Einstein famously promoted the value of curiosity, in life and in scientific endeavor. This episode asks you to try taking an attitude of curiosity–toward patient knowledge.
Patient or ‘lay’ knowledge is an important part of patient communication. And wow, does it vary widely.
I’m inviting you to think about how you take up and make sense of what patients tell you about their background knowledge and experience. Yes, even those times when you can hardly believe what you’re hearing.
How you process what patients are sharing can make a world of difference to the impact of your patient communication, education, and relationships. In this episode you’ll learn four ways that taking an attitude of curiosity toward your patients’ background knowledge can help your practice.
Hi This is 10 minutes to better patient communication. I’m Dr. Anne Marie Liebel.
In this series, I take one communication question or issue that doctors have raised, dig deeper into with some research, then give you a strategy that you can use in your practice today. And I do it all in about 10 minutes.
When I’m talking with health care providers, it’s almost inevitable that at some point, the conversation turns to their frustrations. Over what they see as the disconnects, or gaps between them and their patients. And their related doubts about their ability to bridge those gaps, or make the connections they wish to make.
One of the topics that seems to have great frustration potential is patient knowledge. Sometimes called lay knowledge, or consumer health information depending on your context.
When you listen to your patients, you’re often listening with a purpose.
You may be listening for specific information. You may have your attention tuned to those details that will inform your next steps.
That is to say, you’re likely trying to process what your patient is telling you in such a way that helps everyone move forward.
How about when a patient shares their background knowledge? even if it doesn’t conform to the latest medical knowledge? How are you listening to it? How are you making sense of it?
So in this episode, you’ll learn how doing one thing that might feel counter-intuitive can actually help you bridge the gap between you and your patient. What is it?
As one of my professors, Vivian Gadsden used to say, ‘pretend, for a moment, that you don’t know so much.”
I’ll tell you how being curious, just for a moment, about a patient’s knowledge can improve your practice. In no less than 4 different ways.
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There are plenty of pressures against your listening to patients and taking seriously what they say. Time is a big one. Language or culture can be another.
There’s also history, or the weight of tradition, in clinical medicine. There’s the separation of medical knowledge from lay knowledge. I’m really not sure what the current relationship status is between those two bodies of knowledge but I’m guessing it might not be a close and cozy one.
There’s the traditional separation of ‘hard’ and ‘soft’ data—where the patient’s knowledge might fall in the latter category.
Now I’m not getting into how accurate or relevant some patient knowledge is. Nor am I drawing distinctions between knowledge, beliefs, and assumptions.
I’m telling you that eliciting your patients’ background knowledge— whatever it is, whatever its source–can help you and your patient. Here’s 4 ways how getting curious can help your practice.
#1 So you want to be more patient-centered?
You’re well aware of patient-centeredness, a decades-long move from a focus on disease to a focus on the patient as a whole person.
The term patient-centered can mean many things, depending on which model you look at. But all models include a focus on the patient’s perspective or knowledge. Some include the patient’s experience more broadly.
Patient’s knowledge is also important as one of the key characteristics of shared decision-making (SDM): that both parties share information.
However, in these information sharing parties, patients’ contributions are often limited to opinions and preferences. Certainly these are important. But they are not the same as knowledge and experience.
Furthermore, one research review indicates that “much of the SDM literature focuses on what the professional says, with less attention given to what the patient says.”
It makes sense that your view on a patient’s condition and care is given authority. But that does not mean patient knowledge lacks merit.
In fact, a growing body of studies find that patients’ knowledge itself is an important source of professional learning for practitioners.
Of course, there may be significant differences between your knowledge of the problem, and your patient’s. But both of your knowledge is important.
So try being curious about what your patient brings to the table.
#2 So you want to be more effective in your patient education?
Like it or not, Patients’ knowledge is going to guide their thoughts and actions when they leave you. A study in chronic self-care points out that “The patient’s knowledge and expertise is critical to grounding, integrating and complementing technical-medical/clinical knowledge in everyday chronic self-care.”
I’ve heard several providers mention that patient education should to ‘get patients from A to B.’ If that’s the case, consider patient knowledge as an important part of A.
Effective education links the known to the unknown.
You may have heard of mental schemas, or Vygotsky’s “zone of proximal development” (ZPD). These and other similar theories of learning suggest we learn best when there are explicit connections between what we already know and the new information.
Patient knowledge is the basis for their self-care. Being curious about your patient’s knowledge allows you to find maybe some unexpected places to make links from what they know, to what you believe they need to know.
#3 So you want to have stronger patient relationships?
Learning about a patient’s background knowledge is more than a shrewd strategic move.
As human beings, we want to be heard and understood. Listening closely, and asking thoughtful questions in order to understand someone’s background , is a profound sign of respect.
We seek to be listened to and understood on our own terms. One long term study in England concluded that “For the patient, whether their own knowledge (whatever its source) is acknowledged or accepted by their health-care provider can be crucial.”
Being respectfully curious about someone’s life experiences? That sounds like good relationship building even outside the clinical encounter.
#4 So you want to be a better communicator?
Here’s a pro tip: if you want to be a better communicator—even when patients have cultural or linguistic differences from you—listen when your patients explain their background knowledge.
And take some good notes.
Listen for the specific language your patients use to explain things. Capture as accurately as possible:
- interesting turns of phrase
- powerful images
- metaphors you thought were helpful
- unique connections they made
Why do you want to do this? So many reasons! It’s a win-win-win-win
You’ve just paid someone the respect of asking they a question and listening closely to what they say
Also, This becomes a bank of language for you to use with other patients. That is, in other patient encounters, you can use the actual phrases your patients used. You may even phrase it that way: “One of my patients said it felt like an ice cold balloon was in her stomach.”
You get some real-life examples of alternatives to medical terminology. You may even deepen your professional knowledge in the meantime.
You are indirectly helping your patients learn from each other by using—and sharing–their language.
Make knowledge sharing easy on both of you
- Ask your patient what they already know about the topics on the agenda.
- Consider some non-didactic and open communication
- Remember to be authentic in your asking—that includes being aware of your body language and tone of voice.
- Use your professional judgement to hear the value in your patient’s knowledge, whatever its source.
- To go from A to B, start with what your patient knows, and make an explicit connection to what you have to say
I invite you to approach patient knowledge with a humble, respectful sense of curiosity. See what you might learn.
If you’re listening on itunes, let me know your thoughts. do the rate and review. Leave stars, write something in the box. I read them! On health communication partners dot com, leave a comment and let us know what you think. I’m Dr. Anne Marie Liebel. This has been “10 Minutes to Better Patient Communication”