Significance of eye contact in medical interview : Analysis of videoed interview by medical students for five years

虽然眼神接触是医学访谈中最重要的因素之一，但对它的研究大多是定性的。我们试图在访谈中测量眼神接触时间的比率，以探索眼神接触与患者评价的关系。以高知医学院187名五年制医学生为被试，采用欧安组织、患者评定量表和视频回放确定变量，对他们与病人或模拟病人的访谈进行测量。分别是面谈总时长、眼神接触总时长、面谈中眼神交流率、眼神接触时序。我们培训了一名评估员，以确保视频评估的可靠性。研究结果如下：1.经欧安组织测评，超过60%的学生在约80%的项目上取得了高于平均水平的成绩。因子分析提取了8个因子，其中前3个因子解释了43%的变异。超过80%的受访者在问候语或眼神交流等项目上评价“良好”或“优秀”，73%的受访者在项目中评价“好”或“优秀”，“感觉可以自由交谈”，62%的受访者在项目中评价“好”或“优秀”，即“我很感激”。3.面试的平均时间为12分48秒，眼神交流的平均时间为8分48秒；面试期间的眼神交流率平均为69%。当面试官为女性时，受访者对面试的评价越高，眼神接触率越高，而当受访者为男性时，则相反。这些结果表明，眼神接触的效果因性别和心理病理学的不同而不同，这对医学访谈的学习有一定的启示。

Although eye contact is one of the most important factors in medical interview, it has been investigated mostly qualitatively. We tried to measure the rate of eye contact time during interview to explore the association of eye contact with patients' evaluation. Subjects were one hundred and eighty-seven Five Year medical students of Kochi Medical School and their interview with patients or simulated patients were measured with OSCE, Patient's Assessment Scale, and variables determined with video playback. They were total time of interview, total time of eye contact, the rate of eye contact during interview, and timing of eye contact. We trained an assessor to secure reliability of video assessment. Results were as follows :1. With OSCE assessment, over 60% of the students acquired more than average in about eighty percent of the items. Factor analysis extracted eight factors with top three of them explaining forty-three percent of the variance.2. More than eighty percent of interviewees evaluated "good" or "excellent" in the items such as greetings or eye contact, while seventy-three percent evaluated "good" or "excellent" in the item, "Felt free to talk", and sixty-two percent evaluated "good" or "excellent" in the item, "I was appreciated."3. The average of interview time was twelve minutes and forty-eight seconds and the average of eye contact was eight minutes and forty-eight seconds ; the rate of eye contact during interview was sixty-nine percent in average. When interviewer was female, interviewee put a high value on the interview with the rate of eye contact increasing, while in case interviewee was male, the opposite was true. Simulated patients put a high value on the interview with the rate of eye contact increasing.These results suggest that the effects of eye contact varied according to sex and psychopathology indicating some hint about learning of medical interview.