ORIGINAL RESEARCH article
Front. Med.
Sec. Healthcare Professions Education
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1518517
This article is part of the Research TopicPatient-Centered Care: Strengthening Trust and Communication in Healthcare RelationshipsView all 3 articles
Smiling Doctor, Satisfied Patient -The Impact of Facial Expressions on Doctor-Patient Interactions
Provisionally accepted
Pia Schneider1*
Giulia Zerbini1
Philipp Reicherts1
Miriam Reicherts1Nina Roob2
Tobias Hallmen3Elisabeth André3Thomas Rotthoff4Miriam Kunz1- 1Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- 2Medical Education Sciences, DEMEDA, Faculty of Medicine, University of Augsburg, Augsburg, Germany
- 3Department of Human-Centered Artificial Intelligence, Faculty of Applied Computer Science, University of Augsburg, Augsburg, Germany
- 4Medical Didactics and Education Research, DEMEDA, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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Introduction: Although the importance of facial expressions for good doctor-patient communication is widely acknowledged, empirical evidence supporting this notion is scarce. We used a fine-grained, anatomically-based measure to investigate which facial expressions are displayed in (simulated) doctor-patient consultations and whether these can predict communication quality.Methods: 52 medical students engaged in simulated doctor-patient consultations with standardized patients (SPs) and their facial expressions were analyzed using the Facial-Action-Coding-System (FACS). The quality of the communication was rated by SPs, medical students, and by communication experts. SPs also rated their level of comfort.Results: The predominant facial expression being displayed by medical students was smiling. Medical students' smiling positively predicted the communication quality and level of comfort experienced by SPs. In contrast, smiling had little effect on medical students' self-and expertassessments of communication quality. Smiling of medical students significantly predicted patient level of comfort and perceived quality of communication. This predictive power was found for genuine and for social smiles as well as for smiles displayed during speaking and during listening.Discussion: Smiling seems to be a robust non-verbal behavior that has the potential to improve doctor-patient communication. This knowledge should be taken into consideration in medical training programs.
Keywords: Doctor-patient communication, Facial Expression, non-verbal communication, Patient Satisfaction, Medical students
Received: 04 Nov 2024; Accepted: 31 Mar 2025.
Copyright: © 2025 Schneider, Zerbini, Reicherts, Reicherts, Roob, Hallmen, André, Rotthoff and Kunz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Pia Schneider, Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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