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

Little, Paul, White, Peter, Kelly, Joanne, Everitt, Hazel and Mercer, Stewart (2015) Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations British Journal of General Practice, 65, (635), e351-e356. (PMID:26009529).

Record type: Article



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


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.


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.


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.


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.

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More information

Accepted/In Press date: 21 October 2014
e-pub ahead of print date: 26 May 2015
Published date: 1 June 2015
Keywords: communication, consultation, general practice, nonverbal communication, patient satisfaction
Organisations: Primary Care & Population Sciences


Local EPrints ID: 378260
ISSN: 0960-1643
PURE UUID: 55775d3a-c13a-4145-8153-4c1bc7fb5576
ORCID for Hazel Everitt: ORCID iD

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Date deposited: 22 Jun 2015 15:40
Last modified: 06 Sep 2017 12:19

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Author: Paul Little
Author: Peter White
Author: Joanne Kelly
Author: Hazel Everitt ORCID iD
Author: Stewart Mercer

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