The influence of augmented gaze on nursing telehealth appointments: an experiment

Background: While research has shown that where a person’s gaze lingers when communicating through video conferencing software influences perceptions those viewing that person’s communication, the influence of gaze in telehealth has never been investigated. This study explores the influence of a nurse practitioner’s gaze, specifically simulated eye contact during telehealth interactions, on people’s perceptions of nurse practitioner credibility (competence, caring, and trustworthiness) and attitudes toward telehealth. Using expectancy violation theory as a framework, the study also examines whether a nurse practitioner’s direct gaze and an individual’s previous telehealth experience influence these perceptions. Methods: The study employed an experimental design where participants were exposed to telehealth interactions with varying levels of simulated eye contact (direct gaze or no gaze) from a nurse practitioner. Participants’ prior telehealth experience was also measured. A series of analysis of variance (ANOVA) tests with Bonferroni corrections were used to analyze how gaze and telehealth experience impacted perceptions of a nurse practitioner’s competence, caring, trustworthiness, and attitudes toward telehealth. Competence, caring, and trustworthiness were assessed with the source credibility assessment and attitude towards telehealth was assessed with the generalized attitude scale with telehealth as the referent. Results: Participants with prior telehealth experience rated the nurse practitioner as more competent and trustworthy and had more favorable attitudes toward telehealth services compared to those without prior experience. Bonferroni corrections revealed that simulated eye contact significantly affected perceptions of competence, caring, or trustworthiness only when participants were new to telehealth. Conclusions: While gaze alone had limited direct impact, prior telehealth experience significantly shaped the perceived credibility of a nurse practitioner and telehealth services. Simulated eye contact should be emphasized in telehealth training, particularly for new patients, to foster trust and improve engagement. Telehealth providers should account for patient experience when designing strategies to enhance patient satisfaction.