Donald J. Cegala

Physician communication skills training: a review of theoretical backgrounds, objectives and skills

Context  Significant shortcomings have been noted in the literature in communication skills training for practising doctors. Given the importance of competent communication to the doctor–patient relationship and health care in general, these shortcomings should be addressed in future research.

Interaction involvement: A cognitive dimension of communicative competence

A perspective is presented on communicative competence that is based on Erving Goffmans model of face‐to‐face society. The concept o£ interaction involvement is then explicated in relation to the model as a fundamentally important cognitive dimension of communicative competence. Data from two studies are reported to support the validity of the interaction involvement concept and its operational definition. The results are interpreted as being useful for future basic research on communicative competence as well as applications in classroom and other instructional settings.

Cancer patient preferences for quality and length of life

Optimal patient decision making requires integration of patient values, goals, and preferences with information received from the physician. In the case of a life‐threatening illness such as cancer, the weights placed on quality of life (QOL) and length of life (LOL) represent critical values. The objective of the current study was to describe cancer patient values regarding QOL and LOL and explore associations with communication preferences.

Affective and cognitive manifestations of interaction involvement during unstructured and competitive interactions

The construct of interaction involvement was extended in this study by relating scores on the interaction involvement scale to individuals’ experienced mood state and information recall in two different communication settings. Consistent with hypotheses, highly involved persons felt more positive and less negative during an unstructured conversation and recalled more detail about the conversation than low‐involved persons. Similarly, highly involved persons felt more positive and less negative during a competitive negotiation than low‐involved persons. The results were interpreted to suggest that there is a significant affective component in interaction involvement which in part accounts for a disruption in the capacity for intersubjectivity on the part of low‐involved persons.

Patient communication skills raining for improved communication competence in the primary care medical consultation

Abstract Although considerable attention has been given to doctor‐patient communication over the last 20 years, relatively little research has emphasized the role of patients’ communication skills. This research extended the modest work in patient communication skills training by (a) employing a more sophisticated definition of question‐asking than has been used in previous studies, and (b) expanding training to include information‐verifying skills. The results indicate that the training procedure enhanced patients’: information seeking in the form of direct and indirect questions, comprehension‐checking utterances, the amount and effectiveness of obtained information, and recall of information. These results are discussed in terms of previous and future research into patient training in communication skills, and implications for practice.

Trait verbal aggressiveness and argumentativeness: Relations with parenting style

Research on trait verbal aggressiveness and verbal argumentativeness was extended by examining these constructs in relationship to patterns of self‐reported parental behavior. Subjects were parents of school‐age children (grades Kindergarten to 6). As expected, persons scoring positively on argumentativeness and negatively on aggressiveness reported behaviors consistent with the Authoritative parenting style. Negative argumentativeness and positive aggressiveness was associated with the Authoritarian prototype.

A study of selected linguistic components of involvement in interaction

Numerous scholars have identified interaction involvement as fundamentally important to interpersonal communication. Although researchers have studied trait and nonverbal aspects of involvement, relatively little attention has been directed to its linguistic components. The purpose of this study was to investigate these linguistic components. Two lexical and two syntactic categories were examined. Results indicate that highly involved communicators use more immediate language, speak with greater certainty, and use more relational pronoun references than their less involved counterparts. These results are discussed in relation to previous research on cohesive devices and interaction involvement.

Interaction involvement and discourse strategies: The patterned use of cohesive devices in conversation

Communicative competence entails the ability of speakers to mesh their utterances to form coherent conversation. The research reported here explored the relationship between interaction involvement as a traitlike dimension of communicative competence and the use of grammatical cohesive devices to create explicit ties within conversation. It was hypothesized that three dyad types exhibiting differing patterns of interaction involvement would be differentiated by the patterns of cohesive devices used to create ties within their conversation. Results indicated that the dyads differed significantly in the patterned use of interactive ellipsis and noninteractive reference within T‐units. These patterns were seen as indicators of discourse strategies differing in their relative reliance on minimal passing moves versus more elaborate responses. Finally, it was argued that these discourse strategies are responsive to the relative certainty/uncertainty of the dyads in tracking the flow of conversation and in deter...

A study of the relationship between communicative performance and conversation participants’ thoughts

This study directly examines the assumed relationship between a communicators thoughts and his/her communicative actions. Individuals’ communicative performance (i.e., effectiveness and appropriateness) on an information acquisition task was assessed and assigned to high, moderate and low communication competence groupings. Their thought protocols, as gathered through a stimulated recall procedure, were then compared. As predicted, high competent communicators had more goal‐relevant thoughts than their less competent counterparts. Moreover, communicators’ thoughts corresponded with the type of performance strategies evidenced in their interactions. Other results indicated that low competent communicators had significantly more self assessment thoughts than their more competent counterparts. However, no support was found for a predicted interaction between competence level and goal complexity. The results were discussed in terms of implications for further study of cognitive processing and communicative p...

An Exploration of Factors Promoting Patient Participation in Primary Care Medical Interviews

Streets (2003) ecological model of communication in medical encounters was used to select and examine factors that potentially promote or retard patient participation. Patient participation was defined as information seeking and provision, assertive utterances, and emotional expressions. Patient participation discourse scores were used as the dependent variable in a multilevel regression analysis with 19 predictor variables representing cultural, organizational, and interpersonal factors of the ecological model. The analysis revealed eight significant predictors of patient participation. The results were discussed with respect to other research using the ecological model and their implications for continued study of factors that promote or retard patient participation.