Patient Evaluation of International Medical Graduates’ Verbal and Nonverbal Strategies to Manage Their Lack of Comprehension: Investigating the Role of Goal Inferences

Abstract

Guided by goal understanding theory, we investigated how U.S. patients evaluate communication strategies international medical graduates (IMGs) adopt to manage their lack of comprehension of patient idioms. Participants ( N = 569) watched a video of an IMG and a patient interacting in a 3 (verbal: being blunt, feigning comprehension, providing rationale) × 2 (nonverbal: higher, lower immediacy) × 2 (message variations: “out of sorts,” “frog in the throat”) online experiment. Participants inferred IMG goals of understanding the patient and establishing trust most strongly when IMGs provided rationale with higher nonverbal immediacy and least strongly when IMGs feigned comprehension with lower nonverbal immediacy. These inferred goals were positively associated with participants’ evaluations of IMGs and their satisfaction. The findings suggest that patients may integrate verbal and nonverbal behaviors to infer IMGs’ goals, yielding implications for goals theorizing and IMG communication.