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Nonverbal behavior in prognostic communication: A pilot experiment in virtual reality
Brigitte N Durieux1,2, Jonathan Gordon3, Justin J Sanders1,2
1Department of Family Medicine, McGill University, Montreal, QC, Canada.
PEC Innovation
|September 19, 2025
Summary
Virtual reality (VR) simulations show that while clinician nonverbal behaviors impact patient communication, no single behavior significantly altered patient reactions in this pilot study. Further research is needed to refine VR for studying serious illness communication.
Area of Science:
- Medical Communication
- Human-Computer Interaction
- Psychology
Background:
- Clinicians' nonverbal cues significantly influence patient responses during prognosis communication.
- Empirical evidence on specific nonverbal behaviors and their impact on perceived communication quality is limited.
- Virtual reality (VR) offers a controlled environment to research communication by manipulating nonverbal behaviors.
Purpose of the Study:
- To evaluate if altering avatar doctors' nonverbal behaviors in VR prognosis communication simulations affects participant feelings, reactions, and immersion.
- To explore the potential of VR as a tool for studying the nuances of nonverbal communication in healthcare.
Main Methods:
- A pilot experiment randomized 229 university students to VR prognosis communication scenarios with five nonverbal conditions: no nonverbals, smile only, nod only, lean only, or all nonverbals.
- Outcomes measured included cognitive load, recall, emotional valence, satisfaction, anxiety, and presence/immersion.
- Participants experienced a short prognosis communication simulation in immersive VR.
Main Results:
- Participant responses showed some variation based on manipulated nonverbal behaviors.
- No single nonverbal behavior was identified as the primary driver of patient reactions to prognostic communication.
- The study demonstrated the feasibility of using VR for experimental manipulation of nonverbal behaviors.
Conclusions:
- VR facilitates experimental research into nonverbal behaviors in serious illness communication.
- Further development of VR simulations is necessary for sensitive and ecologically valid communication research.
- Research on discrete nonverbal behaviors can enhance serious illness communication training and practice.
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