U.S. patients’ evaluation of international medical graduate physicians’ verbal and nonverbal strategies to manage their lack of comprehension: A multiple goals perspective

Previous studies on communication between international medical graduates (IMGs) and U.S. patients have focused on describing IMGs’ communication challenges and the effect of IMGs’ identity features on patient perceptions and assessment. Guided by the multiple goals perspective, the current dissertation aimed to extend the field of IMG-patient communication by investigating how U.S. patients evaluate IMGs’ verbal and nonverbal strategies to deal with their lack of comprehension of U.S. patients. White men (N = 569) were recruited from an online research panel to participate in a 3 (verbal strategies: be blunt, feign comprehension, provide rationale) × 2 (nonverbal strategies: high affiliative nonverbals, low affiliative nonverbals) × 2 (verbal message variations: “out of sorts”, “frog in the throat”) full factorial online experiment. Participants were randomly assigned to one of the 12 conditions to watch a video recording of an IMG-patient interactional episode and were asked to imagine that they were the patient in the video. Following the message exposure, participants were asked to report their inferred goals, assessment of IMGs’ competence, warmth, and satisfaction with the interaction. Findings suggested that compared to the verbal strategies of being blunt and providing rationale, IMGs’ feigning comprehension verbal strategy, when became noticeable to patients, elicited less patient inference of other-oriented goals (i.e., understanding patient language use) and relationship-focused goals (i.e., establishing a trusting relationship), which were in turn positively associated with patient assessment and satisfaction with the interaction. Additionally, compared to the other two verbal strategies, IMGs’ feigning comprehension elicited more patient inference of self-oriented goals (i.e., hiding linguistic incompetence), which was in turn negatively associated with patient evaluation. IMGs’ high affiliative nonverbal behaviors elicited more patient inference of relationship-focused goals. Moreover, engaging in noticeable feigning comprehension and low nonverbal affiliative behaviors was particularly detrimental to the patient inference of other-oriented and relationship-focused goals, which were associated with patient evaluation of IMGs and their satisfaction with the visit. Verbal and nonverbal communication channels can potentially complement each other in terms of goal accomplishment, affecting patient goal inferences and evaluation. The findings yield theoretical implications for IMG-patient communication, communication between non-native speakers and native speakers of English, the multiple goals perspective, and discrepant verbal-nonverbal profile theory. Further, the findings offer practical implications for IMGs to improve their communication with U.S. patients both verbally and nonverbally.

Name thesis:degree_name

Ph.D.

Level thesis:degree_level

Dissertation

Discipline thesis:degree_discipline

Communication

Grantor

University of Illinois at Urbana-Champaign

Year dc:date

2022

Author dc:creator

• Liao, Danni

Contributors dc:contributor

• Guntzviller, Lisa M
• Bigman, Cabral A
• Bigsby, Elisabeth
• Caughlin, John P
• Thompson, Charee M

• IMGs
• multiple goals
• nonverbal communication

Statement dc:rights

• Copyright 2022 Danni Liao

Language dc:language

en, eng

Handle dc:identifier

https://hdl.handle.net/2142/116068

OAI record oai:identifier

https://www.ideals.illinois.edu/oai-pmh?verb=GetRecord&metadataPrefix=etdms&identifier=oai%3Awww.ideals.illinois.edu%3A2142%2F116068