Isala Academy, Department of Medical Education and Faculty Development, Isala Hospital, Zwolle, The Netherlands.
Innovation and Research, Isala Hospital, Zwolle, The Netherlands.
BMJ Open. 2023 Sep 28;13(9):e066678. doi: 10.1136/bmjopen-2022-066678.
To analyse verbal interruptions by Dutch hospital consultants during the patient's opening statement in medical encounters.
Cross-sectional descriptive study.
Isala teaching hospital in Zwolle, the Netherlands.
94 consultations by 27 consultants, video recorded in 2018 and 2019.
Physicians' verbal interruptions during patients' opening statements, rate of completion of patients' opening statements, time to first interruption and the effect of gender, age and physician specialty on the rate and type of physicians' verbal interruptions.
Patients were interrupted a median of 9 times per minute during their opening statement, the median time to the first interruption was 6.5 s. Most interruptions (67%) were backchannels (such as 'hm hm' or 'go on'), considered to be encouraging the patient to continue. In 52 consultations (55%), patients could not finish their opening statement due to a floor changing interruption by the consultant. The median time to such an interruption was 31.4 s, on average 20 s shorter than a finished opening statement (p=0.004). Female consultants used more backchannels (median 9, IQR 5-12) than male consultants (median 7, IQR 2-11, p=0.028).
Hospital-based consultants use various ways to interrupt patients during their opening statements. Most of these interruptions are encouraging backchannels. Still, consultants change the conversational floor in more than half of their patients during their opening statements after a median of 31 s.
分析荷兰医院顾问在医患交流中患者开场白时的言语打断情况。
横断面描述性研究。
荷兰兹沃勒的伊斯拉尔教学医院。
2018 年至 2019 年，27 名顾问共记录了 94 次咨询。
医生在患者开场白期间的言语打断次数、患者开场白完成率、首次打断时间以及性别、年龄和医生专业对医生言语打断的频率和类型的影响。
患者在开场白中平均每分钟被打断 9 次，首次打断的中位数时间为 6.5s。大多数打断（67%）是反馈（如“嗯嗯”或“继续”），被认为是鼓励患者继续说下去。在 52 次咨询中（55%），由于顾问插话打断，患者无法完成开场白。这种打断的中位数时间为 31.4s，平均比完成的开场白短 20s（p=0.004）。女性顾问使用的反馈（中位数 9，IQR 5-12）多于男性顾问（中位数 7，IQR 2-11，p=0.028）。
医院顾问在患者开场白时会使用各种方式打断患者。大多数打断是鼓励性的反馈。尽管如此，顾问仍会在患者开场白后平均 31s 左右插话改变谈话内容，这种情况超过一半。
