Journal of General Internal Medicine

, Volume 18, Issue 3, pp 170–174

House staff nonverbal communication skills and standardized patient satisfaction

  • Charles H. GriffithIII
  • John F. Wilson
  • Shelby Langer
  • Steven A. Haist
Original Articles

DOI: 10.1046/j.1525-1497.2003.10506.x

Cite this article as:
Griffith, C.H., Wilson, J.F., Langer, S. et al. J GEN INTERN MED (2003) 18: 170. doi:10.1046/j.1525-1497.2003.10506.x


OBJECTIVE: To examine the association of physician nonverbal communication with standardized patient (SP) satisfaction in the context of the “quality” of the interview (i.e., information provided and collected, communication skills).

DESIGN: Observational.

SETTING: One university-based internal medicine residency program.

PARTICIPANTS: Fifty-nine internal medicine residents.

INTERVIEWING: The 59 residents were recruited to participate in 3 SP encounters. The scenarios included: 1) a straightforward, primarily “medical” problem (chest pain); 2) a patient with more psychosocial overlay (a depressed patient with a history of sexual abuse); and 3) a counseling encounter (HIV risk factor reduction counseling). Trained SPs rated physician nonverbal behaviors (body lean, open versus closed body posture, eye contact, smiling, tone of voice, nod, facial expressivity) in the 3 encounters. Multiple regression approaches were used to investigate the association of physician nonverbal behavior with patient satisfaction in the context of the “quality” of the interview (SP checklist performance, measures of verbal communication skills), controlling for physician characteristics (gender, postgraduate year).

RESULTS: Nonverbal communication skills was an independent predictor of standardized patient satisfaction for all 3 patient stations. The effect sizes were substantial, with nonverbal communication predicting 32% of the variance in patient satisfaction for the chest pain station, 23% of the variance for the depression-sexual abuse station, and 19% of the variance for the HIV counseling station.

CONCLUSION: Better nonverbal communication skills are associated with significantly greater patient satisfaction in a variety of different types of clinical encounters with standardized patients. Formal instruction in nonverbal communication may be an important addition to residency.

Key words

doctor-patient communication nonverbal communication standardized patients 

Copyright information

© Society of General Internal Medicine 2003

Authors and Affiliations

  • Charles H. GriffithIII
    • 1
  • John F. Wilson
    • 2
  • Shelby Langer
    • 3
  • Steven A. Haist
    • 1
  1. 1.the Department of Internal MedicineUniversity of Kentucky College of MedicineLexington
  2. 2.the Department of Behavioral ScienceUniversity of Kentucky College of MedicineLexington
  3. 3.the Fred Hutchinson Cancer Research CenterSeattle
  4. 4.K507 Kentucky ClinicLexington

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