Boosting nonverbal physician-patient communication in medical education

Emiliana dos Santos Valadares,Renata Rodrigues Catani,Helena Borges Martins da Silva Paro,Tânia Maria da Silva Mendonça,Carlos Henrique Martins Silva,Julianni Bernardelli Lacombe

doi:10.1590/1981-5271v45.2-20200327.ing

Emiliana dos Santos Valadares, Renata Rodrigues Catani + Show 4 more

Open Access

https://doi.org/10.1590/1981-5271v45.2-20200327.ing

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Abstract

Abstract: Introduction: Nonverbal communication is an important part of the medical interview. However, nonverbal skills are still underestimated in medical education and instruments for their teaching and assessing in medical schools are scarce. Objective: We aimed to translate and culturally adapt the Relational Communication Scale for Observational measurement of doctor-patient interactions (RCS-O) to Brazilian Portuguese. Methods: We translated the RCS-O in seven stages: initial translation, reconciliation, back translation, review by the author, independent review, consensus version through the Delphi technique, review by a language coordinator, and pre-test. We used video recordings of four medical consultations performed by medical students and residents to pre-test the instrument. During this phase, three independent observers assessed the medical students and residents’ performance in real health care scenarios through the use of the recordings. Results: Most of the difficulties regarding the translation and cultural adaptation were related to the polysemic meaning of some items. Words and expressions such as “stimulating”, “warmth”, “desire”, “relaxed”, “conversation to a deeper level”, “deeper relationship”, “casual”, and “intensely” required adaptation in order to remove the potential sexual connotation that could arise from overintimacy in the physician-patient relationship. Conclusion: The Brazilian version of the RCS-O is a culturally, conceptually, semantically and operationally valid instrument. It may represent an important advance for the strengthening of learning and assessing nonverbal communication in medical education. We hope this study may encourage health educators to invest in the teaching and assessment of nonverbal communication skills in other countries.

Highlights

Nonverbal communication is an important part of the medical interview
The Brazilian version of the relational communication scale (RCS)-O is a culturally, conceptually, semantically and operationally valid instrument. It may represent an important advance for the strengthening of learning and assessing nonverbal communication in medical education
We hope this study may encourage health educators to invest in the teaching and assessment of nonverbal communication skills in other countries

Summary

Introduction

Nonverbal communication is an important part of the medical interview. nonverbal skills are still underestimated in medical education and instruments for their teaching and assessing in medical schools are scarce. Studies have suggested that nonverbal communication plays an important role in the physician-patient relationship[8], being associated with patient satisfaction[9,10,11], emotional distress[12], symptom resolution[13], and malpractice claims[14]. Despite such evidence, nonverbal skills are still underestimated in medical education. Few interventions designed to improve medical students’ nonverbal behavior are reported in the medical education research field. We assume that nonverbal communication skills are determined by a fusion of these extremes[5]

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Discussion

Conclusion