Is a change in vocal loudness a first step towards becoming a medical doctor?

C Kiese-Himmel,W Himmel,M Rodenstock,M Scherer

doi:10.4414/smw.2012.13534

Abstract

Some evidence suggests that a loud voice is a core characteristic of medical professionals. It is unknown whether medical students talk louder than their non-medical peers and, if so, whether they commence their studies with a loud voice, representing a characteristic of admission, or whether sound pressure level changes during education, reflecting model learning. We performed a cross-sectional observation study with 206 students (57% female), stratified in 4 groups (medical and non-medical students as freshmen and fifth-year students). Habitual loudness was defined as a student's sound pressure level, measured with a standardised sound level meter on basis of 2 vocal tasks. The hypothesis was tested in a 2-way analysis of variance, with year of study (first vs. fifth year) and field by study (medicine vs. non-medicine) as main factors. The sound pressure level of freshmen in medicine was, on average, 64.4 dB (SD 3.0), that of fifth-year medical students was 66.3 dB (3.7). The respective scores of non-medical students were 65.3 (SD 2.7) for freshmen and 64.0 (3.4) for fifth-year students, resulting in a significant interaction between field of study and years of study (F = 12.7; p = 0.0005). The findings of this preliminary study present some evidence that medical students, in contrast to their non-medical peers, learn to raise vocal loudness during their education in medical school. Habitual loudness of medical students, as a way to gain professional dominance and a possible risk for hoarseness in later life, deserves more attention.

Highlights

The human voice is a component of body language [1,2] and the volume of one's vocalisation has been identified as a key factor of body expression
It is unknown whether medical students talk louder than their non-medical peers and, if so, whether they commence their studies with a loud voice, representing a characteristic of admission, or whether sound pressure level changes during education, reflecting model learning
An increased habitual loudness at the end of medical studies may be an important carrier signal to understand how this profession gains dominance. It could represent one quality the possession of which is necessary for those persons beginning their career as a medical professional

Summary

Introduction

The human voice is a (non-linguistic) component of body language [1,2] and the volume of one's vocalisation has been identified as a key factor of body expression. Serber [9] detected the acoustic-perceptual voice feature 'speech loudness' ( named 'vocal loudness' or 'loudness of phonation') as one of six variables involved in interactive behaviour. It is defined as "the sound level produced by the voice and perceived by the listener" [10; p. A subject's default sound level, used for the majority of her or his vocalisations is called 'habitual loudness' – "the perceptual correlate to the most frequently produced vocal intensity" [11; p. Experts in acoustics and phoniatrics are typically concerned with the reduction of habitual loudness as a sign of a voice and/or speech disorder [11].

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