Clinically relevant correlates of accurate perception of patients' thoughts and feelings.

The goal was to explore the clinical relevance of accurate understanding of patients' thoughts and feelings. Between 2010 and 2012, four groups of participants (nursing students, medical students, internal medicine residents, and undergraduate students) took a test of accuracy in understanding the thoughts and feelings of patients who were videorecorded during their actual medical visits and who afterward reviewed their video to identify their thoughts and feelings as they occurred (Test of Accurate Perception of Patients' Affect, or TAPPA). Participants' accuracy scores were then correlated with participants' attitudes toward patient-centered care, clinical course background, recall of clinical conversation, evaluations of clinical performance made by preceptors, evaluations of interpersonal skill made by standardized patients in clinical encounters, and independent coding of behavior in a clinical encounter. Accuracy in understanding patients' thoughts and feelings was significantly correlated with nursing students' clinical course experience, clinicians' favorable attitudes to psychosocial discussion, standardized patients' evaluations of medical students' interpersonal skill, independent coding of medical students' patient-centered behavior while taking a social history, and undergraduates' more accurate recall of what an actor-physician said on video. Accuracy in perceiving patients' thoughts and feelings can be objectively measured and is a skill relevant to clinical performance.

The Test of Accurate Perception of Patients' Affect (TAPPA): an ecologically valid tool for assessing interpersonal perception accuracy in clinicians.

OBJECTIVE: A clinician's ability to infer patients' thoughts and feelings is a critical component of high quality care. The goal of this article is to present a new test to measure this ability in clinicians, called the Test of Accurate Perception of Patients' Affect (TAPPA). METHODS: Audiovisual clips were taken from patients' actual medical visits. The patients reviewed the videotape after the visit to identify their thoughts and feelings during the visit. This information was used to extract short audiovisual clips for which the correct answer was the patient's report of the thought or feeling associated with that clip. The TAPPA contains 48 audiovisual clips, each responded to in a multiple choice format. RESULTS: The TAPPA showed good psychometric properties (optimal mean and good variance, adequate internal consistency, and strong re-test reliability) and convergent validity with other tests of emotion recognition. In addition, the test showed predicted better performance by female than male participants. CONCLUSION: The TAPPA promises to be a valuable tool for research and education on provider-patient relationships and quality of care. PRACTICE IMPLICATIONS: A tool for testing clinicians' understanding of patients' thoughts and feelings may contribute to better quality of care and to improved selection and training.