Nonverbal Communication Behaviours During Pediatric Otolaryngology Surgical Consultations

Introduction: Nonverbal behaviour is a key component of communication and is of particular importance in surgical consultations. The objective of this study was to identify what types of nonverbal behaviours are commonly observed in pediatric otolaryngology surgical consultations.

Methods: 55 video-recorded pediatric otolaryngology surgical consultations were used in this cross-sectional study at two academic pediatric hospitals. Consultations pertained to two elective surgeries: tympanostomy tube insertions and adenotonsillectomies. Using the Nonverbal Accommodation Analysis System (NAAS), nonverbal behaviours of the physician, parents and other parties were coded. The primary outcome was the rate of joint behaviours (symmetric parent and patient behaviours) and asymmetric behaviours. Secondary outcomes included individual nonverbal behaviours.

Results: Average patient and parent age was 3 and 37 years old, respectively (35% female patients). Mothers were more frequently the present for the consultation, at 80%, with fathers being present 20% of the time. Relative to parents, physicians had longer talk time and pauses, more frequent interruptions, and faster speech rates. Frequent parent behaviours were longer simultaneous speech and eye contact, as well as frequent gesturing and nodding. Talk time, pauses, simultaneous speech, smiling and nodding were most often found to have joint convergence between physician and parent.

Conclusions: Nonverbal behaviour remains a key component of communication. This is the first study to describe nonverbal behaviors in the setting of pediatric surgical consultations. The knowledge of which nonverbal behaviours are associated with specific clinical outcomes may be of use to physicians to promote positive patient interactions and shared decision making. Future work will examine parent perceived decisional conflict and participation in shared decision-making.