Methodological choices in experimental research on medical communication using vignettes: The impact of gender congruence and vignette modality
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Updated: Oct 15, 2025

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Leonie N C Visser1, Naomi C A van der Velden2, Ellen M A Smets2
1Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden; Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC (location AMC), PO Box 22660, 1100 DD Amsterdam, The Netherlands.
Objective:
Experimental vignette designs are used to systematically test the effects of medical communication. We tested the impact of two methodological choices -gender congruence and vignette modality- on analogue patient reported outcomes.
Methods:
In an online experiment using a vignette portraying an oncological bad news consultation, we manipulated (1) gender congruence between the analogue and the vignette patient, and (2) vignette modality, i.e., text, audio, or video. Cancer-naïve students acting as analogue patients (N = 209, 22 ± 3 years old, 75% F) were assigned one randomly-selected vignette variant and completed questionnaires. Using 3 × 2 (repeated-measures) ANOVAs, we tested main and interaction effects of gender congruence and modality on self-reported engagement, recall, trust, satisfaction and anxiety.
Results:
We found no main effects of gender congruence or modality on any of the outcomes, nor any interaction effects between modality and congruence.
Conclusion:
Our results indicate that researchers may needlessly create gender-congruent vignettes at considerable cost and effort. Also, the currently assumed superiority of videos over other modalities for experimental vignette-based research may be inaccurate.
Practice Implications:
Although further testing in an offline format and among different populations is warranted, decisions regarding gender congruence and modality for future vignette-based studies should be based primarily on their specific aims.
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