Research was carried out to explore and describe student-patient accounts about communication at the health appointment. The intent was to develop improved understanding about the patient-provider communication process from the patient's point of view. A multimethods design was used to address: (1) How do student-patients perceive the communication in a health interview? and (2) Do student-patient accounts of the physician or nurse practitioner interview differ?
Subsequent to a scheduled yearly or revisit appointment, one hundred upperclass and graduate student women completed The Communication Satisfaction Scale and The Medical Interview Satisfaction Scale. Further, twenty-five women were interviewed about their perceptions of communication at the appointment. Symbolic interaction and accounts literature guided the overall effort.
Survey outcomes indicated that participants perceived high levels of communication satisfaction. Further, sample subgroups showed no statistically significant differences; however, suggestive directions were noted. In the older (versus younger) participant subgroup, somewhat more favorable mean ratings of communication satisfaction were seen. In the subgroup by provider gender, very slightly more favorable mean communication satisfaction ratings were seen between student-patients and female physicians and nurse practitioners (than male physicians).
Qualitative data suggested that the symbol of provider gender held the greatest meaning for participants. On biographical data sheets, participants cited minimal preferences related to choice of provider by gender; however, interview transcripts reflected the opposite.
The qualitative data were assessed using a recently developed framework which examines womens' ways of knowing (Belenky et al, 1986). In younger interviewees, woman-to-woman communication more frequently depicted "connected" knowing, and woman-to-man communication, "separate" knowing. In older interviewees, more variable differences were noted.
Assessment of provider symbol by role showed that younger participants hardly differentiated physician and nurse practitioner. For older participants, however, provider symbolism was of moderate influence in their communication.
Overall, both quantitative and qualitative data showed high levels of communication satisfaction. Discussion illuminated the challenge faced by student-patients and providers alike in interpreting words in context, identifying their respective meanings, and managing the overall communication process.
