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The Hawthorne Effect in Direct Observation Research with Physicians and Patients
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Jul 28 2017
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Source: J Eval Clin Pract. 23(6):1322-1328.
Details:
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Alternative Title:J Eval Clin Pract
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Description:Rationale, Aims, and Objectives
This study examines the degree to which a “Hawthorne effect” alters outpatient-visit content.
Methods
Trained research nurses directly observed 4454 visits to 138 family physicians. Multiple data sources were used to examine the Hawthorne effect including: differences in medical record documentation for observed visits and the prior visit by the same patient, time use during visits on the first versus the second observation day of each physician, and report by the patient, physician, and observer of the effect of observation.
Results
Visits on the first versus the second observation day were longer by an average of 1 minute (p<.001); there were time-use differences for 4 of 20 behavior categories evaluated. No effect of the observer on the interaction was reported by 74% of patients and 55% of physicians. The majority of those that reported an affect indicated it was slight. Patients with non-white race, lower educational level and poorer health were more likely to report being affected by the observer.
Conclusions
In a study that was designed to minimize the Hawthorne effect, the presence of an observer had little effect on most patient-physician visits, but appeared to at least slightly effect a subgroup of vulnerable patients.
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Pubmed ID:28752911
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Pubmed Central ID:PMC5741487
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