No abstract available.
Nonverbal Communication

Informed consent (IC) should be a form of communication between a physician and patient in which information regarding all options of a medical procedure and the patient's preference is shared. The aim of this study was to create a standard for communication by IC for physicians. The IC standard was developed based on an analysis of a dialogue in our previous experience with a medical communication program and a review of the literature. The dialogue pattern of the IC standard had the following six elements: opening; orientation; disclosure of information; conforming and complementing; shared decision making; and closing. Factors that influenced effective IC-based communication included preparation, attitude, empathy, listening, a psychosocial factor, nonverbal communication, explanation, and understanding. The IC communication standard will be useful in improving the quality of communication between a physician and patient in obtaining IC. It will also be used as a guideline for communication educators and medical students. Innovative strategies and rigorous studies are needed to improve IC counseling to establish effective patient-centered interviews.
Complement System Proteins ; Counseling ; Decision Making ; Disclosure ; Empathy ; Humans ; Informed Consent* ; Nonverbal Communication ; Psychology ; Students, Medical

PURPOSE: The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training. METHODS: We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station. RESULTS: The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups. CONCLUSION: We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.
Abdominal Pain ; Checklist ; Curriculum ; Educational Measurement ; Empathy ; Humans ; Nonverbal Communication ; Physical Examination ; Reproducibility of Results ; Students, Medical

PURPOSE: Nonverbal communication (NVC) is important in the patient-physician relationship, but the effect of NVC education is not well kown. In this study, we try to identify if students' NVC abilities are improved through communication training. METHODS: First-year medical students conducted medical interviews, which were performed with standardized patients (SPs) before and after communication skill education, and recorded in video. Fifty-one students were enrolled for this study. Two researchers used the NVC checklist, which consists of 12 nonverbal behaviors, to analyze and compare the students' nonverbal expressions in the interviews recorded before and after the education. RESULTS: After the students participated in communication training, open body position and adequate facial expression were increased while unnecessary silence, un-purposive movements, and giggling were decreased. These results can be interpreted as positive effects of the education. However, hand gesture was increased as a negative effect of the education. The total NVC score of the 12 nonverbal behaviors in the NVC checklist improved significantly, rising from 8.56 to 10.03. CONCLUSION: Communication skill education using SPs can improve nonverbal behaviors of medical students, especially facial expression, un-purposive movement, body position, unnecessary silence, and giggle, but not hand gesture. Further research is needed on a variety of teaching methods to improve NVCs.
Checklist ; Education ; Education, Medical ; Facial Expression ; Gestures ; Hand ; Humans ; Nonverbal Communication ; Students, Medical* ; Teaching

The aim of this article was to evaluate the social meaning of alcohol consumption among Koreans. Drinking is considered a method of nonverbal communication, a useful means of maintaining a sense of community and individuality within a community, and a bridge for gathering during work and leisure time. Since Korean society places such a strong social meaning on drinking behavior, the harmful effects of alcohol can extend beyond individual problems to the bigger social picture. The problems associated with excessive alcohol consumption continue to increase every year. The prevalence of high-risk has increased from 14.9% (2005) to 17.1% (2009) and the rate of drinking and driving accidents has increased from 54.79 per 100,000 person (2005) to 57.86 (2009). In addition, the total expenditure on alcohol-related disease in Korea has increased markedly from 3.2 trillion won in 2005 to 6.1 trillion won in 2009. The government's efforts to reduce alcohol harms have not been as effective as anticipated because there is a strong social dependence on alcohol. Regular alcohol consumption can elicit a strong feeling of dependence that is very difficult to reverse. In addition, the powerful social meaning Koreans associate with drinking contributes to their propensity to develop a deeper psychological and physical dependence on alcohol. A strategy to affect cultural change is desperately needed in order to alter the social meaning of drinking to reduce drinking harms in modern Korean society.
Alcohol Drinking ; Drinking ; Drinking Behavior ; Health Expenditures ; Humans ; Individuality ; Korea ; Leisure Activities ; Nonverbal Communication ; Prevalence

This study aimed to determine the effect of the SNAPPS (summarize, narrow, analyze, probe, plan, and select) method versus teacher-centered education on the clinical skills of midwifery students in Iran. In this clinical trial, 36 midwifery students in their 4th year of education in 2015 were enrolled and divided into 6 groups, 3 groups for teacher-centered education and 3 groups for the SNAPPS method, with each group spending 10 days in the outpatient gynecology clinic. A questionnaire and a checklist were used to gather data. An independent t-test and chi-square test were used to analyze the data. Ability to gain the trust of the patient, verbal and nonverbal communication skills, history taking, preparation of the patient for gynecological examination, and diagnosis and treatment of common diseases were significantly better in the SNAPPS group compared to the teacher-centered education group (P<0.05). The SNAPPS education method can significantly improve the clinical skills of midwifery students in gynecology, in particular history taking, differential diagnosis, and treatment of common diseases.
Checklist ; Clinical Competence ; Diagnosis ; Diagnosis, Differential ; Education* ; Gynecological Examination ; Gynecology* ; Humans ; Iran* ; Medical History Taking ; Methods* ; Midwifery* ; Nonverbal Communication ; Outpatients

PURPOSE: Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE. METHODS: A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated. RESULTS: Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score. CONCLUSION: Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.
Checklist ; Education, Medical ; Facial Expression ; Humans ; Medical History Taking ; Nonverbal Communication* ; Patient Satisfaction ; Students, Medical* ; Video Recording ; Voice

Facial esthetics and smiling are key components in nonverbal communication and have an important role in determination of the first impression of a person. The various components of the smile in dental esthetics include Gingival scaffold, lip framework, and Teeth. The periodontist creates a smile by performing various periodontal plastic microsurgery procedures for management of mucogingival problems. A 25-year-old patient reported to the Department of Periodontology at Teerthanker Mahaveer Dental College and Research Center, Moradabad, Northern India, with the chief complaint of long looking teeth in the upper jaw, making him conscious while smiling. Miller class I gingival recession with Maxillary left canine (23) was diagnosed. Periodontal plastic microsurgery employing double papilla grafting with connective tissue graft harvested from the palate in order to cover denuded root was performed using microsurgical instruments and microsuturing with 6-0 suturing material under magnification. Healing was uneventful, with achievement of 100% root coverage of denuded root after three months. The patient was highly impressed and satisfied with his enhanced smile.
Adult ; Connective Tissue ; Esthetics ; Esthetics, Dental ; Gingiva* ; Gingival Recession ; Humans ; India ; Jaw ; Lip ; Microsurgery ; Nonverbal Communication ; Palate ; Plastics ; Smiling ; Tooth ; Transplants

PURPOSE: The purpose of the study was to describe nonverbal behaviors of nurses in communication with patients with dementia in an elderly care institution in Korea. METHODS: Conversation analysis was utilized to analyze the data which were collected using video camera to capture non-verbal as well as verbal behaviors. A total of 66 episodes of everyday conversations were analyzed using seven nonverbal categories: affirmative head nodding; illustrative gestures; patient-directed eye gaze; smiling and/or laughing; forward leaning; affective touch; and instrumental touch. RESULTS: Among seven categories, patient-directed eye gaze(94%) was the most frequently utilized among nurses followed by affirmative head nodding(67%) and forward leaning(67%), while smiling was the least used(32%). Affective touch was identified in 39 episodes(59%). Among them, the most frequently touched area was hand or handshaking(59%) followed by shoulder or back, arm, and face. There were wide differences among nurses in terms of using affective touch, ranging from 0% to 98%. Nonverbal behaviors were more frequently identified in effective episodes than in ineffective episodes. CONCLUSION: Actively utilizing effective nonverbal behaviors may help geriatric nurses in promoting communication and in establishing rapport with patients with dementia.
Aged ; Arm ; Dementia ; Eye ; Geriatric Nursing ; Hand ; Head ; Humans ; Korea ; Nonverbal Communication ; Nurse-Patient Relations ; Qualitative Research ; Shoulder ; Smiling ; Verbal Behavior

Autism spectrum disorder (ASD) is a neurodevelopmental disorder typically identified in early toddlerhood. Both retrospective and prospective follow up studies of high risk infants reveal early risk signs of ASD at 12-24 months of age. The most frequently replicated early signs of ASD are atypical visual tracking and coordination, lack of social reciprocity, abnormal social communication and unusual patterns of manipulating objects, atypical sensory exploration, expressed as uncoordinated eye contact, unresponsiveness to naming, lack of social smile, delayed development of nonverbal communication and joint attention, less sharing interest, and unusually repetitive use of objects. Early intervention, before 2 years of age, appears to change the underlying developmental trajectories of the brain in individuals with ASD. In this review, the early risk signs of ASD in infancy and toddlerhood, along with early intervention and their implications, are discussed.
Autistic Disorder* ; Brain ; Child ; Autism Spectrum Disorder* ; Early Intervention (Education) ; Early Medical Intervention ; Follow-Up Studies ; Humans ; Infant ; Joints ; Nonverbal Communication ; Prodromal Symptoms ; Prospective Studies ; Retrospective Studies