Communicating with Your Patients

Communication may be challenging for some and it can lead to uncomfortable situations if not handled correctly. There are helpful hints out there to assist you with achieving success when communicating with your patients such as Ask-Tell-Ask and Tell Me More.

ASK-TELL-ASK- involves building on the knowledge that your patient may already have when a conversation is initiated. It also helps to build a relationship because it allows the practitioner to listen and talk over what is on the mind of the patient.

ASK- Ask the patient to describe his/her current understanding of the issue. By beginning your conversation with asking an open ended question, this will allow you as the practitioner to gage the knowledge of your patient on the subject matter, the emotional state and the overall degree of education. Some examples of open ended questions include:

• What brings you here today?
• What would you like to discuss today?
• What is the most important issue you would like to discuss today?
• To make sure we are on the same page, can you tell me what your understanding of your disease is?

The questions you are asking are helping you as the practitioner to gain knowledge of your patient so you can better communicate the information you need to.

TELL- It is best to communicate with your patient in a straightforward manner and communicate what it is that you need to. This can be bad news, treatment options, or any other information you believe needs to be conveyed. Avoid medical jargon and do not give information in long sentences with a lot of detail, you may lose your patient along the way. The rule of thumb is not to give more than three pieces of information at a time.

ASK- Asking your patient if he/she understood what you said is important. A good technique is to ask the patient to repeat back what you just said in his/her own words. This will allow you as the practitioner awareness of the patient’s understanding of the information you provided. This also gives you an opportunity to clarify, restate, or elaborate on the information to assure a positive interaction with your patient. Some questions to help identify your patient’s understanding include:

• Who are you going to tell about this visit when you get home?
• To make sure I did a good job in explaining this information to you, what will you tell your family when you get home if you wish to share the information?

TELL ME MORE- Sometimes a conversation can get off track and you as the practitioner may need to bring it back to the right place. You can say something such as “I think we are not on the same track” and ask the patient to explain where he/she is in the conversation. There are three levels of conversation to keep in mind when communicating:

• “What is happening?”- the patient is trying to comprehend the information
• “How do I feel about this?”- the patient may be trying to figure out his/her own emotions, are they valid and what and how can I express myself to the practitioner
• “What does this mean to me?”- an identity conversation; the patient may be trying to figure out what the new information means in terms of his/her self

As a practitioner, if you understand these three levels, you may better understand what is going through the mind of your patient during the conversation. You can ask questions that may help initiate the “tell me more” concept such as:

• Could you tell me more about what information you need at this point?
• Could you tell me what this means for you?
• Could you say something about how you are feeling about we have discussed?

These are just a few recommendations that you may want to adopt into your communication techniques to help you achieve successful conversations when discussing care with your patients.

Resource:
onlinelibrary.wiley.com/doi/full/10.3322/canjclin.55.3.164