The Influence of Physician use of Analogies on Patient Understanding and Perceptions of Physician
Physicians must explain medical information to patients in a way that patients can understand, and physician use of analogies is one strategy that may help patients better understand health information. The present dissertation, guided by patient-centered communication, investigated whether the use of analogies by a physician within a medical encounter enhances participants’ objective understanding, perceived understanding, and perceptions of clarity regarding information about a health condition, and perceptions of the physician in areas of liking, similarity, satisfaction, and affective communication. The experiment consisted of eight conditions with a 2 (familiar/unfamiliar health condition) x 4 (no analogies, diagnosis analogies, treatment analogies, both diagnosis and treatment analogies) design, and the conditions varied by being exposed to the familiar or unfamiliar health issue first. An actor physician delivered a 1-2 minute video-recorded message, diagnosing the participants, serving as analogue patients, with the familiar or unfamiliar health issue. After watching the video and responding to the dependent variable measures based on their perceptions of the physician and video message, U.S. adult participants read a vignette of another physician diagnosing them with the other (familiar or unfamiliar) health issue, and answered the same dependent variable measures regarding the physician and vignette message. Open-ended questions sought to understand what participants remembered from the message and whether they recalled analogies in their retelling of the physician messages, whether they (dis)liked the analogies, what they (dis)liked about the physicians and whether these perceptions differed by analogy conditions, whether they remembered any analogies from their own clinicians, and in which medical situations they found provider analogies to be useful. Findings indicated when including health literacy as a covariate, analogies did not enhance perceptions of clarity, perceived understanding, or objective understanding. Regarding positive perceptions, analogies did not influence liking, similarity, satisfaction, or affective communication. There was no significant interaction between use of analogies and health issues, nor a difference in the effectiveness of the analogies based on whether they were used to describe diagnosis or treatment. Explanations containing analogies resulted in increased objective understanding for the vignette compared to the video format. When recalling the physician’s message, participants rarely recalled analogies, nor explicitly mentioned them as something they liked or disliked. However, some participants recalled clinician use of particular analogies, and most of them indicated they found clinician analogies to be useful, especially when describing complex health issues that are difficult for patients to understand. The dissertation results indicate that healthcare providers may want to use analogies when interacting with patients, which could potentially improve the doctor-patient relationship.