Specific Communication Behaviors Research Articles

Explicit Training in Systematic Communication Strategies: A Pilot Study Exploring the Incorporation of Communication Tools by First-Year Residents in Simulation and in Clinical Practice.

Educational approaches for training physicians in clinical communications vary, and whether physicians apply the communication skills they learn or find them useful in the clinic is not well known. The aim of this study was to determine how first-year residents who received explicit instruction in 7 communication strategies would apply them in a simulation exercise and in clinical practice. First-year Internal Medicine residents at an urban teaching hospital received instruction in 7 systematic communication strategies: Ask-Tell-Ask, Teach-back, open-ended questioning, NURSE, open body language, pausing, and plain language. Residents were evaluated on their use of specific communication behaviors associated with the 7 strategies during a simulation exercise of disclosing a medical error to a standardized patient. Control group residents who did the simulation before attending the training program and training group residents who did the simulation after the training were compared. Residents were queried 6 months after the training program on their use of communication strategies during clinical practice. A total of 27 residents participated (n = 13 control group; n = 14 training group). The training group performed behaviors for "establishing patient understanding" significantly more often than the control group. Both groups used non-verbal communication and behaviors for addressing patient emotions at similar levels. Of the 24 residents who responded to the 6-month follow-up questionnaire, 24 (100%) reported using Ask-Tell-Ask, open-ended questioning, and Teach-back, and 22 (92%) reported using NURSE statements and non-verbal communication. Most respondents reported using the strategies in clinical practice often or very often (79%) and found the strategies useful or very useful (96%). Providing explicit instruction in systematic communication strategies, particularly those focused on establishing patient understanding, may be an efficient approach for helping early career physicians develop effective communication skills that can be readily implemented during clinical training and practice.

Adolescent, Parent, and Clinician Perspectives on Increasing Adolescent Involvement in Decision-Making During Clinic Visits

This study aimed to describe adolescent, parent, and clinician ideas for enhancing adolescent decision-making involvement (DMI) during clinic visits for chronic illness. Adolescents who recently attended a follow-up visit for a chronic illness, their parents, and clinicians were interviewed. Participants completed semistructured interviews; transcripts were coded and analyzed in NVivo. Responses to questions about ideas to increase adolescent DMI were reviewed and sorted into categories and themes. There were five themes: (1) adolescents need to understand their condition and regimen, (2) adolescents and parents should prepare before the visit, (3) clinicians and adolescents should have one-on-one time, (4) opportunities for condition-specific peer support would be helpful, and (5) clinicians and parents should engage in specific communication behaviors. Findings from this study highlight potential clinician-, parent-, and adolescent-focused strategies for enhancing adolescent DMI. Clinicians, parents, and adolescents may need specific guidance on how to enact new behaviors.

Exploring Communication Ability in Individuals With Angelman Syndrome: Findings From Qualitative Interviews With Caregivers.

Communication deficits have a substantial impact on quality of life for individuals with Angelman syndrome (AS) and their families, but limited qualitative work exists to support the necessary content of measures aiming to assess communication for these individuals. Following best practices for concept elicitation studies, we conducted individual qualitative interviews with caregivers and clinicians to elicit meaningful aspects of communication for individuals with AS. Caregivers were able to discuss their child's specific communication behaviors within a large number of expressive, receptive, and pragmatic functions via numerous symbolic and non-symbolic modalities. These results aligned well with published literature on communication in AS and will be used to inform the design of a novel caregiver-reported measure. Future studies on communication in individuals with AS should focus on gathering quantitative data from large samples of diverse caregivers, which would allow for estimations of the frequency of specific behaviors across the population.

Competence-Questioning Communication and Gender: Exploring Mansplaining, Ignoring, and Interruption Behaviors.

The online version contains supplementary material available at 10.1007/s10869-022-09871-7.

Preferred Communication Strategies Used by Physical Therapists in Chronic Pain Rehabilitation: A Qualitative Systematic Review and Meta-Synthesis.

ObjectiveLack of clarity regarding effective communication behaviors in chronic pain management is a barrier for implementing psychologically informed physical therapy approaches that rely on competent communication by physical therapist providers. This study aimed to conduct a systematic review and meta-synthesis to inform the development of a conceptual framework for preferred communication behaviors in pain rehabilitation.MethodsTen databases in the health and communication sciences were systematically searched for qualitative and mixed-method studies of interpersonal communication between physical therapists and adults with chronic pain. Two independent investigators extracted quotations with implicit and explicit references to communication and study characteristics following Standards for Reporting Qualitative Research and Strengthening the Reporting of Observational Studies in Epidemiology guidelines. Methodological quality for individual studies was assessed with Critical Appraisal Skills Programme, and quality of evidence was evaluated with GRADE-CERQual. An inductive thematic synthesis was conducted by coding each quotation, developing descriptive themes, and then generating behaviorally distinct analytical themes.ResultsEleven studies involving 346 participants were included. The specificity of operationalizing communication terms varied widely. Meta-synthesis identified 8 communication themes: (1) disclosure-facilitating, (2) rapport-building, (3) empathic, (4) collaborative, (5) professional accountability, (6) informative, (7) agenda-setting, and (8) meta-communication. Based on the quality of available evidence, confidence was moderate for 4 themes and low for 4 themes.ConclusionThis study revealed limited operationalization of communication behaviors preferred by physical therapists in chronic pain rehabilitation. A conceptual framework based on 8 communication themes identified from the literature is proposed as a preliminary paradigm to guide future research.ImpactThis proposed evidence-based conceptual framework for preferred communication behaviors in pain rehabilitation provides a framework for clinicians to reflect on their own communication practices and will allow researchers to identify if and how specific communication behaviors impact clinical outcomes.

Dynamic Inter-Brain Networks Correspond With Specific Communication Behaviors: Using Functional Near-Infrared Spectroscopy Hyperscanning During Creative and Non-creative Communication.

Social interaction is a dynamic and variable process. However, most hyperscanning studies implicitly assume that inter-brain synchrony (IBS) is constant and rarely investigate the temporal variability of the multi-brain networks. In this study, we used sliding windows and k-mean clustering to obtain a set of representative inter-brain network states during different group communication tasks. By calculating the network parameters and temporal occurrence of the inter-brain states, we found that dense efficient interbrain states and sparse inefficient interbrain states appeared alternately and periodically, and the occurrence of efficient interbrain states was positively correlated with collaborative behaviors and group performance. Moreover, compared to common communication, the occurrence of efficient interbrain states and state transitions were significantly higher during creative communication, indicating a more active and intertwined neural network. These findings may indicate that there is a close correspondence between inter-brain network states and social behaviors, contributing to the flourishing literature on group communication.

Understanding Chinese mobile social media users’ communication behaviors during public health emergencies

Mobile social media has become a significant platform for information exchange and social interaction during public health emergencies, and it has experienced exponential growth during the COVID-19 pandemic. The pandemic has forced many emergency agencies to rethink the way emergency information is disseminated. Mobile social media can be applied to public health emergency response, and it has great potential value as a tool for fostering government-citizen relationships during public health emergencies. Furthermore, consideration of specific risk cultures and rigorous censorship of social media may influence citizens’ use of mobile social media during the pandemic or other public health emergency. Thus, to investigate the specific mobile social media communication behaviors of Chinese citizens during the COVID-19 pandemic, we surveyed 2,074 mobile social media users in China from February to August 2020. We found that the state-oriented risk culture and strict censorship of social media, influence Chinese mobile social media users to seek and share information about the pandemic during public health emergencies; this finding has practical implications and academic value, because it increases the understanding of mobile social media users’ communication behaviors, supports shared situational awareness, and increases social resilience when responses to public health emergencies.

What Did They Learn? Objective Assessment Tools Show Mixed Effects of Training on Science Communication Behaviors

There is widespread agreement about the need to assess the success of programs training scientists to communicate more effectively with non-professional audiences. However, there is little agreement about how that should be done. What do we mean when we talk about “effective communication”? What should we measure? How should we measure it? Evaluation of communication training programs often incorporates the views of students or trainers themselves, although this is widely understood to bias the assessment. We recently completed a 3-year experiment to use audiences of non-scientists to evaluate the effect of training on STEM (Science, Technology, Engineering and Math) graduate students’ communication ability. Overall, audiences rated STEM grad students’ communication performance no better after training than before, as we reported in Rubega et al. 2018. However, audience ratings do not reveal whether training changed specific trainee communication behaviors (e.g., jargon use, narrative techniques) even if too little to affect trainees’ overall success. Here we measure trainee communication behavior directly, using multiple textual analysis tools and analysis of trainees’ body language during videotaped talks. We found that student use of jargon declined after training but that use of narrative techniques did not increase. Flesch Reading Ease and Flesch-Kincaid Grade Level scores, used as indicators of complexity of sentences and word choice, were no different after instruction. Trainees’ movement of hands and hesitancy during talks was correlated negatively with audience ratings of credibility and clarity; smiling, on the other hand, was correlated with improvement in credibility, clarity and engagement scores given by audience members. We show that objective tools can be used to measure the success of communication training programs, that non-verbal cues are associated with audience judgments, and that an intensive communication course does change some, if not all, communication behaviors.

Student-instructor relationships and ethics education: examining student perceptions of the integrative ethical education model

The National Communication Association has positioned ethics education as a key student learning outcome for those graduating with a degree in communication. However, as central as this learning outcome is, few studies, within communication and across disciplines investigating teaching/learning, have explored specific instructor behaviors that promote students’ ethical development. This study explores how instructor behaviors are recognized by students as fulfilling the integrative ethical education (IEE) model. A relationally based approach, the tenets of the IEE model propose pedagogical practices that can be implemented in order to promote student learning and ethical development. Conducting a thematic analysis of focus group and interview data, we identified specific instructor communication behaviors students connected to the IEE model. Further, our findings suggest that central to implementing the IEE model are the development of a strong student-instructor relationship and classroom community. Implications for ethics education in communication and future research directions are discussed.

Strategie komunikacyjne minimalnie werbalnych dzieci rozpoczynających edukację przedszkolną

In the so-called minimally verbal, a negligible degree of expressing communication behavior is diagnosed, which significantly reduces participation in interaction and reduces the effectiveness of communication. The minimal-verbal communication behaviors of preschool children in interaction are characterized by: sub-competence and transitional competence. With a shortage of linguistic resources, the child has specific communication behaviors, i.e. strategies that involve participation in interaction, the process of receiving and decoding meanings, and to a large extent the production and transmission of a message that is as understandable to the environment as possible. With limited language tools, children entering preschool education either withdraw from communicating or look for any possible means of interaction –both strategies can be observed in both natural and simulated pedagogical situations. The minimum verbosity of pre-school children does not exclude the possibility of interaction with other communication partners. The gradual transition from the level of sub-competency and transitional competence to a higher level requires early therapeutic and pedagogical activities, incentives to use achievement strategies more often, and to build bridges between communicative, linguistic and cultural competences. Without therapy, the strategies used may lead to fossilization, i.e. inhibit communication and the development of linguistic competence.

Improving Patients' Experiences Communicating With Nurses and Providers in the Emergency Department

IntroductionAs health care becomes increasingly patient centered, organizations strive to improve patients’ ratings of satisfaction with care. Communication with nurses and providers drives overall satisfaction, yet little evidence exists to guide them in ensuring effective communication in the emergency department. MethodsA semistructured interview guide based on the Hospital Consumer Assessment of Healthcare Providers survey was used to elicit qualitative data from 30 patients seen in the emergency department and fast track regarding communication with nurses and providers. Data were analyzed using content analysis methodology. ResultsTwo types of overarching themes emerged. Foundational themes include behaviors that convey courtesy and respect and are required for participants to view their interactions with nurses and providers as positive. Interactive themes describe humanistic ways in which nurses and providers conveyed courtesy and respect, reassurance through careful listening, attentiveness, and explaining things in an understandable way. DiscussionThe findings underscore existing evidence regarding patients’ perceptions of being treated with courtesy and respect via nurses’ and providers’ use of positive verbal phrasing and nonverbal body language. They reveal new insights into the importance of specific communication behaviors used by nurses and providers during interactions. Treating patients as individuals amidst a fast-paced care environment, proactively recognizing and responding to patients’ fears and concerns, and explaining information clearly to ensure understanding were critical.

Identifying Effective Motivational Interviewing Communication Sequences Using Automated Pattern Analysis.

Motivational Interviewing (MI) is an evidence-based strategy for communicating with patients about behavior change. Although there is strong empirical evidence linking "MI-consistent" counselor behaviors and patient motivational statements (i.e., "change talk"), the specific counselor communication behaviors effective for eliciting patient change talk vary by treatment context and, thus, are a subject of ongoing research. An integral part of this research is the sequential analysis of pre-coded MI transcripts. In this paper, we evaluate the empirical effectiveness of the Hidden Markov Model, a probabilistic generative model for sequence data, for modeling sequences of behavior codes and closed frequent pattern mining, a method to identify frequently occurring sequential patterns of behavior codes in MI communication sequences to inform MI practice. We conducted experiments with 1,360 communication sequences from 37 transcribed audio recordings of weight loss counseling sessions with African-American adolescents with obesity and their caregivers. Transcripts had been previously annotated with patient-counselor behavior codes using a specialized codebook. Empirical results indicate that Hidden Markov Model and closed frequent pattern mining techniques can identify counselor communication strategies that are effective at eliciting patients' motivational statements to guide clinical practice.

Communicating Racism: A Study of Racial Microaggressions in a Southern University and the Local Community

ABSTRACTThe current study was conducted with the goal of identifying specific communication behaviors – both verbal and nonverbal – that SOC at a PWI consciously and subconsciously identify as either an RMA or a contributing factor to the likelihood of one occurring. The experiences and voices of multiracial college students privileged over those of monoracial students in an effort to inspire institutional change and resist systemic oppression in its most basic form. The findings are consistent RMA research, while also introducing new categories and concepts that contribute to how scholars and SOC are “naming, detailing and classifying the actual manifestations of aversive racism”. The students in this study experienced and reported on RMA they are experiencing both at the university and in the local community, which is consistent with previous research. Regardless of their race/ethnicity, these SOC experienced verbal and nonverbal RMA on a daily basis. These findings further demonstrate that communication is at the center of understanding RMA, as evidenced by the seven categories of communication responses and 30 corresponding concepts that are new to RMA scholarship.

The Bursts and Lulls of Multimodal Interaction: Temporal Distributions of Behavior Reveal Differences Between Verbal and Non-Verbal Communication.

Recent studies of naturalistic face-to-face communication have demonstrated coordination patterns such as the temporal matching of verbal and non-verbal behavior, which provides evidence for the proposal that verbal and non-verbal communicative control derives from one system. In this study, we argue that the observed relationship between verbal and non-verbal behaviors depends on the level of analysis. In a reanalysis of a corpus of naturalistic multimodal communication (Louwerse, Dale, Bard, & Jeuniaux, ), we focus on measuring the temporal patterns of specific communicative behaviors in terms of their burstiness. We examined burstiness estimates across different roles of the speaker and different communicative modalities. We observed more burstiness for verbal versus non-verbal channels, and for more versus less informative language subchannels. Using this new method for analyzing temporal patterns in communicative behaviors, we show that there is a complex relationship between verbal and non-verbal channels. We propose a "temporal heterogeneity" hypothesis to explainhow the language system adapts to the demands of dialog.

Provider Information Provision and Breast Cancer Patient Well-Being

ABSTRACTResearch continues to delineate and clarify specific communication behaviors associated with improved patient outcomes. In the context of breast cancer surgery, this exploratory study examined the effect of breast surgeon information provision on the immediate post-visit outcomes of patients’ anxious preoccupation, intention to adhere to treatment recommendations, and treatment plan satisfaction. Participants included 51 newly diagnosed breast cancer patients receiving care from one breast surgeon at a National Cancer Institute-designated cancer center in the northeastern United States. Participants completed pre- and post-visit questionnaires. Medical interactions were recorded, transcribed, and analyzed via multidimensional analysis, a method of linguistic analysis that uses exploratory factor analysis to identify how specific types of words are patterned and work to accomplish communicative goals (Biber, 1988). The multidimensional analysis identified constellations of language used by providers and patients. Although five linguistic dimensions emerged, one dimension, impersonal information provision, is of unique interest in understanding how providers communicate with patients. Impersonal information provision encompasses the ways in which the provider, using an impersonal tone, discussed the logistics, details, and implications of treatment options. Increased impersonal information provision was associated with patients’ decreased anxious preoccupation (β = –.22, t = −2.82, p = .007), increased treatment plan satisfaction (β = .36, t = 2.54, p = .012), and increased intention to adhere to treatment recommendations (β = .34, t = 2.45, p = .018). Findings suggest that specific provider behavior and types of information provided have unique and important effects on patients’ health outcomes.

Comparing doctor-elderly patient communication between traditional Chinese medicine and Western medicine encounters: Data from China.

Effective doctor-patient communication has been widely endorsed as pivotal for optimal medical care and the building of a positive and lasting relationship between caregivers and patients. While the literature suggests that traditional Chinese medicine (TCM) doctors have better interpersonal skills than Western medicine (WM) doctors, and that the doctor-patient relationship in TCM is more lasting, a comparison of specific communication behaviors in both encounters has not yet been carried out. This paper examines the similarities and differences in communication behaviors between these two types of consultations in relation to doctor-elderly patient communication. Forty-five consultations were included for analysis using the Roter Interaction Analysis System (RIAS). Significant differences were found in communication behaviors at the level of lifestyle and psychosocial exchanges, type of questions, non-medical small talk, and emotional disclosure. The study's limitations and implications are discussed.

Patient-Centered Communication Behaviors That Correlate With Higher Patient Satisfaction Scores.

Background:With increased emphasis on improving the patient experience, clinicians are being asked to improve their patient-centered communication behaviors to improve patient satisfaction (PS) scores.Local Problem:The relationship between clinician communication behaviors and PS is poorly studied in the emergency department (ED) setting. The purpose of this study was to identify whether specific communication behaviors correlate with higher PS scores in the ED setting.Methods:During a quality improvement project, we performed 191 bedside observations of ED clinicians during their initial interaction with patients and recorded the frequency of 8 positive communication behaviors as defined by the PatientSET tool.Interventions:The frequency of use of the PatientSET communication behaviors was compared between known high performers in Press Ganey PS scores versus low performers.Results:Being a high Press Ganey performer was associated with a significantly higher frequency of performance in 6 of the 8 PatientSET communication behaviors.Conclusions:Positive communication behaviors such as those in the PatientSET tool occurred more frequently in ED clinicians with higher PS scores.

Using Rhetorical/Relational Goal Theory to Examine College Students’ Impressions of Their Instructors

Guided by rhetorical/relational goal theory, the purpose of this study was to examine whether students’ impressions of their instructors’ credibility, attraction, and homophily are influenced by four specific rhetorical and relational communication behaviors that instructors use when communicating with their students in the classroom. Participants were 193 undergraduate students enrolled in a variety of introductory communication courses at a large mid-Atlantic university. Using a series of multiple regression analyses, it was found that (a) clarity emerged as the sole indicator of instructor competence, trustworthiness, and task attraction; (b) clarity and confirmation emerged as indicators of goodwill; and (c) humor and confirmation emerged as indicators of social attraction and attitude homophily.

Effects of Minimal Versus Intensive Intervention to Enhance Motivational Interviewing in HIV Care.

We conducted a randomized trial comparing the effect of two different levels of motivational interviewing training on clinician communication behaviors and patient experiences. We enrolled 12 HIV clinicians who attended a one-day MI workshop focusing on behavior change counseling skills. We then randomized clinicians to receive (or not) 3-5 rounds of personalized feedback from the MI trainer. We compared outcomes before and after the interventions and between the intervention groups. We tested time-by-study arm interactions to determine if one group improved more than the other. For all analyses, we used generalized estimating equations to account for clustering of patients within clinicians, with Gaussian or negative binomial distributions as appropriate. Patients of clinicians in both intervention groups rated their visits as more MI consistent (6.86 vs. 6.65, p=0.005) and audio-recording analysis revealed that visits were more patient-centered (1.34 vs. 0.96, p=0.003) with a more positive patient affect (22.36 vs. 20.84, p<0.001) after versus before the intervention, without differences between intervention arms. Several specific clinician behaviors such as empathic statements, asking patient opinions and open-ended questions improved more in the workshop+feedback versus the workshop-only intervention arm. A few specific communication behaviors increased (total and complex reflections) after versus before the intervention, without differences between intervention arms. The workshop alone was as effective as the workshop plus feedback in improving patient experiences and overall communication measures. Certain communication behaviors improved more with the more intensive intervention, but these additional benefits may not warrant the extra financial and logistical resources required.

Communication Behaviors of Principals at High Performing Title I Elementary Schools in Virginia: School Leaders, Communication, and Transformative Efforts

&lt;p align="center"&gt;Abstract&lt;/p&gt;&lt;p&gt;Principals of modern Title I elementary schools, where at least half of the student population lives in poverty, must possess a broader set of leadership skills than has been historically necessary. The ability to motivate teachers utilizing effective communication is one such skill set. This qualitative research proposes a division-level training program designed to improve communication skills of principals and aspiring principals based on the self-reported communication strategies of principals at high-performing Title I elementary schools. High performing Title I schools represented just 8% of all Title I schools in Virginia during 2014. This qualitative data was derived from semi-structured interviews with 8 of these principals, surveys of principals, and publicly available data about these schools. Analysis of the self-reported information resulted in 11 specific communication strategies practiced by most or all of the principals in the participating high performing Title I elementary schools. Further uncovered were 5 themes of communication in leadership which include: a student-centered approach to decision-making; transparency of decision-making; shared decision-making with principal and teachers; the role of faculty trust; and principal preparation. Specific principal communication behaviors with teachers were implemented in motivating teachers toward earning high-performing status. These included frequent face-to-face and personal communications, minimal use of whole-school meetings, and weekly principal participation in grade level meetings. Additionally, principal certification programs were found to have had little impact on the participants in the area of communication. Finally, the critical importance of mentoring, together with school-division level training in the area of communication development, was revealed. This research concluded that communication skills are necessary for building trust between school principals and teachers, with trusting relationships vital for leading teachers toward effective instruction. More structured leadership training is essential in the area of communication skills in preparing school leaders and is most effective at the school division level.&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;p&gt; &lt;/p&gt;