White Coats Do Not Improve Knowledge Retention from

Health-Informative Video

Clarissa Santiano, Emma Wells, Parthiv Mathur, and Audrey Hills

There has been a lot of research proving placebo effects, including “the white coat effect” where

patients perceive doctors wearing white coats to be more attractive and trustworthy. But how does the

presence of a white coat in an information presentation affect information retention among viewers? We

tested subjects on their knowledge of a health topic before and after presenting them with an

informational video. The video was either presented by a doctor in a white coat or the same doctor in a

normal outfit, but was otherwise the same. We found that the groups who watched the non-white coat

video actually did better than the groups who watched the white coat video. This leads us to believe that

white coats do not improve information retention, but more studies on the impact of the placebo effect of

white coats in knowledge retention in other formats are desired.

drug/treatment that are due to a patient’s belief in its efficacy rather than an actual property of the

drug/treatment. Placebo effects are a puzzling phenomenon considering they can often have a greater

impact on a patient recovering than a well-known surgery. One type of placebo effect studied by Gary

Brase and colleagues (2006) is the “white coat effect”, where patients seem to view people wearing doctor

coats as authority-figures and be more trusting of them, sometimes even seeing better results when treated

by them. However, as far as we know, there has not been a study analyzing the effect of white coats on

knowledge retention—does the placebo effect apply there? The question we sought to answer: how does

white coat presence in an informative presentation affect knowledge retention among viewers? We

hypothesize that knowledge retention will be higher with a white coat present than without because of the

placebo effect. A doctor’s white coat is a symbol of education, credibility, and prestige which would make

the patient more likely to listen to their words as truth and trust them with their health knowledge.

Trusting and learning from people with status symbols, rather than those without, would increase fitness

and be evolutionarily advantageous by ensuring information that informs the way you maintain your

health is legitimate and truthful. This behavioral adaptation where people follow “prestige cues” has been

supported in past studies, leading us to believe it could be present in this scenario.

To collect data for our study, we had a doctor film a short educational video about cholesterol and

statins, which are drugs that can help lower cholesterol. The doctor filmed the video two times: once

while wearing a white coat, and once in standard casual clothing. We then created a short quiz, which

asked questions about cholesterol that were answered in the educational video. We surveyed 71 friends,

family members, and UW students by having them take the quiz testing their knowledge before the video,

watch one of the two educational videos (randomly assigned by picking the number 1 or 2), and then take

the identical quiz again afterwards. We measured performance before and after as well as improvement.

Our control group consisted of the 37 participants who watched the educational video without the white

coat, and our experimental group consisted of the 34 participants who watched the educational video with

the lab coat worn.

subtracted by pre quiz score), which will measure the participants’ knowledge retention. We will then

create two histograms, one each for the control and experimental group which display the change in quiz

scores. We will compare the distributions of each histogram to determine if the educational video with the

white coat had any affect on the knowledge retention of the participants. Additionally, we will control for

pre-video participant knowledge on cholesterol medication by evaluating the percent of potential

improvement obtained by the participants in the two groups according to their score on the pre-test.

If our hypothesis is correct, then the group that watched the white coat educational video’s

histogram distribution will lean further to the right, meaning they experienced a higher change in quiz

score on average, as they likely paid more attention due to the prestige the doctor had (F1). Moreover, we

should see that when we control for pre-test scores, participants in the white coat-viewing group will

consistently obtain a higher proportion of potential improvement after viewing the video (F2).

Consequently, under the null hypothesis there would be no substantial difference in the changes of quiz

scores nor the proportion of potential improvement obtained after controlling for pre-video knowledge for

the participants who watched either educational video (F3; F4).

For our results, on the pre-test, the participants assigned into the non-white coat group (n=34) and

the white coat group (n=37) scored roughly the same (F5). After watching their assigned videos and

taking the post-video quiz, the non-white coat participants scores are more heavily skewed towards the

right relative to the white coat group (F6). Analyzing the raw difference between pre- and post-test scores

reveals that on average, the participants in the control group experienced a greater improvement in their

score after watching their video than the experimental group (F7). Controlling for pre-test scores did not

change the trend. In every pre-test score control condition except for one, the non-white coat group on

average obtained a higher proportion of potential improvement than the white coat group (F8). This

contradicts our predictions and hypothesis as it suggests that the white coat video-viewing participants are

not retaining as much information relative to the non-white coat video group. The one pre-test control

condition that supported our hypothesis is pre-test=0 points. Under this condition, the experimental group
obtained on average 15% more of potential improvement relative to the control. It is important to note

however that the pre-test=0 condition had quite a small sample size relative to the other pre-test

conditions with n(white coat)=1 and n(non-white coat)=4, thus limiting how much significance we can

draw from this finding.

From the data collected, we conclude that individuals who watched the white coat video did not

retain knowledge any better than those who watched the non-white coat video. Contradictory to our

hypothesis, the mean change in pre vs post test scores were slightly higher for the control group (F7).

Additionally, the control group obtained higher percentages of potential improvement controlled for

pre-test scores (F9). Cumulatively, our results do not support our hypothesis, instead supporting the null.

Strengths of our study include that our experimental design minimized any potential bias about selecting

the two educational videos by blinding, as the participants chose which video to watch without seeing

them both. It also controlled for initial knowledge by having a pre-video quiz, which allowed us to record

changes in the pre vs post test scores as a function of knowledge retention from the shown videos. It was

also a novel question, not previously asked which is interesting and worthwhile. However, our study’s

weaknesses include that our educational videos were fast-paced and jargon-heavy, which may have

introduced learning fatigue as an unwanted factor. Some people may have not thoroughly watched the

video, skipping it and lackadaisical finishing the survey just to get it over with, which would’ve made our

data poor and unreliable. For example, one person guessed on the first quiz, but selected “I don’t know”

for all answers on the second quiz, making it possible to get points on the first quiz, but not the second.

Moreover, our sample size was very small and the participants were not representative of the population

as a whole, since they were mostly UW students and our friends, so that introduced bias into our sample.

A few questions remain after the completion of our experiment. First of all, could our hypothesis

still be correct? Our poor data and small sample size might be the only reason we see the trend we did.

Also, is it possible that the prestige attributed to white coats only does not occur in online settings? We

might see white coat’s positive impact on knowledge retention in an in-person setting. Additionally,

would showing the speaker’s whole body, making it a more obvious difference, in the white coat
distinguish them as more prestigious? Although the data collected does not indicate our hypothesis is

correct, answering these questions experimentally will provide a better understanding of the white coat

effect.

Looking ahead, repeating this experiment with a larger sample size and introducing a form of

monitoring to ensure the video is being watched would help us gain clarity on this study’s results. A larger

sample size provides data that more closely represents the population, and also accounts for any outliers.

If the white coat effect only applies for in person situations, then changing the format from online videos

to in-person presentations would provide data that supported our hypothesis. More studies would provide

useful information about what contexts the white coat effect applies, and if it could be a result of adaptive

behavior.
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 Literature Cited

Brase, Gary et al. The White-Coat Effect: Physician Attire and Perceived Authority, Friendliness, and
Attractiveness. Journal of Applied Social Psychology 34: 2469-2481.10.1111/j.1559-1816.2004.tb01987.