Relationships Between Genetic Counseling Students’ Screensharing, Nonverbal and Verbal Communication, and Satisfaction in Simulated Telehealth Visits

OBJECTIVE:To examine the relationships between genetic counseling students' use of screensharing and nonverbal communication with verbal communication and standardized patient satisfaction during simulated telehealth visits. METHODS:From 2021-2022, 59 genetic counseling students from the U.S. and Canada conducted video-recorded standardized patient sessions via Zoom. Session recordings were coded using the Roter Interaction Analysis System (RIAS) and the standardized patients completed post-session satisfaction questionnaires. All instances and the total duration of screensharing during each session were recorded by watching the video recordings in full. Nonverbal communication behaviors (nodding, smiling, hand gesturing, eye gaze, forward lean, distance from the camera, and camera angle) were coded from systematic "thin slice" samples of between 15 and 30 s segments from throughout each session. Multiple linear regression models assessed relationships between the students' nonverbal behaviors, use of screensharing, verbal communication, and standardized patients' satisfaction with session communication. RESULTS:Increased screensharing was associated with decreased use of facilitating statements (p < 0.05), decreased patient-centeredness (p < 0.01), and increased verbal dominance (p < 0.05). Nodding was negatively correlated with verbal dominance (p < 0.05). Forward lean was positively correlated with standardized patient satisfaction with session communication (p < 0.05). CONCLUSION:Screensharing, nodding, and forward lean may affect patient-provider communication via telehealth in ways that are analogous to in-person clinical interactions. PRACTICE IMPLICATIONS:The possible negative consequences of screensharing suggest a need for additional research to inform best practices for providing patient-centered care in the telehealth setting.