Response to Letter to the Editor in Response to “The link between perception of clinical empathy and nonverbal behavior: The effect of a doctor’s gaze and body orientation”

Abstract

We thank Dr. Charaf for her interest in our study and for bringing under the attention an important research field [1]. More research is indeed needed on the effects of keeping up the electronic health care record (computer screen engagement) during consultations on nonverbal communication and specific patient outcomes. Concern for any unwanted effects of computer use in the medical office was one of the reasons we conducted our research. In our study, we researched the effect of a doctor’s gaze and body orientation on respondents’ perception of sincerity, engagement and empathy by using standardized video vignettes in which actors performed as doctors. In the video vignettes, four conditions were determined: (1) patient-centered gaze and body orientation, (2) averted gaze and body orientation, (3) patient-centered gaze and averted body orientation and (4) averted gaze and patientcentered body orientation. In condition 2 and 3, the actor’s body was turned toward the computer. To make these conditions more realistic, all actors were instructed to use the computer as if they were entering data into an electronic health care record before expressing the standardized empathic statement. In condition 2, the actor kept looking at the computer (averted gaze), in condition 3, the actor stopped typing and looked in to the camera (patientcentered gaze) while maintaining the body orientation toward the computer screen. In other words, through our design, we did not explore the effect of computer use as such but rather focused on the effect of different nonverbal cues. Although we did not discuss this in our article, we expected that the use of a computer is of less influence than the effect of gaze; technology does not influence the patient if the doctor is mindful of maintaining eye contact to the patient. From our results it can be concluded that condition 2 (averted gaze, averted body orientation) was rated lowest out of the four with respect to the