Interruption and rapport disruption: measuring the prevalence and nature of verbal interruptions during back pain consultations

Abstract

Background: evaluating the impact of communication during clinical encounters is complex. One behaviour, largely ignored in clinical practice and training, is interruptions in verbal communication. Two types exist: an ‘overlap’ (an error projecting when a turn ends); and an ‘interruption’ (when an individual starts talking before the speaker's turn is complete). This paper reports the prevalence of these behaviours during initial consultations involving physiotherapists and patients with back pain.

Methods: 25 initial back pain consultations were observed, audio-recorded, transcribed verbatim, analysed thematically and managed using a Framework approach.

Results: the data set comprised 15,489 turns: 7659 by patients; 7647 by clinicians; and 183 by others (patients’ spouse or clinical colleagues). Clinicians were 7 times more likely to interrupt than patients (284 and 39 respectively), however overlaps were 1.5 times more prevalent among patients (n = 582) compared to clinicians (n = 385). The main functions for interruptions by clinicians and patients were to ‘seek’ or ‘give’ additional information respectively. A trend was noted that female physiotherapists were 3 times more likely to interrupt than male clinicians and overall, the prevalence of interruptions in same-sex consultations was twice as likely as in mixed-sex encounters, however the small sample size precluded secondary analyses.

Conclusion: alongside measuring the prevalence of interruptions in back pain consultations, this study identified differences in the nature of interruptions made by physiotherapists and patients. It highlights the complexity of clinical encounters and being aware of interruptions is important to optimize rapport and clinician-patient relationships.

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Identifiers

ORCID for Lisa C. Roberts: orcid.org/0000-0003-2662-6696

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