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Measuring verbal communication in initial physical therapy encounters

Measuring verbal communication in initial physical therapy encounters
Measuring verbal communication in initial physical therapy encounters
Background: Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician.

Objective: The purpose of this study was to measure verbal communication between physical therapists and patients with back pain during their initial consultation and trial management of the data using a novel, Web-based application.

Design: A cross-sectional study was conducted.

Methods: Nine musculoskeletal physical therapists and 27 patients with back pain participated in this study. Twenty-five initial consultations were observed, audio recorded, and categorized 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.

Results: In this sample, physical therapists spoke for 49.5% of the encounter and patients for 33.1%. Providers and patients spent little time overtly discussing emotions (1.4% and 0.9%, respectively). More-experienced clinicians used more “history/background probes,” more “advice/suggestion,” and less “restatement” than less-experienced staff, although they demonstrated a greater prevalence of talking concurrently and interrupting patients (7.6% compared with 2.6%).

Limitations: Although studies measuring actual behavior are considered to be the gold standard, audio recordings do not enable nonverbal behaviors to be recorded.

Conclusion: This study investigated a method for measuring the verbal content of clinical encounters in a physical therapy outpatient setting. The study has directly contributed to developing a research-friendly version of the application (ie, Synote Researcher). Given the pivotal role of communication in ensuring a positive experience and outcome for both patient and provider, investing time in further developing communication skills should be an on-going priority for providers. Further work is needed to explore affective behaviors and the prevalence of interrupting patients, considering differences in sex and provider experience.
0031-9023
479-491
Roberts, L.
0a937943-5246-4877-bd6b-4dcd172b5cd0
Whittle, C.
8df82fe7-6527-4281-b0b6-50b3ffc5c86c
Cleland, J.
9015a550-0b00-480c-85d8-88126d986570
Wald, M.
90577cfd-35ae-4e4a-9422-5acffecd89d5
Roberts, L.
0a937943-5246-4877-bd6b-4dcd172b5cd0
Whittle, C.
8df82fe7-6527-4281-b0b6-50b3ffc5c86c
Cleland, J.
9015a550-0b00-480c-85d8-88126d986570
Wald, M.
90577cfd-35ae-4e4a-9422-5acffecd89d5

Roberts, L., Whittle, C., Cleland, J. and Wald, M. (2012) Measuring verbal communication in initial physical therapy encounters. Physical Therapy, 93 (4), 479-491. (doi:10.2522/ptj.20120089). (PMID:23197846)

Record type: Article

Abstract

Background: Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician.

Objective: The purpose of this study was to measure verbal communication between physical therapists and patients with back pain during their initial consultation and trial management of the data using a novel, Web-based application.

Design: A cross-sectional study was conducted.

Methods: Nine musculoskeletal physical therapists and 27 patients with back pain participated in this study. Twenty-five initial consultations were observed, audio recorded, and categorized 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.

Results: In this sample, physical therapists spoke for 49.5% of the encounter and patients for 33.1%. Providers and patients spent little time overtly discussing emotions (1.4% and 0.9%, respectively). More-experienced clinicians used more “history/background probes,” more “advice/suggestion,” and less “restatement” than less-experienced staff, although they demonstrated a greater prevalence of talking concurrently and interrupting patients (7.6% compared with 2.6%).

Limitations: Although studies measuring actual behavior are considered to be the gold standard, audio recordings do not enable nonverbal behaviors to be recorded.

Conclusion: This study investigated a method for measuring the verbal content of clinical encounters in a physical therapy outpatient setting. The study has directly contributed to developing a research-friendly version of the application (ie, Synote Researcher). Given the pivotal role of communication in ensuring a positive experience and outcome for both patient and provider, investing time in further developing communication skills should be an on-going priority for providers. Further work is needed to explore affective behaviors and the prevalence of interrupting patients, considering differences in sex and provider experience.

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More information

e-pub ahead of print date: 29 November 2012
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 350898
URI: http://eprints.soton.ac.uk/id/eprint/350898
ISSN: 0031-9023
PURE UUID: de5f7512-9f65-4a9b-8673-5d37ebb2e189

Catalogue record

Date deposited: 10 Apr 2013 10:35
Last modified: 12 Dec 2019 01:38

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Contributors

Author: L. Roberts
Author: C. Whittle
Author: J. Cleland
Author: M. Wald

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