Observe the interaction between a health care provider and a patient, paying special attention to body language and speech patterns. 


- Students will be able to analyze one or more dimensions of provider-patient communication (e.g. body language, diction, timing)

- Students will be able to assess the strengths and weaknesses of provider-patient communication.


Any shadowing site which involves interaction between health care providers and patients.

Recommended Preparatory Reading:

DR Rhoades, KF McFarland, WH Finch, AO Johnson "Speaking and Interruptions During Primary Care Office Visits." Family Medicine 33, no. 7 (2001): 528-32. 


About half an hour.

Appropriate For: 

advanced undergraduate students; undergraduate medical students; graduate students in the health professions.

Activity Description:

You will be observing the interaction between a health care provider and a patient. Your notes about the observation will have two components:

1) A narrative depiction of the interaction. This will include a description of the setting, a summary of the conversation, and relevant notes about the body language of the provider and patient. 

2) A quantification of one aspect of the interaction. Examples of aspects of communication that you may want to count include:

- The amount of time patients speak before the provider interrupts them

- The number of interruptions during the visit

- The amount of time patients speak compared to the amount of time the provider speaks

- The number of questions asked by the patient and by the provider

- The distance between the patient and provider at different points during the interaction

- The length of time the provider and patient make eye contact before one or the other looks away

- The words per minute spoken by the provider and patient

As you observe the interaction, count and record the aspect of the interaction that you have decided to quantify. After the conclusion of the interaction, record the narrative. 

Analyze both components of the interaction (the narrative and quantitative record) complement each other. How does looking at both aspects of the interaction give you a richer, more detailed observation?

You might consider the following questions:

- If you asked the patient and provider to each give an account of the interaction, to what extent do you think their stories would match? As a third party observing the interaction, what do you think you noticed that they probably didn't?

- Before observing the interaction, what number did you estimate you would record for your "quantification"? How accurate was your estimate? Were you surprised by the number you ultimately recorded?

- What is the relationship between the aspect of the interaction you quantified and the overall quality of the provider-patient interaction?

- What has observing this interaction taught you about provider-patient communication? About the way health care may be typically delivered in the US today?

Drawing on notes from this analysis activity and your additional experiences during this shadowing site visit, write a blog post or short reflection essay.

Author: CD Clark