TY - JOUR
T1 - Interactive and evaluative correlates of dialogue sequence
T2 - A simulation study applying the RIAS to turn taking structures
AU - Roter, Debra L.
AU - Larson, Susan M.
AU - Beach, Mary Catherine
AU - Cooper, Lisa A.
N1 - Funding Information:
This work was supported by a grant from the National Heart, Lung, and Blood Institute (1R01-HL69403).
PY - 2008/4
Y1 - 2008/4
N2 - Objective: This study explores novel characterizations of turn taking structure and its interaction and evaluative correlates. Methods: The Roter Interaction Analysis System (RIAS) was applied to videotapes of 51 physicians with a simulated patient (SP) to create a variety of novel turn taking measures including turn frequency, rate of interactivity, density, duration, and statement pacing. Results: Visits averaged 52 speaker turns with an interactivity rate of 3.9 turns per visit minute. For physicians, turn duration averaged 13.7 s with a turn density of 4.2 statements paced at one statement every 3 s. For the SP, turn duration was 3 s with a turn density of 1.4 statements paced at one statement every 2 s. More turns, briefer turn duration and faster physician pacing were significantly related to positive ratings of affective demeanor, interpersonal satisfaction and collaborative decision-making. These measures, and interactivity, were also associated with a RIAS-based patient-centeredness score and more overall patient talk. Conclusion: Turn taking structures can be characterized in novel ways lending depth and richness to our understanding of dialogue, relationships to the patient-centeredness of a visit, and evaluative judgments of physician performance. Practice implications: The study findings suggest specificity to the interviewing admonishment "talk less and listen more" by enhancing the interactivity of the dialogue and guarding against doctors tendency toward long monologues.
AB - Objective: This study explores novel characterizations of turn taking structure and its interaction and evaluative correlates. Methods: The Roter Interaction Analysis System (RIAS) was applied to videotapes of 51 physicians with a simulated patient (SP) to create a variety of novel turn taking measures including turn frequency, rate of interactivity, density, duration, and statement pacing. Results: Visits averaged 52 speaker turns with an interactivity rate of 3.9 turns per visit minute. For physicians, turn duration averaged 13.7 s with a turn density of 4.2 statements paced at one statement every 3 s. For the SP, turn duration was 3 s with a turn density of 1.4 statements paced at one statement every 2 s. More turns, briefer turn duration and faster physician pacing were significantly related to positive ratings of affective demeanor, interpersonal satisfaction and collaborative decision-making. These measures, and interactivity, were also associated with a RIAS-based patient-centeredness score and more overall patient talk. Conclusion: Turn taking structures can be characterized in novel ways lending depth and richness to our understanding of dialogue, relationships to the patient-centeredness of a visit, and evaluative judgments of physician performance. Practice implications: The study findings suggest specificity to the interviewing admonishment "talk less and listen more" by enhancing the interactivity of the dialogue and guarding against doctors tendency toward long monologues.
KW - Patient-centeredness
KW - RIAS
KW - Sequence analysis
KW - Turn taking
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U2 - 10.1016/j.pec.2007.10.019
DO - 10.1016/j.pec.2007.10.019
M3 - Article
C2 - 18093788
AN - SCOPUS:40049090701
SN - 0738-3991
VL - 71
SP - 26
EP - 33
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 1
ER -