Towards More Accurate Recognition of Patient Emotion Cues: Meta-Analysis of Training Literature and Development of an Assessment Tool and Multi-Component Intervention for Clinicians

The ability to make accurate perceptions of others is a valuable skill related to a variety of positive intra- and interpersonal attributes (Hall, Andrzejewski, & Yopchick, 2009). For healthcare providers in particular, accurate perception of patients, particularly accurate recognition of patient emotions, is an ability associated with better patient care, and more satisfied and adherent patients (Hall, Roter, Blanch, & Frankel, 2009). A critical component of quality in empathic provider-patient communication is the provider's ability to recognize the emotional needs of the patient. Despite the importance of this skill for effective communication, research on clinically relevant assessment tools and training programs for emotion cue recognition ability is extremely limited. This dissertation examines the effectiveness of training to improve person perception accuracy, with a particular focus on improving healthcare providers' ability to accurately recognize their patients' emotion cues.;To summarize the existing literature and assess the combined effect of training on person perception accuracy, a meta-analysis was conducted of the existing literature on person perception training interventions in healthy adult populations. Moderators of training effectiveness were also examined. Overall, training interventions were shown to significantly increase person perception accuracy in nonclinical adult populations who had received the training, as compared to those who had not. Feedback and practice were more effective approaches than instruction alone; however, a combination of approaches was the most effective training intervention. No study included in the meta-analysis experimentally assessed the impact of a training intervention to improve basic emotion cue recognition ability in healthy adult populations.;With the goal of improving emotion cue recognition in healthcare providers, this dissertation also presents an experimental investigation of the effectiveness of a comprehensive training intervention and its individual components to increase emotion cue recognition ability. The comprehensive training included raising awareness about the importance of emotion cues in healthcare interactions, providing instruction for how to increase emotion cue recognition accuracy, and practicing emotion recognition while receiving feedback. Undergraduate participants role-playing medical students were randomly assigned to receive the comprehensive training condition, a control group with none of these training components, or one of four training conditions where participants received either consciousness-raising, instruction, practice alone, or practice with feedback. Emotion cue recognition ability following training was compared across conditions. Participants were significantly more accurate on a standardized test of emotion cue recognition in the comprehensive condition, when they practiced, and when they practiced and were given feedback about the correct answer, as compared to those participants in the control condition. The impact of training condition on participant mood and reactions to the training are also discussed. Results suggest that a 30-minute emotion recognition training intervention could significantly improve emotion recognition accuracy.;In addition to testing the effects of training, this dissertation presents validation studies of the Patient Emotion Cue Test (PECT), as a novel assessment of emotion recognition ability, developed for healthcare providers (Blanch-Hartigan, 2011). The PECT consists of video clips depicting emotion cues of an actress portraying a patient with content derived from real patient interactions. Unlike other measures of emotion recognition ability, the PECT clips are specific to a healthcare context, vary in the intensity of both verbal and nonverbal cues, and cover five emotion categories and neutral affect. In three validation studies, the PECT demonstrated sufficient reliability, normally distributed accuracy scores, significantly better than chance responding, and no ceiling effect. Construct validity was established through significant correlations with established measures of emotion recognition. The PECT was used as the primary assessment tool for the training intervention.;Results of the meta-analysis and training intervention study suggest that training and assessing emotion cue recognition accuracy in healthcare providers is possible. The results can be used to guide development and implementation of future programs and research aimed at increasing providers' emotion recognition.