management facilitated analysis of the content of verbal communication during clinical encounters with potential for sub-group analyses. Among the patterns identified in the data were that more-experienced clinicians employed more ‘history and background probes’, more ‘advice/suggestion’ and less ‘restatement’ than less-experienced staff, although they demonstrated a greater prevalence of talking concurrently and interrupting patients.
Limitations. The aim of this exploratory study was to trial the methods; it was not powered for sub-group analyses.
Conclusion: Verbal communication can be measured in physical therapy consultations for back pain using valid tools and managed using Synote. This study has directly contributed to developing a research-friendly version of the application: ‘Synote Researcher’. Investing time in further developing communication skills is vital for maximizing clinical outcomes. This study highlighted differences in communication associated with levels of clinical experience and gender, which has implications for clinical practice and teaching.
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