How Touching: Analysis of Expressive Touch by Medical Students To Simulated Patients

John Wilde

doi:10.1016/j.jpainsymman.2025.02.392

1. Effectively apply evidence-based expressive touch with appropriate location, quality, and timing, aligned with patient preferences, to enhance rapport and empathy, particularly in gender-sensitive contexts. 2. Identify the significant gap between medical learners' comfort with performing expressive touch and the preferences of simulated patients, highlighting the need for future curriculum development to better train medical trainees in this skill. This study evaluates patient and medical trainee preferences regarding expressive touch (ET). The results highlight the significant role of gender in comfort levels with ET, and significantly higher comfort levels of touch that SPs have compared to learners. Findings will inform a new curriculum on effective ET in healthcare, with implications for patient communication and empathy-building in medical practice. Expressive touch (ET) refers to warm, friendly physical contact with patients beyond task-oriented interactions (1,2). Despite its recognized benefits in building rapport (3) and demonstrating empathy, limited research has explored patient and healthcare provider preferences regarding ET, particularly considering the impact of gender and the COVID-19 pandemic. This two-part study aims to evaluate patient and medical trainee preferences and comfort levels related to ET and subsequently develop and validate a curriculum to guide proper use of ET in healthcare settings. The first phase involved survey research with simulated patients (SPs) and medical students to assess their comfort and preferences regarding ET. Likert scale items and open-ended questions examined various touch locations, context, timing, and quality of ET. Statistical analysis, including two sample t-tests, was used to identify significant differences based on gender and other variables. Results A two-sample equal variance T-test showed that for female SP (n = 46), there was a statistically significantly higher comfort in receiving ET from female MSP compared to males in the hands (P = 0.04), forearms (P = 0.03), arms/shoulders (P = 0.03), knees (P = 0.001), thighs (P = 0.01), and upper back (P = 0.005). There was no statistically significant difference of male SP (n = 10) preference for ET between females to male MSP. Generally, both male and female SP were more comfortable with ET in the upper extremities and upper back, becoming increasingly uncomfortable proximally. This study also revealed that SPs were more comfortable receiving ET than medical students were in providing it. The pandemic influenced preferences, with varying desires for touch that differed from before. Findings from this study can inform the development of a healthcare communication curriculum focused on effective ET, especially for female patients. This study can provide a methodological basis for stimulating further methodological perspective studies that may be expanding expressive touch research to patients, families, and practicing providers. 1. Cocksedge, S., George, B., Renwick, S., & Chew-Graham, C. A. (2013). Touch in primary care consultations: qualitative investigation of doctors’ and patients’ perceptions. In British Journal of General Practice (Vol. 63, Issue 609, pp. e283–e290). Royal College of General Practitioners. 2. Kelly, M., Svrcek, C., King, N., Scherpbier, A., & Dornan, T. (2020). Embodying empathy: A phenomenological study of physician touch. In Medical Education (Vol. 54, Issue 5, pp. 400–407). Wiley. 3. Kravetz, R. E. (2009). To Touch or Not to Touch: That Is the Question. In The American Journal of Gastroenterology (Vol. 104, Issue 9, pp. 2143–2144). Ovid Technologies (Wolters Kluwer Health). 4. W E Osmun, J B Brown, M Stewart, S Graham (2000). Patients' attitudes to comforting touch in family practice. In Canadian Family Physician Journal (Vol. 46, Issue 12, pp 2411-2416) 5. Davin, L., Thistlethwaite, J., Bartle, E., & Russell, K. (2019). Touch in health professional practice: a review. In The Clinical Teacher (Vol. 16, Issue 6, pp. 559–564). Wiley. 6. Verghese, A. (2009). A Touch Of Sense. In Health Affairs (Vol. 28, Issue 4, pp. 1177–1182). Health Affairs (Project Hope).

How Touching: Analysis of Expressive Touch by Medical Students To Simulated Patients

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