@article {Littlee357, author = {Paul Little and Peter White and Joanne Kelly and Hazel Everitt and Shkelzen Gashi and Annemieke Bikker and Stewart Mercer}, title = {Verbal and non-verbal behaviour and patient perception of communication in primary care: an observational study}, volume = {65}, number = {635}, pages = {e357--e365}, year = {2015}, doi = {10.3399/bjgp15X685249}, publisher = {Royal College of General Practitioners}, abstract = {Background Few studies have assessed the importance of a broad range of verbal and non-verbal consultation behaviours.Aim To explore the relationship of observer ratings of behaviours of videotaped consultations with patients{\textquoteright} perceptions.Design and setting Observational study in general practices close to Southampton, Southern England.Method Verbal and non-verbal behaviour was rated by independent observers blind to outcome. Patients competed the Medical Interview Satisfaction Scale (MISS; primary outcome) and questionnaires addressing other communication domains.Results In total, 275/360 consultations from 25 GPs had useable videotapes. Higher MISS scores were associated with slight forward lean (an 0.02 increase for each degree of lean, 95\% confidence interval [CI] = 0.002 to 0.03), the number of gestures (0.08, 95\% CI = 0.01 to 0.15), {\textquoteleft}back-channelling{\textquoteright} (for example, saying {\textquoteleft}mmm{\textquoteright}) (0.11, 95\% CI = 0.02 to 0.2), and social talk (0.29, 95\% CI = 0.4 to 0.54). Starting the consultation with professional coolness ({\textquoteleft}aloof{\textquoteright}) was helpful and optimism unhelpful. Finishing with non-verbal {\textquoteleft}cut-offs{\textquoteright} (for example, looking away), being professionally cool ({\textquoteleft}aloof{\textquoteright}), or patronising, ({\textquoteleft}infantilising{\textquoteright}) resulted in poorer ratings. Physical contact was also important, but not traditional verbal communication.Conclusion These exploratory results require confirmation, but suggest that patients may be responding to several non-verbal behaviours and non-specific verbal behaviours, such as social talk and back-channelling, more than traditional verbal behaviours. A changing consultation dynamic may also help, from professional {\textquoteleft}coolness{\textquoteright} at the beginning of the consultation to becoming warmer and avoiding non-verbal cut-offs at the end.}, issn = {0960-1643}, URL = {https://bjgp.org/content/65/635/e357}, eprint = {https://bjgp.org/content/65/635/e357.full.pdf}, journal = {British Journal of General Practice} }