Fogarty et al. already demonstrated the

effect of short segments of empathy to decrease psychological arousal in clinical communication [6]. Our study further elaborates on this finding by showing that a few empathic remarks also have the power to affect physiological activity of APs’ SNS. These insights might be valuable to clinicians. Firstly, activation of the SNS is known to influence patients’ well-being [1]. Secondly, the effect of a core aspect of clinical communication, conveying medical information [52], can be severely hampered LY2109761 purchase due to the effect of SNS activation on patients’ memory [18]. As expected from prior research (e.g. [28]), affective communication did not only affect AP’s physiological arousal, but also improved APs’ recall of provided information, potentially partly by reducing physiological arousal. Notably, recall was only improved for information that was provided during the part of the consultation where the clinician HDAC inhibitor used affective communication and physiological arousal was lowered; 21% of the variance in recall could be explained by variance in physiological arousal. This might be an indication that patients’ psychophysiological responses to clinicians’ communication play a mediating role in the effectiveness of affective communication, more specifically in improving recall. Although we have not tested the connection between physiological arousal and recall

directly, our results illustrate the often emphasised importance of addressing patients’ emotions in clinical communication [52] and suggest that clinicians need to deal with patients’ emotions before providing additional

medical information to them. The strength of this study is the use of an experimental design, which allowed us to investigate the causal effect of communication in a bad news consultation. Another strength is the measurement of physiological arousal [50], since it offered the opportunity to get a better understanding of the mechanisms underlying patients’ cognitive and Thiamet G emotional processes during bad news consultations. Last, it allowed us to investigate the effects of specific communication elements more objectively and in different parts of the consultation [31] and [44]. The study also has some limitations. Although the analogue patient paradigm allowed us to use an experimental design, it might lowered the ecological validity of the results, as our results are based on findings from healthy participants, not clinical patients. Although a recent review study demonstrated that using APs do seem to be valid [41], clinical patients might react differently. However, in case of real bad news consultations, physiological responses might even be stronger and information recall further hampered, thus enhancing the potential alleviating role of affective communication. This has to be tested in clinical studies.