One area of physician- patient interaction that has received very little attention in research is the physician's accuracy in perceiving the patient's affective states, even though this is a crucial skill for physicians. In this application, the investigators propose to adapt methods from social psychology to measure such accuracy in a standardized test called the Test of Accurate Perception of Patients'Affect (TAPPA). This audiovisual test will consist of four 10-minute test modules each containing 12 excerpts of patient communication, representing patients varying in gender and ethnicity, which can be combined to form tests of varying lengths (from 12 to 48 items). Patients shown in the TAPPA will be actual patients, videotaped with their permission during regular medical visits. After their visit, the patients will review the videotape and describe in detail how they were feeling at specific moments during the visit, and this information will be used as criteria for scoring the accuracy of future test-takers, who will view the excerpts and record their own impressions of the patient's feelings. Accuracy consists of the match between these impressions and what the patients actually said about their feelings. In the proposed research, a video archive will be developed from which the test excerpts will be selected;the test will be assembled;psychometric analyses to ensure optimal item selection will be conducted;and the validity in four samples of psychology students, nursing students, medical students, and medical residents will be assessed. In each validity sample, test-takers'scores on the TAPPA will be correlated with background information, other tests of interpersonal perception, self-reports of attitudes toward patient-centered care and empathy, and/or administrative records collected at their respective institutions pertaining to evaluations of interactions with patients (e.g., preceptor and faculty ratings of interpersonal behavior and clinical communication). The network of correlations between the TAPPA and these measures will establish the validity of the TAPPA as a test that can be used in research on clinician-patient interaction. Finally, the investigators will conduct a training study to ascertain whether a short-term training intervention can improve the skill measured by the TAPPA.

Public Health Relevance

The quality of physician-patient interactions is of great public health significance because these relationships influence patient behavior, health, and the overall well-being of physicians and patients alike. The proposed research will develop and validate a test of physicians'ability to understand patients'feelings during actual (previously recorded) medical visits. This test will then contribute to understanding how this crucial clinical skill contributes to the overall quality of physicians'and other clinicians'performance and relationships with patients. The research is cost-effective in that it builds on existing data sources in several institutions.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
Project #
Application #
Study Section
Health Care Quality and Effectiveness Research (HQER)
Program Officer
Mullican, Charlotte
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Northeastern University
Schools of Arts and Sciences
United States
Zip Code
Hall, Judith A; Ship, Amy N; Ruben, Mollie A et al. (2015) Clinically relevant correlates of accurate perception of patients' thoughts and feelings. Health Commun 30:423-9