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Doctors, Patients Identify Tacit Clues in Their Interactions

Non-verbal tacit clues most common, but interpretation differs for doctors and patients

FRIDAY, Sept. 30 (HealthDay News) -- Both doctors and patients identify tacit clues as well as judgments based on these clues during video elicitation interviews of health maintenance examinations, according to a study published in the October issue of the Journal of Evaluation in Clinical Practice.

Stephen G. Henry, M.D., from the University of Michigan in Ann Arbor, and colleagues investigated whether information likely to be tacit clues or judgments based on tacit clues during health maintenance examinations were identified by doctors and patients. Video elicitation interview transcripts of 18 community-based primary care doctors and 36 patients were assessed. Description and analysis of tacit clues and judgments based on tacit clues revealed by participants were the main outcomes.

The investigators identified 57 references to tacit clues and 53 references to judgments based on tacit clues from the video transcripts. The most common category of tacit clues was non-verbal behavior. With respect to doctor-patient relationship, patients mostly discussed judgments based on tacit clues, while doctors discussed using non-verbal behaviors to provide patients with tacit clues. Tacit clues informing about medical judgments and decision making were also mentioned by doctors. Tacit clue-based gestalt judgments were common, and present in 33 percent of doctors' comments. Difficulty in articulating their rationale for specific judgments was identified by several patients. There was a wide variation in how frequently the doctors mentioned tacit clues.

"During video elicitation interviews, patients and doctors identified tacit clues and judgments based on these clues as playing a role during health maintenance examinations," the authors write.

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