Randomised controlled trial of a brief intervention targeting predominantly non-verbal communication in general practice consultations

Background

The impact of changing non-verbal consultation behaviours is unknown.

Aim

To assess brief physician training on improving predominantly non-verbal communication.

Design and setting

Cluster randomised parallel group trial among adults aged ≥16 years attending general practices close to the study coordinating centres in Southampton.

Method

Sixteen GPs were randomised to no training, or training consisting of a brief presentation of behaviours identified from a prior study (acronym KEPe Warm: demonstrating Knowledge of the patient; Encouraging back-channelling by saying ‘hmm’, for example]; Physically engaging touch, gestures, slight lean]; Warm-up: cool/professional initially, warming up, avoiding distancing or non-verbal cut-offs at the end of the consultation); and encouragement to reflect on videos of their consultation. Outcomes were the Medical Interview Satisfaction Scale (MISS) mean item score (1–7) and patients’ perceptions of other domains of communication.

Results

Intervention participants scored higher MISS overall (0.23, 95% confidence interval CI] = 0.06 to 0.41), with the largest changes in the distress–relief and perceived relationship subscales. Significant improvement occurred in perceived communication/partnership (0.29, 95% CI = 0.09 to 0.49) and health promotion (0.26, 95% CI = 0.05 to 0.46). Non-significant improvements occurred in perceptions of a personal relationship, a positive approach, and understanding the effects of the illness on life.

Conclusion

Brief training of GPs in predominantly non-verbal communication in the consultation and reflection on consultation videotapes improves patients’ perceptions of satisfaction, distress, a partnership approach, and health promotion.