Measuring Verbal Communication in Initial Physical Therapy Encounters

Background

Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician.

Objective

The purpose of this paper was to measure verbal communication between physical therapists and patients with back pain during their initial consultation, and trial management of the data using a novel, web-based application.

Design

Cross-sectional study.

Methods

Nine musculoskeletal physical therapists and 27 patients with back pain participated in this study. Twenty-five initial consultations were observed, audio-recorded and categorized using The Medical Communications Behavior System. Data were managed using Synote, a freely-available application enabling synchronization of audio-recordings with transcripts and coded notes.

Results

In this sample, physical therapists spoke for 49.5% of the encounter and patients for 33.1%. Providers and patients spent little time overtly discussing emotions (1.4% and 0.9% respectively). More-experienced clinicians employed more ‘history/background probes’, more ‘advice/suggestion’ and less ‘restatement’ than less-experienced staff, although they demonstrated a greater prevalence of talking concurrently and interrupting patients (7.6% compared with 2.6%).

Limitations

Whilst studies measuring actual behavior are considered the gold standard, audio-recordings do not enable non-verbal behaviors to be recorded.

Conclusions

This study reports a method for measuring the verbal content of clinical encounters in a physical therapy out-patient setting. The study has directly contributed to developing a research-friendly version of the application — ‘Synote Researcher’. Given the pivotal role of communication in ensuring a positive experience and outcome for both patient and provider, investing time in further developing communication skills should be an ongoing priority for providers. Further work is needed to explore affective behaviors and the prevalence of interrupting patients, considering differences in gender and provider experience.

Source: http://ptjournal.apta.org/cgi/content/short/ptj.20120089v1?rss=1

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