Being vulnerable, a qualitative inquiry of physician touch in medical education

Martina Kelly*, Lara Nixon, Tom Rosenal, Lindsay Crowshoe, Adrian Harvey, Wendy Tink, Tim Dornan

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Purpose
Effective nonverbal communication is associated with empathic behavior and improved patient outcomes. Touch, as a form of non-verbal communication is relatively unexplored in medical education. This study sought to gain in-depth insights into physicians’ experiences communicating with touch and to examine how this could inform communication skills curricula.

Method
Collaborative inquiry, a form of action research, was used. Six experienced physician educators from the University of Calgary met eight times between 2015-2018 to critically reflect on their experiences of touch in clinical practice, teaching and learning. Data comprised meeting transcripts, individual narrative accounts and digital recordings of role-plays. Interpretative phenomenology, the study of lived experience, guided analysis.

Results
Two themes were identified – touch as presence and touch as risk. Participants engaged with touch to demonstrate presence and a shared humanity with patients, to express ‘being with’ a patient. Risk was not associated with the physical experience of touch but its social meaning, interpreted through gender, culture, relationships and context. Individual experiences were open to many interpretations. Participants expressed tension between their personal experience communicating with touch to express empathy and formal curricular structures. Reflection, role-modelling and clinical debriefs were suggested as ways to encourage situational awareness and sensitive use of touch.

Conclusions
Touch is a powerful means to communicate with patients but is highly subjective. Rather than avoiding touch for fear of misinterpretation, promoting dialogue about its complexity could promote a more balanced understanding of touch and its potential to convey empathy as well as more effectively manage risk.
Original languageEnglish
JournalAcademic Medicine
Early online date05 May 2020
DOIs
Publication statusEarly online date - 05 May 2020

Fingerprint Dive into the research topics of 'Being vulnerable, a qualitative inquiry of physician touch in medical education'. Together they form a unique fingerprint.

Cite this