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Related Experiment Videos

A theory-based approach to analysing conversation sequences.

Wolf Langewitz1, Matthias Nübling, Heidemarie Weber

  • 1Division Psychosomatic Medicine, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland. wlangewitz@uhbs.ch

Epidemiologia E Psichiatria Sociale
|August 15, 2003
PubMed
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Sequence analysis of physician-patient conversations reveals open questions elicit longer patient responses and increase concern expression. Communication skills training improved empathy and reciprocity, correlating with global quality scores.

Area of Science:

  • Medical Communication
  • Health Services Research

Background:

  • Traditional methods for assessing communication quality include categorizing utterances or using global observer ratings.
  • The study explores sequence analysis as a potentially more precise method for reflecting conversational processes.

Purpose of the Study:

  • To evaluate if sequence analysis of physician-patient interactions provides a more accurate reflection of conversational dynamics compared to traditional methods.
  • To examine the impact of different question types on patient speech length and content.
  • To assess the effectiveness of communication skills training on reciprocity indices and their correlation with global quality assessments.

Main Methods:

  • Re-analysis of data from a randomized controlled intervention study involving simulated patient interviews.

Related Experiment Videos

  • Utilized the U-file of the Roter Interaction Analysis System (RIAS) to analyze physician question types (open, closed, facilitators) and their effect on patient utterances.
  • Investigated changes in reciprocity indices and their correlation with the Maastricht History and Advice Checklist (MAAS-R) global scores post-training.

    • Main Results:

    • Open-ended physician questions resulted in significantly longer patient responses (2.75 utterances) compared to closed questions (1.78 utterances).
    • The likelihood of patients expressing concerns was over 10 times higher following open-ended questions.
    • While reciprocal sequences constituted less than 2% of conversations, they correlated with global MAAS-R scores, and an 'empathy index' improved post-training.

    Conclusions:

    • Sequence analysis offers a nuanced understanding of communication dynamics, highlighting the impact of question types on patient engagement.
    • Open-ended questions are crucial for eliciting detailed patient responses and concerns.
    • Communication skills training effectively enhances empathy and reciprocity, suggesting its value in improving patient-physician interactions.