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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 Topic Patient-Centered Care: Strengthening Trust and Communication in Healthcare Relationships View all articles

Smiling Doctor, Satisfied Patient -The Impact of Facial Expressions on Doctor-Patient Interactions

Provisionally accepted
Pia Schneider Pia Schneider 1*Giulia Zerbini Giulia Zerbini 1Philipp Reicherts Philipp Reicherts 1Miriam Reicherts Miriam Reicherts 1Nina Roob Nina Roob 2Tobias Hallmen Tobias Hallmen 3Elisabeth André Elisabeth André 3Thomas Rotthoff Thomas Rotthoff 4Miriam Kunz Miriam Kunz 1
  • 1 Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany
  • 2 Medical Education Sciences, DEMEDA, Faculty of Medicine, University of Augsburg, Augsburg, Germany
  • 3 Department of Human-Centered Artificial Intelligence, Faculty of Applied Computer Science, University of Augsburg, Augsburg, Germany
  • 4 Medical Didactics and Education Research, DEMEDA, Faculty of Medicine, University of Augsburg, Augsburg, Germany

The final, formatted version of the article will be published soon.

    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

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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