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Patient Educ Couns. 2008 Apr;71(1):26-33. Epub 2008 Feb 21.

Interactive and evaluative correlates of dialogue sequence: a simulation study applying the RIAS to turn taking structures.

Author information

  • 1Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, United States. droter@jhsph.edu

Abstract

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.

PMID:
18093788
[PubMed - indexed for MEDLINE]
PMCID:
PMC2760431
Free PMC Article
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