Is it good to express uncertainty to a patient? Correlates and consequences for medical students in a standardized patient visit

Patient Education and Counseling

Volumn 76, Issue 3, 2009, Pages 300-306

  Blanch, Danielle C ^a   Hall, Judith A ^a   Roter, Debra L ^b   Frankel, Richard M ^c  

^a NORTHEASTERN UNIVERSITY   (United States)

^b JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH   (United States)

^c INDIANA UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

Communication; Expressions of uncertainty; Gender; Medical education; Medical students; RIAS; Verbal behavior

Indexed keywords

ANXIETY; ARTICLE; CLINICAL EXAMINATION; CONCEPT FORMATION; EXPRESSION OF UNCERTAINTY; HEALTH SERVICE; INTERPERSONAL COMMUNICATION; MEDICAL EDUCATION; MEDICAL STUDENT; PATIENT SATISFACTION; PRIORITY JOURNAL; PROFESSIONAL COMPETENCE; RATING SCALE; ROTER INTERACTION ANALYSIS SYSTEM; SEX DIFFERENCE; STUDENT ATTITUDE; VERBAL COMMUNICATION; ADULT; DOCTOR PATIENT RELATION; FEMALE; HUMAN; MALE; STATISTICS; TEACHING; UNCERTAINTY; VIDEORECORDING;

ADULT; COMMUNICATION; EDUCATION, MEDICAL; FEMALE; HUMANS; MALE; PHYSICIAN-PATIENT RELATIONS; SEX FACTORS; STATISTICS AS TOPIC; STUDENTS, MEDICAL; TEACHING; UNCERTAINTY; VIDEOTAPE RECORDING;

EID: 68849125499     PISSN: 07383991     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.pec.2009.06.002     Document Type: Article

References (45)

1. Fox R.C. The evolution of medical uncertainty. Milbank Mem Fund Q Health Soc 58 (1980) 1-49
2. Katz J. Why doctors don't disclose uncertainty. Hastings Cent Rep 14 (1984) 35-44
3. Politi M.C., Han P.K., and Col N.F. Communicating the uncertainty of harms and benefits of medical interventions. Med Decis Making 27 (2007) 681-695
4. Fabre J.M. The expression of uncertainty: two contextual effects. Euro J Cog Pyschol 3 (1991) 399-412
5. Braddock III C.H., Edwards K.A., Hasenberg N.M., Laidley T.L., and Levinson W. Informed decision making in outpatient practice: time to get back to basics. J Amer Med Assoc 282 (1999) 2313-2320
6. Hayward R. Balancing certainty and uncertainty in clinical medicine. Dev Med Child Neurol 48 (2006) 74-77
7. Fargason Jr. C.A., Evans H.H., Ashworth C.S., and Capper S.A. The importance of preparing medical students to manage different types of uncertainty. Acad Med 72 (1997) 688-692
8. Spafford M.M., Schryer C.F., Lingard L., and Hrynchak P.K. What healthcare students do with what they don't know: the socializing power of 'uncertainty' in the case presentation. Commun Med 3 (2006) 81-92
9. Simpson D.E., Dalgaard K.A., and O'Brien D.K. Student and faculty assumptions about the nature of uncertainty in medicine and medical education. J Fam Pract 23 (1986) 468-472
10. Schor R., Pilpel D., and Benbassat J. Tolerance of uncertainty of medical students and practicing physicians. Med Care 38 (2000) 272-280
11. Hewson M.G., Kindy P.J., Van Kirk J., Gennis V.A., and Day R.P. Strategies for managing uncertainty and complexity. J Gen Intern Med 11 (1996) 481-485
12. Sorenson J.R. Biomedical innovation, uncertainty, and doctor-patient interaction. J Health Soc Behav 15 (1974) 366-374
13. Beach M.C., and Inui T. Relationship-centered care. A constructive reframing. J Gen Intern Med 21 Suppl. 1 (2006) S3-8
14. Mead N., and Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med 51 (2000) 1087-1110
15. Calnan M. Clinical uncertainty: is it a problem in the doctor-patient relationship?. Soc Health Illness 6 (1984) 74-85
16. Epstein R.M., Hadee T., Carroll J., Meldrum S.C., Lardner J., and Shields C.G. Could this be something serious?" Reassurance, uncertainty, and empathy in response to patients' expressions of worry. J Gen Intern Med 22 (2007) 1731-1739
17. Ogden J., Fuks K., Gardner M., Johnson S., McLean M., Martin P., and Shah R. Doctors expressions of uncertainty and patient confidence. Patient Educ Couns 48 (2002) 171-176
18. Gordon G.H., Joos S.K., and Byrne J. Physician expressions of uncertainty during patient encounters. Patient Educ Couns 40 (2000) 59-65
19. Lazarus P.A. Patients' experiences and perceptions of medical student candidates sitting a finals examination. Med Teach 29 (2007) 478-483
20. Johnson C.G., Levenkron J.C., Suchman A.L., and Manchester R. Does physician uncertainty affect patient satisfaction?. J Gen Intern Med 3 (1988) 144-149
21. Roter D.L., Hall J.A., and Aoki Y. Physician gender effects in medical communication: a meta-analytic review. J Amer Med Assoc 288 (2002) 756-764
22. Roter D.L., and Hall J.A. Physician gender and patient-centered communication: a critical review of empirical research. Annu Rev Publ Health 25 (2004) 497-519
23. Schmid Mast M. Dominance and gender in the physician-patient interaction. JMHG 1 (2004) 354-358
24. Hoff T.J. Doing the same and earning less: male and female physicians in a new medical specialty. Inquiry 41 (2004) 301-315
25. Roter D.L., and Hall J.A. How physician gender shapes the communication and evaluation of medical care. Mayo Clin Proc 76 (2001) 673-676
26. Hall J.A., Irish J.T., Roter D.L., Ehrlich C.M., and Miller L.H. Satisfaction, gender, and communication in medical visits. Med Care 32 (1994) 1216-1231
27. Weisman C.S., and Teitelbaum M.A. Physician gender and the physician-patient relationship: recent evidence and relevant questions. Soc Sci Med 20 (1982) 1119-1127
28. Hall J.A., Roter D.L., and Katz N.R. Meta-analysis of correlates of provider behavior in medical encounters. Med Care 26 (1988) 657-675
29. Schmid Mast M., Hall J.A., and Roter D.L. Disentangling physician sex and physician communication style: their effects on patient satisfaction in a virtual medical visit. Patient Educ Couns 68 (2007) 16-22
30. Roberts C.A., and Aruguete M.S. Task and socioemotional behaviors of physicians: a test of reciprocity and social interaction theories in analogue physician-patient encounters. Soc Sci Med 50 (2000) 309-315
31. Shapiro D.E., Boggs S.R., Melamed B.G., and Graham-Pole J. The effect of varied physician affect on recall, anxiety, and perceptions in women at risk for breast cancer: an analogue study. Health Psychol 11 (1992) 61-66
32. Roter D.L., Hall J.A., and Katz N.R. Relations between physicians' behaviors and analogue patients' satisfaction, recall, and impressions. Med Care 25 (1987) 437-451
33. Roter D., and Larson S. The Roter interaction analysis system (RIAS): utility and flexibility for analysis of medical interactions. Patient Educ Couns 46 (2002) 243-251
34. Skelton J.R., Murray J., and Hobbs F.D. Imprecision in medical communication: study of a doctor talking to patients with serious illness. J R Soc Med 92 (1999) 620-625
35. Lakoff R. Language and woman's place. Lang Soc 2 (1973) 45-80
36. Aries E. Men and women in interaction (2006), Oxford University Press, New York
37. Thomas C.S., Mellsop G., Callender K., Crawshaw J., Ellis P.M., Hall A., MacDonald J., Silfverskiold P., and Romans-Clarkson S. The oral examination: a study of academic and non-academic factors. Med Educ 27 (1993) 433-439
38. Blanch D.C., Hall J.A., Roter D.L., and Frankel R.M. Medical student gender and issues of confidence. Patient Educ Couns 72 (2008) 374-381
39. Eagly A.H., and Johnson B.T. Gender and leadership style: a meta-analysis. Psychol Bull 108 (1990) 233-256
40. Eagly A.H., and Karau S.J. Role congruity theory of prejudice toward female leaders. Psychol Rev 109 (2002) 573-598
41. Lingard L., Garwood K., Schryer C.F., and Spafford M.M. A certain art of uncertainty: case presentation and the development of professional identity. Soc Sci Med 56 (2003) 603-616
42. Mast M.S. On the importance of nonverbal communication in the physician-patient interaction. Patient Educ Couns 67 (2007) 315-318
43. Kimble C.E., and Seidel S.D. Vocal signs of confidence. J Nonverbal Behav 15 (1991) 99-105
44. Maslow C., Yoselson K., and London H. Persuasiveness of confidence expressed via language and body language. Br J Soc Clin Pyschol 10 (1971) 234-240
45. Walker M.B. The relative importance of verbal and nonverbal cues in the expression of confidence. Aust J Psychol 29 (1977) 45-57