Friends of the Nonverbal Communication Blog, this week we present the paper “Nonverbal Synchrony: An Indicator of Clinical Communication Quality in Racially-Concordant and Racially- Discordant Oncology Interactions”, by Hamel, L. M.; Moulder, R.; Ramseyer, F. T.; Penner, L. A.; Albrecht, T. L.; Boker, S. and Eggly, S. (2022), in which authors use two previous studies to know how nonverbal synchrony affects the communicative process of the interactions between doctors and patients when their races match and when they do not match.

Communication, both verbal and nonverbal, is the key to social interactions in all areas, including healthcare.

Good, high-quality patient-physician communication is associated, as we have noted in previous articles, with good adherence to treatment. Conversely, poor communication can lead to poorer treatment outcomes, with consequences such as discontinuity of care, patient dissatisfaction, and higher costs overall.

Unfortunately, it appears that the quality of clinical care is also influenced by patient race. Black patients, for example, would experience poorer quality communication more frequently compared to white patients.

For oncology cases, previous research indicates that physicians tend to be less patient-centered, verbally more dominant, more confrontational, and also give less information during interactions with black patients.

Research has consistently demonstrated the relationship between verbal and nonverbal doctor-patient communication and patient health outcomes, considering elements such as trust, satisfaction, understanding, symptom resolution….

For example, it has been shown that, when it comes to focusing on the patient, having interactions with him/her, developing an empathic relationship and being aware of any psychological problems the patient may have, eye contact is a great ally.

Another example of the effect of nonverbal communication is that the authors’ team observed that, in an oncology setting, if patients and physicians smile and show “open to interaction postures”, the results of the interaction will be more positive.

In this week’s study, authors wanted to investigate the dynamic, interdependent, and unconscious nature of nonverbal interpersonal communication during oncology interactions with black patients in racially discordant contexts and, on the other hand, with white patients in racially concordant contexts.

And how did they do this? They used software that was able to measure the synchrony of patient-physician interactions based on the movement coordination. It is understood that the greater the synchrony, the greater the likelihood that communication is occurring effectively and to the benefit of both parties.

People synchronize more with those with whom they have existing positive relationships, or with those with whom they want to develop them. Higher levels of nonverbal synchrony result in more subsequent positive affect and sympathy.

The analysis in this article was conducted using data from two recent studies. The first was conducted between 2002 and 2006 and the second between 2012 and 2014. Both studied different aspects and influences of nonverbal communication in oncology patients and included video data.

The total number of patients analyzed reached more than 220 people. Numerous research studies have shown that unconscious processes affect the outcome of human interactions. Authors’ findings suggest that, among black patients and nonblack doctors, unconscious processes were operating to overcome possible cultural and racial barriers and, thus, help create greater nonverbal synchrony. These motivations may have been absent in racially concordant interactions between black physicians and black patients.

There is evidence that people with higher levels of implicit racial bias may work harder to control it during interracial interactions.

On the other hand, it appears that black patients who had experienced higher levels of prior discrimination were more verbally active when communicating with their white or nonblack physicians, which may suggest that black patients may use verbal and nonverbal strategies, consciously and unconsciously, to be more in control of the medical interaction.

Ideally, racial discordance or concordance would not affect the quality of communication in oncology interactions. The reality is, however, quite different. The authors concluded that there are differences in nonverbal communication that are almost certainly beyond conscious control.

An important idea to keep in mind for future studies is that one should study whether the differences found in nonverbal synchrony in racially discordant and concordant interactions replicate in other types of medical interactions. If they do, then why these differences in Healthcare occur and how to combat them should be investigated. 

If you want to know more about nonverbal behavior and how it affects personal relationships, visit our Master of Science in Nonverbal and Deceptive Behavior, which you can take in English or Spanish, with special grants for readers of the Nonverbal Communication Blog.

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