The Role of Communication Technology in Patient-Physician Relationships: Technology Violating Immediacy Expectations
Professor Rebecca DeVries, Hope College
Ongoing research indicates that there are numerous benefits to patient-centered care (Beck & Gordon, 2010). Patient-centered care involves physicians treating patients as co-experts in their own health care (Epstien, Franks, Fiscella, Shields, Meldrum, Kravits, & Duberstein, 2005). Much of the communication involved in satisfying patient-centered care, among other factors, relies heavily on a physician’s ability to create nonverbal immediacy with a patient (Wanzer, Booth-Butterfield, & Gruber, 2004). Since nonverbal immediacy is built through smooth, open, and warm interpersonal behaviors (Richmond, Smith, Heisel, & McCroskey, 2001), the introduction of communication technology during a medical examination has the potential to affect behaviors, thus affecting the interaction. To test this, a 2 X 2 factorial design is utilized looking at the interactions between high or low nonverbal immediacy behaviors and the presence or absence of communication technology in a standard medical examination. Participants are randomly assigned to one of the four conditions for this internet video experiment. After viewing the video, participants are asked to complete a survey that measures beliefs about patient-centered communication, participants' technological readiness, and overall satisfaction with perceived care. Depending on how technologically ready the participants are and whether or not they buy into a collaborative mindset for patient-physician interactions, they will evaluate the physician's use of communication technology (in this case, a computerized tablet) as enhancing or minimizing patient-centered communication and overall satisfaction. According to Roger's model of Diffusion of Innovation (1995) and Burgoon's Expectancy Violation Theory (1993), this study predicts that participants who are early-adopters of technology and believe in a collaborative (patient-centered) interaction will evaluate the non-seamless (low nonverbal immediacy) use of communication technology during the patient-physician interaction as a violation of their expectations, therefore lowering the participants' level of satisfaction with perceived care.
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