Resonance and dissonance in professional helping relationships at the dyadic level: Determining the influence of positive and negative emotional attractors on effective physician-patient communication

This research is a qualitative and quantitative study based on an archival examination of the relationships between the demonstration of behavioral affect as represented by positive and negative emotional attractors (PEA and NEA) and medical student effectiveness in a clinical diagnostic intervention, namely, the Clinical Skills Exam (CSE). The research question is "Does a medical student's overall positive versus negative emotional tone influence his or her effectiveness in a clinical diagnostic encounter with a standardized patient (SP)?" The study analyzed 116 videotaped CSE encounters between medical students from the Class of 2009 at a medical school in a major mid-western university and SPs. A codebook of themes was developed from a sample of encounters between the Class of 2008 medical students and SPs which was used to code the behavior of the Class of 2009 medical students during the encounters. The associations among PEA and NEA themes and medical student effectiveness as measured by SP scores of the encounters, Faculty scores of notes written by medical students immediately after the encounters, and differential diagnosis scores were determined using moderated multiple regression (MMR) analysis. Medical student MCAT scores were examined as a possible moderator of the associations. MMR analyses found a significant positive association (p<.05) between PEA and the SP scores near significant positive association (p<.10) between PEA and the Faculty scores of student notes significant positive association (p<.05) between NEA and the Faculty scores of student notes and a significant negative association (p<.05) between MCAT scores and the SP scores. A near significant positive moderating effect (p<.10) of MCAT scores on the association between PEA and the Faculty scores of student notes was also found.Keywords: Positive and negative emotion, intentional change, complex systems, helping relationships, physician-patient communication, positive psychology...