Artículos Generales
29 junio 2022

Analysis of the Verbal Behaviour of the Physiotherapist in the First Clinical Session : A Cross-Sectional Study

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verbal behaviour, observational methodology, physiotherapy
Vol. 4 Núm. 1 (2022): Junio



Objective: This paper presents a preliminary study about verbal behaviour of a physiotherapist exploring possibilities of a system of coding verbal behaviour   developed before to study verbal behaviour of psychologists

Methods: Principal variable verbal behaviour of physiotherapist was coded using  Frojan’s the categorization system of the therapist's verbal behaviour (SISC-CVT) that includes several different types of verbal behaviours: discriminative, evocative, reinforcement, punishment, informative, instructional, motivational. Record during a first clinical session of Physical Therapy sample compress seven physiotherapists

Results: Regarding inter-rater reliability, Kappa values were modest: very good (1), good (1), moderate (6), weak (7), poor (2). The discriminative category was the most repeated with an average of 71.20 interventions per session, followed by the reinforcement category with an average of 59.05 interventions per session. The less frequency appeared in the results of the evocative category, with an average of 4.4 interventions per session, and of the punitive category, appearing twice for every first 5 clinical sessions

Conclusions: This paper presents some preliminary results from a different approach to research verbal behaviour of physiotherapists. Future research need more training of coding to increase reliability. SISC-CVT reveals differences between several physiotherapist We encourage other researchers to continue exploring verbal behaviour of physiotherapists.

  Cómo citar

PARDO J, Bielsa López del Castillo JP, Rodríguez García SJ, La Touche R, Paris Alemany A, Cuenca Martínez F. Analysis of the Verbal Behaviour of the Physiotherapist in the First Clinical Session : A Cross-Sectional Study . MOVE [Internet]. 29 de junio de 2022 [citado 7 de agosto de 2022];4(1):435-44. Disponible en:


Bar M, Neta M, Linz H. Very first impressions. Emotion. 2006;6(2):269–278. DOI:

Botelho M, Gao X, Bhuyan SY. Mixed-methods analysis of videoed expert-student dialogue supporting clinical competence assessments. Eur J Dent Educ. 2020;24(3):398–406. DOI:

Bugaj TJ, Nikendei C. Practical Clinical Training in Skills Labs: Theory and Practice. GMS J Med Educ. 2016;33(4). DOI:

Curtis JR, Back AL, Ford DW, Downey L, Shannon SE, Doorenbos AZ, Kross EK, Reinke LF, Feemster LC, Edlund B, Arnold RW, O’Connor K, Engelberg RA. Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial. JAMA. 2013;310(21):2271–2281. DOI:

Douglas AH, Acharya SP, Allery LA. Communication skills learning through role models in Nepal; what are medical students really learning? A qualitative study. BMC Med Educ. 2021;21(1). DOI:

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344–9. DOI:

Froján-Parga MX, Calero-Elvira A, Montaño-Fidalgo M. Study of the Socratic method during cognitive restructuring. Clin Psychol Psychother. 2011;18(2):110–123. DOI:

Froján-Parga MX, Montaño-Fidalgo M, Calero-Elvira A, García-Soler Á, Garzón-Fernández Á, Ruiz-Sancho ME. Sistema de categorización de la conducta verbal del terapeuta. Psicothema. 2008;20:603–609. Available at: Accessed July 1, 2022.

García-Fariña A, Jiménez-Jiménez F, Teresa Anguera M. Observation of Communication by Physical Education Teachers: Detecting Patterns in Verbal Behavior. Front Psychol. 2018;9(MAR). DOI:

Jones A, Cupit R, Choy V, Jones D. Student-patient communication during physiotherapy treatment. Aust J Physiother. 1998;44(3):181–186. DOI:

Kogan JR, Holmboe ES, Hauer KE. Tools for direct observation and assessment of clinical skills of medical trainees: a systematic review. JAMA. 2009;302(12):1316–1326. DOI:

Kollhoff M, Owings CS, Cathcart-Rake W.Preparing Medical Students for the Medical Interview. Kansas Journal of Medicine. 2017;10(1):22. DOI:

Korpi H, Piirainen A, Peltokallio L. Practical work in physiotherapy students’ professional development. 2017;18(6):821–836. DOI:

Lærum E, Indahl A, Skouen JS. What is “the good back-consultation”? A combined qualitative and quantitative study of chronic low back pain patients’ interaction with and perceptions of consultations with specialists. J Rehabil Med. 2006;38(4):255–262. DOI:

Landis JR, Koch GG. An Application of Hierarchical Kappa-type Statistics in the Assessment of Majority Agreement among Multiple Observers. Biometrics. 1977;33(2):363. DOI:

Liaw SY, Ooi SW, Rusli KD bin, Lau TC, Tam WWS, Chua WL. Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Trial on Team Communication and Teamwork Attitudes. J Med Internet Res. 2020;22(4). DOI:

Lonsdale C, Hall AM, Murray A, Williams GC, McDonough SM, Ntoumanis N, Owen K, Schwarzer R, Parker P, Kolt GS, Hurley DA. Communication Skills Training for Practitioners to Increase Patient Adherence to Home-Based Rehabilitation for Chronic Low Back Pain: Results of a Cluster Randomized Controlled Trial. Arch Phys Med Rehabil. 2017;98(9):1732-1743.e7. DOI:

MacDonald-Wicks L, Levett-Jones T. Effective teaching of communication to health professional undergraduate and postgraduate students: A Systematic Review. JBI Libr Syst Rev. 2012;10(28 Suppl):1–12. DOI:

Martin KD, Roter DL, Beach MC, Carson KA, Cooper LA. Physician communication behaviors and trust among black and white patients with hypertension. Med Care. 2013;51(2):151–157. DOI:

Michels MEJ, Evans DE, Blok GA. What is a clinical skill? Searching for order in chaos through a modified Delphi process. Med Teach. 2012;34(8). DOI:

Miciak M, Mayan M, Brown C, Joyce AS, Gross DP. The necessary conditions of engagement for the therapeutic relationship in physiotherapy: an interpretive description study. Arch Physiother. 2018;8(1). DOI:

Montaño-Fidalgo M, Froján-Parga MX, Ruiz-Sancho ME, Virués-Ortega J. El Proceso Terapéutico “Momento a Momento” desde una Perspectiva Analítico-Funcional A “Moment-to-Moment” Analysis of the Therapeutic Process Using a Functional-Analytic Approach. 2011;22:2011–101. DOI:

Mumtaz S, Zahra T. Role-play as a learning modality in Pakistan. Clin Teach. 2016;13(2):124–129. DOI:

Parry RH, Brown K. Teaching and learning communication skills in physiotherapy: what is done and how should it be done? Physiotherapy. 2009;95(4):294–301. DOI:

Przymuszała P, Marciniak-Stępak P, Cerbin-Koczorowska M, Borowczyk M, Cieślak K, Szlanga L, Zielińska-Tomczak Ł, Marciniak R. ’Difficult Conversations with Patients’-A Modified Group Objective Structured Clinical Experience for Medical Students. Int J Environ Res Public Health. 2021;18(11). DOI:

Roberts LC, Whittle CT, Cleland J, Wald M. Measuring verbal communication in initial physical therapy encounters. Phys Ther. 2013;93(4):479–491. DOI:

Shahnazi H, Araban M, Karimy M, Basiri M, Ghazvini A, Stein L. A quasi-experimental study to improve health service quality: implementing communication and self-efficacy skills training to primary healthcare workers in two counties in Iran. BMC Med Educ. 2021;21(1). DOI:

Soundy A, Hemmings L, Gardiner L, Rosewilliam S, Heneghan NR, Cronin K, Reid K. E-learning communication skills training for physiotherapy students: A two phased sequential mixed methods study. Patient Educ Couns. 2021;104(8):2045–2053. DOI:

Stentoft D. Problem-based projects in medical education: extending PBL practices and broadening learning perspectives. Adv Health Sci Educ Theory Pract. 2019;24(5):959–969. DOI:

Talwalkar JS, Fortin AH, Morrison LJ, Kliger A, Rosenthal DI, Murtha T, Ellman MS. An Advanced Communication Skills Workshop Using Standardized Patients for Senior Medical Students. MedEdPORTAL. 2021;17:11163. DOI:

Tavakoly Sany SB, Behzhad F, Ferns G, Peyman N. Communication skills training for physicians improves health literacy and medical outcomes among patients with hypertension: a randomized controlled trial. BMC Health Serv Res. 2020;20(1). DOI:

Tongue S. Every day brings a first impression. Nurs Stand. 2007;22(4):62. Available at: Accessed July 1, 2022.

Vargas-De La Cruz I, Pardo-Cebrián R, Sánchez HM, Froján-Parga MX. Rule Emission: A Possible Variable for Improved Therapeutic Practice. Span J Psychol. 2018;21. DOI:

Virues-Ortega J, Montaño-Fidalgo M, Froján-Parga MX, Calero-Elvira A. Descriptive analysis of the verbal behavior of a therapist: a known-group validity analysis of the putative behavioral functions involved in clinical interaction. Behav Ther. 2011;42(4):547–559. DOI:

Wilkinson SM, Leliopoulou C, Gambles M, Roberts A. Can intensive three-day programmes improve nurses’ communication skills in cancer care? Psychooncology. 2003;12(8):747–759. DOI: