PT  - JOURNAL ARTICLE
AU  - Roberts, Lisa C.
AU  - Whittle, Christopher T.
AU  - Cleland, Jennifer
AU  - Wald, Mike
TI  - Measuring Verbal Communication in Initial Physical Therapy Encounters
AID  - 10.demo/ptj.20120089
DP  - 2013 Apr 01
TA  - Demo Journal of Physical Therapy
PG  - 479--491
VI  - 93
IP  - 4
4099  - http://demo.highwire.org/content/93/4/479.short
4100  - http://demo.highwire.org/content/93/4/479.full
AB  - Background Communication in clinical encounters is vital in ensuring a positive experience and outcome for both patient and clinician.Objective The purpose of this study 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 A cross-sectional study was conducted.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 used 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 Although studies measuring actual behavior are considered to be the gold standard, audio recordings do not enable nonverbal behaviors to be recorded.Conclusion This study investigated a method for measuring the verbal content of clinical encounters in a physical therapy outpatient setting. The study has directly contributed to developing a research-friendly version of the application (ie, 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 on-going priority for providers. Further work is needed to explore affective behaviors and the prevalence of interrupting patients, considering differences in sex and provider experience.