What makes a physician an exemplary communicator with patients?

Objective: A pilot study was conducted to examine the characteristics, capacities (beliefs, values and intentions) and skills that distinguish exemplary communicators from less exemplary communicators in patient-physician encounters. Methods: Forty physicians participated in a four-station videotaped OSCE focusing on a variety of adolescent sexual health issues and assessed using seven quantitative measures. Results determined the top 15%, and the bottom 15%. An interviewer reviewed and discussed two of the videotaped scenarios with physicians in both groups. Interviews were analyzed to determine differences between groups. Results: Results consistently identified the top 15% (6) and bottom 15% (6) physicians. The t-tests showed statistically significant differences on all skills and capacity measures. "Notable" differences (25% or higher) were found on two quantitative instruments assessing skills. There were no notable differences in capacities. The qualitative inquiry confirmed notable differences in skills and identified capacities of empathy, non-judgement and self-reflection as restricted to the exemplary group. Conclusion: Using quantitative and qualitative measures, it is possible to determine skills and capacities that distinguish exemplary communicators from less exemplary communicators. Practice implications: In addition to effective skills, physician empathy, non-judgement and self-reflection appear to be necessary components for exemplary physician communication with adolescents. (C) 2007 Elsevier Ireland Ltd. All rights reserved.