Multiscale movement coordination dynamics in collaborative team problem solving

Resilient performance in building maintenance: A macro-cognition perspective during sudden breakdowns

Building maintenance encompasses multiple tightly inter-connected agents (e.g., technicians, occupants, supervisors, and equipment). Variable working conditions and limited resources may affect the safety and sustainability of the activities. Although recent studies have explored how complex systems can perform resilient behavior in facing the complexity of everyday activities, the factors that effectively contribute to resilient performance are still paired with limited empirical evidence. We studied the performance of the maintenance team during sudden breakdowns of air-conditioning devices in a large university campus, using the Functional Resonance Analysis Method (FRAM). A FRAM diagram containing 30 functions was organized including six macro-cognitive functions (expertise, sensemaking, communication, coordination, collaboration, and adaptation/improvisation), examining their role in anticipating, and responding to emergencies, and eight functional units that are directly impacted by disturbances were analyzed in more detail. Results indicate that macro-cognitive functions can greatly impact the functionality of the maintenance team in pursuit of their goals. Moreover, we noted those macro-cognitive functions here analyzed depend on each other to produce resilient performance.

A Typology for the Application of Team Coordination Dynamics Across Increasing Levels of Dynamic Complexity

OBJECTIVE

This review and synthesis examines approaches for measuring and assessing team coordination dynamics (TCD). The authors advance a system typology for classifying TCD approaches and their applications for increasing levels of dynamic complexity.

BACKGROUND

There is an increasing focus on how teams adapt their coordination in response to changing and uncertain operational conditions. Understanding coordination is significant because poor coordination is associated with maladaptive responses, whereas adaptive coordination is associated with effective responses. This issue has been met with TCD approaches that handle increasing complexity in the types of TCD teams exhibit.

METHOD

A three-level system typology of TCD approaches for increasing dynamic complexity is provided, with examples of research at each level. For System I TCD, team states converge toward a stable, fixed-point attractor. For System II TCD, team states are periodic, which can appear complex, yet are regular and relatively stable. In System III TCD, teams can exhibit periodic patterns, but those patterns change continuously to maintain effectiveness.

RESULTS

System I and System II are applicable to TCD with known or discoverable behavioral attractors that are stationary across mid-to long-range timescales. System III TCD is the most generalizable to dynamic environments with high requirements for adaptive coordination across a range of timescales.

CONCLUSION

We outline current challenges for TCD and next steps in this burgeoning field of research.

APPLICATION

System III approaches are becoming widespread, as they are generalizable to time- and/or scale-varying TCD and multimodal analyses. Recommendations for deploying TCD in team settings are provided.

Entropy for team communication pattern recognition

This work aims to demonstrate entropy as a method that can be used to analyze team coordination using naturalistic team communication content. Much of team coordination happens through communication; understanding team communication is vital to better formulate and train teams for successful performance outcomes. Several decades of team communication research have led to various methods for analyzing team communication patterns. Many existing methods for team communication analysis have not been tested with naturalistic communication or only consider the frequency or flow of communication. Sliding-window entropy is used to analyze team coordination dynamics with team communication as a proxy. The resulting time series are evaluated using nonlinear dynamical systems analysis and clustering. Various team coordination patterns are identified using communication entropy at the team level. Entropy can be used to identify team communication patterns and their relation to team performance. While team coordination happens at the team level, a posteriori analysis indicates members' individual characteristics affect the overall team coordination patterns. In teams where the contribution is unequal, some members disproportionately affect the overall team coordination, which may undermine the team impact and affect team performance.

A Methodological Framework to Study Change in Team Cognition Under the Dynamical Hypothesis

The dynamical hypothesis claims that cognitive systems, such as teams, are dynamical systems (i.e., an interdependent collection of individuals and their technology that change together over time). Following this hypothesis, team researchers have adopted dynamical approaches to better understand the team cognitive processes and states that form team cognition, as well as how they emerge over time. One approach focuses on team coordination dynamics, which examines the coupling of signals between interacting individuals in various modalities, and has been shown to reflect aspects of team functioning including team cognition. However, how changes in team coordination relate to high-level team cognitive processes and states, as well as important events, are not yet fully understood. To this end, we advance a methodological framework for researching team cognition under the dynamical hypothesis. Subsequently, we provided an empirical case-study application of this framework. Thereby, this work contributes methodologically and empirically to a deeper understanding of team cognition, the dynamical hypothesis, and the synergy between them.

multiSyncPy: A Python package for assessing multivariate coordination dynamics

In order to support the burgeoning field of research into intra- and interpersonal synchrony, we present an open-source software package: multiSyncPy. Multivariate synchrony goes beyond the bivariate case and can be useful for quantifying how groups, teams, and families coordinate their behaviors, or estimating the degree to which multiple modalities from an individual become synchronized. Our package includes state-of-the-art multivariate methods including symbolic entropy, multidimensional recurrence quantification analysis, coherence (with an additional sum-normalized modification), the cluster-phase 'Rho' metric, and a statistical test based on the Kuramoto order parameter. We also include functions for two surrogation techniques to compare the observed coordination dynamics with chance levels and a windowing function to examine time-varying coordination for most of the measures. Taken together, our collation and presentation of these methods make the study of interpersonal synchronization and coordination dynamics applicable to larger, more complex and often more ecologically valid study designs. In this work, we summarize the relevant theoretical background and present illustrative practical examples, lessons learned, as well as guidance for the usage of our package - using synthetic as well as empirical data. Furthermore, we provide a discussion of our work and software and outline interesting further directions and perspectives. multiSyncPy is freely available under the LGPL license at: https://github.com/cslab-hub/multiSyncPy , and also available at the Python package index.

Prospects for Augmenting Team Interactions with Real-Time Coordination-Based Measures in Human-Autonomy Teams

Complex work in teams requires coordination across team members and their technology as well as the ability to change and adapt over time to achieve effective performance. To support such complex interactions, recent efforts have worked toward the design of adaptive human-autonomy teaming systems that can provide feedback in or near real time to achieve the desired individual or team results. However, while significant advancements have been made to better model and understand the dynamics of team interaction and its relationship with task performance, appropriate measures of team coordination and computational methods to detect changes in coordination have not yet been widely investigated. Having the capacity to measure coordination in real time is quite promising as it provides the opportunity to provide adaptive feedback that may influence and regulate teams' coordination patterns and, ultimately, drive effective team performance. A critical requirement to reach this potential is having the theoretical and empirical foundation from which to do so. Therefore, the first goal of the paper is to review approaches to coordination dynamics, identify current research gaps, and draw insights from other areas, such as social interaction, relationship science, and psychotherapy. The second goal is to collate extant work on feedback and advance ideas for adaptive feedback systems that have potential to influence coordination in a way that can enhance the effectiveness of team interactions. In addressing these two goals, this work lays the foundation as well as plans for the future of human-autonomy teams that augment team interactions using coordination-based measures.

Collective Rhythm as an Emergent Property During Human Social Coordination

The literature on social interactions has shown that participants coordinate not only at the behavioral but also at the physiological and neural levels, and that this coordination gives a temporal structure to the individual and social dynamics. However, it has not been fully explored whether such temporal patterns emerge during interpersonal coordination beyond dyads, whether this phenomenon arises from complex cognitive mechanisms or from relatively simple rules of behavior, or which are the sociocultural processes that underlie this phenomenon. We review the evidence for the existence of group-level rhythmic patterns that result from social interactions and argue that the complexity of group dynamics can lead to temporal regularities that cannot be predicted from the individual periodicities: an emergent collective rhythm. Moreover, we use this interpretation of the literature to discuss how taking into account the sociocultural niche in which individuals develop can help explain the seemingly divergent results that have been reported on the social influences and consequences of interpersonal coordination. We make recommendations on further research to test these arguments and their relationship to the feeling of belonging and assimilation experienced during group dynamics.

Nonverbal Synchrony: An Indicator of Clinical Communication Quality in Racially-Concordant and Racially-Discordant Oncology Interactions

Objectives

The aim of this cross-sectional study was to apply a novel software to measure and compare levels of nonverbal synchrony, as a potential indicator of communication quality, in video recordings of racially-concordant and racially-discordant oncology interactions. Predictions include that the levels of nonverbal synchrony will be greater during racially-concordant interactions than racially-discordant interactions, and that levels of nonverbal synchrony will be associated with traditional measures of communication quality in both racially-concordant and racially-discordant interactions.

Design

This is a secondary observational analysis of video-recorded oncology treatment discussions collected from 2 previous studies.

Setting

Two National Cancer Institute-designated Comprehensive Cancer Centers and another large urban cancer center.

Participants

Participants from Study 1 include 161 White patients with cancer and 11 White medical oncologists. Participants from Study 2 include 66 Black/African-American patients with cancer and 17 non-Black medical oncologists. In both studies inclusion criteria for patients was a recent cancer diagnosis; in Study 2 inclusion criteria was identifying as Black/African American.

Main outcome measures

Nonverbal synchrony and communication quality.

Results

Greater levels of nonverbal synchrony were observed in racially-discordant interactions than in racially-concordant interactions. Levels of nonverbal synchrony were associated with indicators of communication quality, and these associations were more consistently found in racially-discordant interactions.

Conclusion

This study advances clinical communication and disparities research by successfully applying a novel approach capturing the unconscious nature of communication, and revealing differences in communication in racially-discordant and racially-concordant oncology interactions. This study highlights the need for further exploration of nonverbal aspects relevant to patient-physician interactions.

Analyzing multidimensional movement interaction with generalized cross-wavelet transform

Humans are able to synchronize with musical events whilst coordinating their movements with others. Interpersonal entrainment phenomena, such as dance, involve multiple body parts and movement directions. Along with being multidimensional, dance movement interaction is plurifrequential, since it can occur at different frequencies simultaneously. Moreover, it is prone to nonstationarity, due to, for instance, displacements around the dance floor. Various methodological approaches have been adopted for the study of human entrainment, but only spectrogram-based techniques allow for an integral analysis thereof. This article proposes an alternative approach based upon the cross-wavelet transform, a state-of-the-art technique for nonstationary and plurifrequential analysis of univariate interaction. The presented approach generalizes the cross-wavelet transform to multidimensional signals. It allows to identify, for different frequencies of movement, estimates of interaction and leader-follower dynamics across body parts and movement directions. Further, the generalized cross-wavelet transform can be used to quantify the frequency-wise contribution of individual body parts and movement directions to overall movement synchrony. Since both in- and anti-phase relationships are dominant modes of coordination, the proposed implementation ignores whether movements are identical or opposite in phase. The article provides a thorough mathematical description of the method and includes proofs of its invariance under translation, rotation, and reflection. Finally, its properties and performance are illustrated via four examples using simulated data and behavioral data collected through a mirror game task and a free dance movement task.

Exploring the "Dark Matter" of Social Interaction: Systematic Review of a Decade of Research in Spontaneous Interpersonal Coordination

Interpersonal coordination is a research topic that has attracted considerable attention this last decade both due to a theoretical shift from intra-individual to inter-individual processes and due to the development of new methods for recording and analyzing movements in ecological settings. Encompassing spatiotemporal behavioral matching, interpersonal coordination is considered as "social glue" due to its capacity to foster social bonding. However, the mechanisms underlying this effect are still unclear and recent findings suggest a complex picture. Goal-oriented joint action and spontaneous coordination are often conflated, making it difficult to disentangle the role of joint commitment from unconscious mutual attunement. Consequently, the goals of the present article are twofold: (1) to illustrate the rapid expansion of interpersonal coordination as a research topic and (2) to conduct a systematic review of spontaneous interpersonal coordination, summarizing its latest developments and current challenges this last decade. By applying Rapid Automatic Keyword Extraction and Latent Dirichlet Allocation algorithms, keywords were extracted from PubMed and Scopus databases revealing the large diversity of research topics associated with spontaneous interpersonal coordination. Using the same databases and the keywords "behavioral matching," "interactional synchrony," and "interpersonal coordination," 1,213 articles were identified, extracted, and screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. A total of 19 articles were selected using the following inclusion criteria: (1) dynamic and spontaneous interactions between two unacquainted individuals (2) kinematic analyses, and (3) non-clinical and non-expert adult populations. The results of this systematic review stress the proliferation of various definitions and experimental paradigms that study perceptual and/or social influences on the emergence of spontaneous interpersonal coordination. As methods and indices used to quantify interpersonal coordination differ from one study to another, it becomes difficult to establish a coherent picture. This review highlights the need to reconsider interpersonal coordination not as the pinnacle of social interactions but as a complex dynamical process that requires cautious interpretation. An interdisciplinary approach is necessary for building bridges across scattered research fields through opening a dialogue between different theoretical frameworks and consequently provides a more ecological and holistic understanding of human social cognition.

Comparing learners' knowledge, behaviors, and attitudes between two instructional modes of computer programming in secondary education

BACKGROUND

Unplugged programming is proved to be an effective means to foster the learner-centered programming learning. In addition to the final tests, learners' programming knowledge, skills, and capacities are primarily demonstrated throughout the programming process, particularly in the situation when they encounter challenges and problems. However, few studies examine how learners engage in the programming processes and to what extent unplugged programming fosters learning. This research used a quasi-experimental design to investigate two instructional modes in China's secondary education, namely, the instructor-directed lecturing and the learner-centered unplugged programming. Based on an analytical framework, this research used mixed methods to compare learners' knowledge, behaviors, and attitudes under these two instructional modes.

RESULTS

The research results revealed discrepancies between two instructional modes. First, learners in the unplugged programming class achieved significantly higher scores on the programming knowledge assessment, compared to learners in the traditional lecturing class. Second, compared to the traditional lecturing class, learners in the unplugged programming class had higher test scores of the computational thinking skills, particularly on the cooperativity dimension. Next, discrepancies of in-class behaviors showed that learners in the unplugged programming class had frequent behaviors of listening to the instructor's instructions and discussing with peers, while learners in the instructor-directed class had frequent behaviors of listening to instructor, taking notes, and irrelevant activities. Learners' self-reported attitudes in the unplugged programming indicated a higher level of confidence than learners in the traditional lecturing class. Overall, this research revealed that the learner-centered unplugged programming had potential to improve learners' programming knowledge, behaviors, and attitudes compared to the traditional instructor-directed lecturing of programming.

CONCLUSIONS

As a feasible and easy-to-use instructional activity in computer science education, unplugged programming is encouraged to be integrated in formal education to increase learners' programming interests, motivations, and qualities. This quasi-experimental research compared learners' programming knowledge, behaviors, and attitudes under two instructional modes. The results revealed critical discrepancies between two instructional modes on learners' knowledge gains, in-class behaviors, and changes of attitudes towards programming. Pedagogical and analytical implications were provided for future instructional design and learning analytics of computer programming education.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s40594-021-00311-1.

Windowed multiscale synchrony: modeling time-varying and scale-localized interpersonal coordination dynamics

Social interactions are pervasive in human life with varying forms of interpersonal coordination emerging and spanning different modalities (e.g. behaviors, speech/language, and neurophysiology). However, during social interactions, as in any dynamical system, patterns of coordination form and dissipate at different scales. Historically, researchers have used aggregate measures to capture coordination over time. While those measures (e.g. mean relative phase, cross-correlation, coherence) have provided a wealth of information about coordination in social settings, some evidence suggests that multiscale coordination may change over the time course of a typical empirical observation. To address this gap, we demonstrate an underutilized method, windowed multiscale synchrony, that moves beyond quantifying aggregate measures of coordination by focusing on how the relative strength of coordination changes over time and the scales that comprise social interaction. This method involves using a wavelet transform to decompose time series into component frequencies (i.e. scales), preserving temporal information and then quantifying phase synchronization at each of these scales. We apply this method to both simulated and empirical interpersonal physiological and neuromechanical data. We anticipate that demonstrating this method will stimulate new insights on the mechanisms and functions of synchrony in interpersonal contexts using neurophysiological and behavioral measures.

An Active Inference Model of Collective Intelligence

Collective intelligence, an emergent phenomenon in which a composite system of multiple interacting agents performs at levels greater than the sum of its parts, has long compelled research efforts in social and behavioral sciences. To date, however, formal models of collective intelligence have lacked a plausible mathematical description of the relationship between local-scale interactions between autonomous sub-system components (individuals) and global-scale behavior of the composite system (the collective). In this paper we use the Active Inference Formulation (AIF), a framework for explaining the behavior of any non-equilibrium steady state system at any scale, to posit a minimal agent-based model that simulates the relationship between local individual-level interaction and collective intelligence. We explore the effects of providing baseline AIF agents (Model 1) with specific cognitive capabilities: Theory of Mind (Model 2), Goal Alignment (Model 3), and Theory of Mind with Goal Alignment (Model 4). These stepwise transitions in sophistication of cognitive ability are motivated by the types of advancements plausibly required for an AIF agent to persist and flourish in an environment populated by other highly autonomous AIF agents, and have also recently been shown to map naturally to canonical steps in human cognitive ability. Illustrative results show that stepwise cognitive transitions increase system performance by providing complementary mechanisms for alignment between agents’ local and global optima. Alignment emerges endogenously from the dynamics of interacting AIF agents themselves, rather than being imposed exogenously by incentives to agents’ behaviors (contra existing computational models of collective intelligence) or top-down priors for collective behavior (contra existing multiscale simulations of AIF). These results shed light on the types of generic information-theoretic patterns conducive to collective intelligence in human and other complex adaptive systems.

Change Process in Coaching: Interplay of Nonverbal Synchrony, Working Alliance, Self-Regulation, and Goal Attainment

Background: Psychological literature emphasizes that self-regulation is important as goal intentions, goal setting, or implementation intention does not automatically result in effective results in coaching. The question which coaching strategies to apply to strengthening clients' self-regulatory capacities as prerequisites of effective change outcomes remains a black box in coaching.

Method: This quantitative study explored clients' self-regulatory mechanisms by addressing how nonverbal synchrony influences clients' cognitive and emotional self-regulation across sessions. One hundred eighty-four coach–client pairs and their evolving change process were observed over 8 months. Video-recorded sessions were assessed with motion energy analysis to automatically capture coach and client nonverbal behavior and quantify nonverbal synchrony at the level of the dyad.

Results: Synchrony was differentially associated with clients' post-session questionnaires on result-oriented problem-reflection and self-reflection, affect balance, and working alliance. Network analyses suggested that the association between synchrony and other process variables did not correspond to the previously found positive association between synchrony and positive aspects of alliance or outcome. Instead, this association depended on the level of perceived outcome.

Discussion: Coaching success may be predicted by process variables assessed after each session: goal reflection, alliance, and mood all predict successful coaching. The assessment of nonverbal synchrony suggests a state-dependent effect of embodied processes on a coaching outcome that warrants further inspection.

Beyond Dyadic Coordination: Multimodal Behavioral Irregularity in Triads Predicts Facets of Collaborative Problem Solving

We hypothesize that effective collaboration is facilitated when individuals and environmental components form a synergy where they work together and regulate one another to produce stable patterns of behavior, or regularity, as well as adaptively reorganize to form new behaviors, or irregularity. We tested this hypothesis in a study with 32 triads who collaboratively solved a challenging visual computer programming task for 20 min following an introductory warm-up phase. Multidimensional recurrence quantification analysis was used to examine fine-grained (i.e., every 10 s) collective patterns of regularity across team members' speech rate, body movement, and team interaction with the shared user interface. We found that teams exhibited significant patterns of regularity as compared to shuffled baselines, but there were no systematic trends in regularity across time. We also found that periods of regularity were associated with a reduction in overall behavior. Notably, the production of irregular behavior predicted expert-coded metrics of collaborative activity, such as teams' ability to construct shared knowledge and effectively negotiate and coordinate execution of solutions, net of overall behavioral production and behavioral self-similarity. Our findings support the theory that groups can interact to form interpersonal synergies and indicate that information about system-level dynamics is a viable way to understand and predict effective collaborative processes.

Body synchrony in triadic interaction

Humans subtly synchronize body movement during face-to-face conversation. In this context, bodily synchrony has been linked to affiliation and social bonding, task success and comprehension, and potential conflict. Almost all studies of conversational synchrony involve dyads, and relatively less is known about the structure of synchrony in groups larger than two. We conducted an optic flow analysis of body movement in triads engaged in face-to-face conversation, and explored a common measure of synchrony: time-aligned bodily covariation. We correlated this measure of synchrony with a diverse set of covariates related to the outcome of interactions. Triads showed higher maximum cross-correlation relative to a surrogate baseline, and 'meta-synchrony', in that composite dyads in a triad tended to show correlated structure. A windowed analysis also revealed that synchrony varies widely across an interaction. As in prior studies, average synchrony was low but statistically reliable in just a few minutes of interaction. In an exploratory analysis, we investigated the potential function of body synchrony by predicting it from various covariates, such as linguistic style matching, liking, laughter and cooperative play in a behavioural economic game. Exploratory results do not reveal a clear function for synchrony, though colaughter within triads was associated with greater body synchrony, and is consistent with an earlier analysis showing a positive connection between colaughter and cooperation. We end by discussing the importance of expanding and codifying analyses of synchrony and assessing its function.

Applying ergonomics within the multi-modelling paradigm with an example from multiple UAV control

This article presents a position statement on using ergonomics in conjunction with the multi-modelling paradigm. Multi-modelling is a computational approach to combine models of systems and components for design and simulation of cyber physical systems and systems of systems. Despite potentially significant benefits in terms of more human-centric system modelling, there is limited evidence of the application of ergonomics within multi-modelling. This article presents the case for applying ergonomics within multi-modelling. We open with an introduction to multi-modelling and benefits, applications and gaps for ergonomics in multi-modelling, and of potentially useful models from ergonomics. We then describe a proof-of-concept implementation of ergonomics within a multi-model of UAV control. This demonstrates that as well as user-centred modelling, this approach supports ergonomics in how we can access rich systems models, and the collaborative value of applying ergonomics theory in systems design. Practitioner Summary: Examines multi-modelling, a computational approach for complex modelling, and the contribution of ergonomics. An autonomous UAV test implementation demonstrates the application of ergonomics knowledge for improving design and evaluation processes, and how multi-modelling can give ergonomics access to rich systems models. Abbreviations: ACT-R: adaptive control of thought-rational; API: application programming interface; CFD: computational fluid dynamics; COTS: commerical off the shelf; CPS: cyber-physical system; CT: continuous time; DE: discrete event; DSE: design space exploration; FME: finite element modeling; FMI: functional mock-up interface; FMU: functional mock-up unit; GOMS: goals, operators, methods, selections; HCI: human-computer interaction; IMPRINT: improved performance research integration tool; INTO-CPS: integrated toolchain for cyber-physical system modeling; KLM: keystroke level model; MPC: model-predictive control; SysML: system markup language; SoS: system of system; UAV: unmanned aerial vehicle.

Complexity matching and coordination in individual and dyadic performance

Complexity matching is a measure of coordination based on information exchange between complex networks. To date, studies have focused mainly on interpersonal coordination, but complexity matching may generalize to interacting networks within individuals. The present study examined complexity matching in a double, coordinated Fitts' perceptual-motor task with comparable individual and dyadic conditions. Participants alternated touching targets with their left and right hands in the individual condition, or analogously with the left hand of one partner and the right hand of another in the dyadic condition. In Experiment 1, response coupling was manipulated by making targets drift either randomly or contingently based on prior responses. Here, drift refers to the variability in the target movements between response locations. Long-range correlations in time series of inter-response intervals exhibited complexity matching between the left and right hands of dyads and individuals. Response coupling was necessary for complexity matching in dyads but not individuals. When response coupling was absent in the dyadic condition, the degree of complexity matching was significantly reduced. Experiment 2 showed that the effect of coupling was due to interactions between left and right responses. Results also showed a weak, negative relationship between complexity matching and performance as measured by total response time. In conclusion, principles and measures of complexity matching apply similarly within and between individuals, and perceptual-motor performance can be facilitated by loose response coupling.

Nonverbal synchrony as a behavioural marker of patient and physician race-related attitudes and a predictor of outcomes in oncology interactions: protocol for a secondary analysis of video-recorded cancer treatment discussions

INTRODUCTION

Racial disparities in cancer treatment contribute to racial disparities in mortality rates. The quality of patient-physician communication during clinical interactions with black patients and non-black physicians (racially discordant) is poorer than communication quality with white patients (racially concordant). Patient and physician race-related attitudes affect the quality of this communication. These attitudes are likely expressed through subtle non-verbal behaviours, but prior research has not examined these behaviours. Nonverbal synchrony, the coordination of physical movement, reflects the preinteraction attitudes of participants in interactions and predicts their postinteraction perceptions of and affect towards one another. In this study, peer reviewed and funded by the National Institute of Minority Health and Health Disparities (R21MD011766), we will investigate non-verbal synchrony in racially concordant and discordant interactions to better understand racial disparities in clinical communication.

METHODS AND ANALYSIS

This secondary analysis includes racially concordant (n=163) and racially discordant (n=68) video-recorded oncology interactions, patient and oncologist self-reported race-related attitudes, perceptions of the interaction and observer ratings of physician patient-centred communication and patient and physician affect and rapport. In aim 1, we will assess and compare non-verbal synchrony between physicians and patients in racially concordant and discordant interactions. In aim 2, we will determine the influence of non-verbal synchrony on patient and physician affect and communication. In aim 3, we will examine possible causes (ie, race-related attitudes) and consequences (ie, negative perceptions) of non-verbal synchrony in racially discordant interactions. In aim 4, we will develop and test a mediational model linking physician and patient race-related attitudes to non-verbal synchrony and, in turn, interaction outcomes.

ETHICS AND DISSEMINATION

The parent and current studies were approved by the Wayne State University Institutional Review Board. Since only archival data will be used, ethical or safety risks are low. We will disseminate our findings to relevant conferences and journals.