Abstract
Introduction: Empathic physician behavior is associated with improved patient outcomes. One way to demonstrate empathy is through nonverbal communication including touch. To date, research on nonverbal communication, and specifically touch, has been relatively limited in medicine, which is surprising given the central role it plays in conveying affective and empathic messages. To inform curriculum development on nonverbal communication, this study aimed to examine physicians’ experiences of communicating with touch.
Methods: Interpretative phenomenological study. Fifteen physicians (7 women and 8 men), from different specialties, both recent graduates and experienced doctors, described in detail specific instances of touch drawn from their clinical practices. Interview prompts encouraged participants to recall exact details such as the context, their relationship with the patient they touched, and their physical experience of touching. Interviews (45-100 mins) were analyzed with template analysis, followed by a process of dialectic questioning, moving back and forth between the data and researchers’ personal reflections on them, drawing on phenomenological literature to synthesize a final interpretation.
Findings: Participants described two dimensions of the experience of touch, ‘choosing and inviting touch’ and ‘expressing empathy’. Touch was a personal and fragile process. Participants interpreted nonverbal patient cues to determine whether or not touch was appropriate. They interpreted facial expression and body language in the here and now, to make meaning of patients’ experiences. They used touch to share emotions, demonstrate empathy and presence. Participants’ experiences of touch framed it as a form of embodied empathic communication.
Conclusion: Touch was a powerful form of nonverbal communication which established human connection. Phenomenological accounts of empathy, which emphasize its embodied intersubjective nature, could be used to theoretically enrich pedagogical approaches to touch in medical education and deepen our understanding of empathy.
Methods: Interpretative phenomenological study. Fifteen physicians (7 women and 8 men), from different specialties, both recent graduates and experienced doctors, described in detail specific instances of touch drawn from their clinical practices. Interview prompts encouraged participants to recall exact details such as the context, their relationship with the patient they touched, and their physical experience of touching. Interviews (45-100 mins) were analyzed with template analysis, followed by a process of dialectic questioning, moving back and forth between the data and researchers’ personal reflections on them, drawing on phenomenological literature to synthesize a final interpretation.
Findings: Participants described two dimensions of the experience of touch, ‘choosing and inviting touch’ and ‘expressing empathy’. Touch was a personal and fragile process. Participants interpreted nonverbal patient cues to determine whether or not touch was appropriate. They interpreted facial expression and body language in the here and now, to make meaning of patients’ experiences. They used touch to share emotions, demonstrate empathy and presence. Participants’ experiences of touch framed it as a form of embodied empathic communication.
Conclusion: Touch was a powerful form of nonverbal communication which established human connection. Phenomenological accounts of empathy, which emphasize its embodied intersubjective nature, could be used to theoretically enrich pedagogical approaches to touch in medical education and deepen our understanding of empathy.
| Original language | English |
|---|---|
| Pages (from-to) | 400-407 |
| Number of pages | 8 |
| Journal | Medical Education |
| Volume | 54 |
| Issue number | 5 |
| Early online date | 3 Dec 2019 |
| DOIs | |
| Publication status | Published - 1 May 2020 |
