Purpose: This study aims to explore the role of interactants' nonverbal sensitivity, anxiety and sociodemographic characteristics in learning and satisfaction within the genetic counseling context. Design/methodology/approach: This is a combined simulation and analogue study. Simulations were videotaped with 152 prenatal and cancer genetic counselors and nine simulated clients. The videotapes were shown to 559 subjects recruited to act as analogue clients (ACs) with the instruction to imagine themselves as the client in the simulation. The profile of nonverbal sensitivity (PONS), a video and audio test of accuracy in the interpretation of nonverbal cues, was administered to both the genetic counselors and ACs. In addition, the ACs completed a literacy screen and post session measures of learning and session satisfaction. Findings: The study finds that ACs' post-session knowledge score was positively associated with both their own and the counselors' audio PONS scores. Also related to knowledge were clients' literacy, younger age and non-minority ethnicity. Ratings of session satisfaction were inversely related to ACs' and counselors' video PONS scores and ACs' literacy and anxiety. Research limitations/implications: While based on the performance of a large number of practicing genetic counselors, simulated and analogue clients are used to explore study questions. Practical implications: The nonverbal sensitivity of both providers and ACs plays a role in medical communication and its cognitive and affective consequences. These findings warrant greater attention to nonverbal dynamics in future research and interventions. Originality/value: No similar studies have investigated the role of nonverbal sensitivity in predicting learning and satisfaction for users of health care services. (Contains 5 tables.)