Beyond Bedside Manner: Defining Clinical Presence from the Patient's Perspective

Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Organization Development & Change (D.O.D.C.)

Department

Organization Development

First Advisor

William O'Brien (Committee Chair)

Second Advisor

Frances Baldwin (Committee Member)

Third Advisor

Margaret Brooks (Committee Member)

Fourth Advisor

Rachel Vannatta (Other)

Abstract

Clinician presence (CP) has emerged as a critical yet underexplored dimension of the patient-clinician relationship, with implications for patient trust, satisfaction, and health outcomes. While prior scholarship has examined presence primarily through the lens of clinician intent and expert consensus, the patient's perspective has remained absent from the literature. This study addresses that gap by investigating how patients define, experience, and perceive clinician presence during healthcare encounters. Using the Enhanced Critical Incident Technique (ECIT), semi-structured interviews were conducted with 16 participants who described specific, memorable experiences with healthcare clinicians across a range of clinical settings, including specialist consultations, primary care visits, and procedural preparation. Data were analyzed through an eight-phase manual thematic analysis process, resulting in a comprehensive codebook grounded in participant narratives. The analysis yielded nine behavioral dimensions of clinician presence as perceived by patients: Emotional Attunement, Unhurried Demeanor, Personalized Recognition, Adaptive Nonverbal Communication, Respectful Touch, Active Listening, Patient Education, Shared Decision Making, and Professional Humility. These dimensions were compared against two established clinician-centric frameworks, Brown-Johnson et al. (2019) and Zulman et al. (2020), revealing both meaningful convergence and important gaps, most notably the absence of Respectful Touch. Patient Education, and Professional Humility from prior models. The findings advance the field by providing a patient-validated behavioral model of clinician presence that moves beyond clinician intent toward observable, teachable, and measurable behaviors. The implications of this research extend to clinical training, organizational development, and healthcare policy, offering a practical foundation for cultivating the human connection that lies at the heart of effective medical care.

Link to Full Text

Share

COinS