Examining Medical Interview Asymmetry Using the Expectation States Approach

Abstract

In this study we examine medical interview asymmetry using the expectation states approach. Physicians lead clinical interviews because of a feature inherent in those interviews, namely the status difference between doctor and patient. This power differential varies: it is greatest when the biomedical aspects of the interview are emphasized. These observations are consistent with status characteristics theory (SCT), which is based on the expectation states approach to understanding the emergence of power-prestige orders in groups facing shared tasks. From an SCT perspective, when the required scope conditions are met the status characteristics of doctor and patient trigger expectation states that result in inequalities relevant to the biomedical tasks of the interview. We examine interactions between medical students and standardized patients from the perspective of SCT. We observe the emergence of vocal spectrum inequalities when the interview task is biomedical. Other nonverbal behavioral outcomes emerge as well, which are consistent with the asymmetry literature.