Effects of mode of presentation on ratings of empathic communication in medical interviews
Related Experiment Video
Updated: Jun 18, 2026
Virtual Agent for Real-Time Motivational Interviewing by Integrating Adaptive Nonverbal Behavior and Language Models
Published on: December 23, 2025
Jennifer Nicolai1, Ralf Demmel, Karin Farsch
1Department of Psychosomatic and General Internal Medicine, University of Heidelberg, Heidelberg, Germany. Jennifer.Nicolai@med.uni-heidelberg.de
Objective:
To test the impact of nonverbal behaviour on the assessment of a clinician's level of empathic communication.
Methods:
One hundred volunteers were asked to assess a clinician's level of empathic communication using the Rating Scales for the Assessment of Empathic Communication in Medical Interviews (REM). Participants were randomly assigned to three groups differing with regard to the level of nonverbal information made available to them. Participants either watched a simulated medical interview, listened to an audio-only version of this interview, or read a transcribed version of the interview.
Results:
Compared to watching a video and listening to an audiotape, respectively, reading a transcribed version of the interview produced lower empathy ratings and interrater reliabilities.
Conclusions:
The findings suggest that assessments of a clinician's level of empathic communication may differ according to the level of nonverbal information made available to the raters.
Practice Implications:
Focusing on the verbal level of communication alone ignores the fact that empathy can be expressed through nonverbal means. Hence, nonverbal channels need to be taken into account in addition to the verbal channel when conducting research on empathic communication in health care.
Related Concept Videos
01:15Techniques of therapeutic communication I: Active Listening, Sharing Observations, Validation, and Using Touch
Therapeutic communication is not the same as social interaction. Social interaction has no goal or purpose and consists of casual information sharing, whereas therapeutic communication has a plan or purpose for the conversation. Therapeutic...
01:30Therapeutic Communication
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal...
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
02:34Empathy
01:23Techniques of Therapeutic Communication II: Focusing, Paraphrasing, and Summarizing
This therapeutic technique can also be used when a patient brings up pertinent information during a health-related conversation. The...
01:25Role of Communication in the Nursing Process I: Assessment and Diagnosis
The nursing process considers the patient's emotional and physical well-being. The process can be repeated or stopped at any point if judged essential. Assessment is the first step in the nursing process.