ArticleGMS journal for medical education2026
Smiling and first impressions in ad hoc entrustment decisions: An avatar-based simulation study.
Article in GMS journal for medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Motivation: Not as easy as it seems.GMS journal for medical education · 2026Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Objective: We aimed to examine how neutral and smiling facial expressions, as indicators of non-verbal first impressions, influence ad hoc entrustment and perceptions of trustworthiness in a person in medical scenarios that demand entrustment decisions. Methodology: Within the framework of entrustable professional activities (EPA), we tested three hypotheses in an online study using avatar simulations. As a pilot study and for reasons of sample accessibility, 268 medical students (67.2% female) read 36 narrative clinical entrustment situations in a randomized order. The participants then had to decide whether to entrust the clinical task to fellow students who appeared in short videos as standardized avatars. For each scenario, two avatars were presented and randomly matched for different facial expressions (Duchenne smile (DS), neutral), genders, and morphologies. The participants also assessed the avatars' perceived trustworthiness. Results: Entrustment and trustworthiness were positively correlated (H1). However, when utilizing mixed-effects models, no significant differences were found between the avatars that displayed a DS and those with a neutral expression regarding positive entrustment decisions (H2) or trustworthiness ratings (H3). Conclusion: We found that trustworthiness was linked to entrustment, which supports previous findings on trustworthiness as a person-related prerequisite for entrustment decisions. Internalized patterns of the DS did not influence the medical students' entrustment decisions in the first-impression situations. This suggests that in ad hoc medical entrustment scenarios, factors such as context or other aspects of a trustee's first impression may shape trustors' decisions.
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