The effects of communication skills on perceptions of virtual and human physicians in a medical consultation about the common cold: a randomised trial.

Abstract

Virtual humans are embodied conversational agents that are starting to be investigated in healthcare to combat critical staff shortages. It is important to investigate their ability to deliver empathic consultations compared to human physicians. Incorporating good communication behaviours may help to build trust and adherence. This study's primary aim was to investigate the effects of clinical communication skills (good or poor) and physician type (virtual or human physician) on participants' perceptions of a brief medical consultation. A 2 (a virtual or human physician) x 2 (good or poor communication skills) parallel randomised controlled trial. Community-dwelling adults recruited over social media. One hundred twenty-four adults aged 18 years or over. Participants watched a video of an actor in a medical consultation with either a virtual physician or a human physician, with either good or poor communication skills. Ratings of physician empathy, warmth, trust, competence, and adherence intention. Consultations with good communication skills were rated better on physician empathy, warmth, trust, competence, and adherence intention for both physician types (P < .005). The virtual physician was rated more empathetic than the human physician in the poor communication skill condition (P < .001). In addition, the actor was rated less likely to adhere to the virtual physician than the human physician (P = .010). Building good clinical communication skills into virtual physicians can encourage warm, trusting and competent relationships, which may improve adherence. Future research could investigate dynamic and real-world patient settings. Key messages What is already known on this topic: Good communication skills can improve patient trust and adherence in medical consultations. It is not known whether communication skills affect perceptions of virtual physicians compared to human physicians. What this study adds: Good clinical communication skills improve perceptions of physician empathy, warmth, trust, competence, and adherence intention, in virtual physicians similar to human physicians. Perceptions may favour virtual physicians compared to human physicians when they have poor communication skills. How this study might affect research, practice or policy: The study supports the use of virtual physicians with good communication skills. Three research questions-as snappy bullet points-that outline the current research questions-i.e. not the ones that you have answered but the ones that remain or have emerged as a result of your work. Will patients trust virtual physicians in real clinical consultations? Will trust in virtual physicians depend on the severity of the patient's condition? Will adherence differ between physicians and virtual physicians after real patient consultations?