Nonverbal Affiliation by Physician Assistant Students during Simulated Clinical Examinations: Genotypic Effects

In the relationship between patients and health care providers, the use of nonverbal affiliative behaviors—including smiling, facial expressiveness, and a lack of dominance—is associated with multiple benefits to patient satisfaction, compliance, and health. However, little is known about what accounts for variance in providers’ tendencies to enact nonverbal affiliative behaviors during routine patient encounters. The present exploratory study examines nonverbal affiliative behaviors by physician assistant students in interactions with standardized patients. Each student conducted three clinical interviews over a 6-month period, each of which was coded for a cadre of nonverbal affiliative behaviors. Students also provided saliva samples for genotyping six single-nucleotide polymorphisms on the oxytocin receptor gene (OXTR) that are linked empirically to affiliation and other prosocial behaviors. Consistent with recent research, this study adopted a cumulative risk approach wherein students were scored for their number of risk alleles on the single-nucleotide polymorphisms. Results indicated that cumulative risk on the oxytocin receptor gene significantly predicted four out of five nonverbal affiliative behaviors.