This is a time for reflection and action. As individuals, and collectively in our organizations and institutions.
Here’s how we can provide support.
Today, perhaps more than ever, professionals across the health sector are stopping and asking hard questions of ourselves. About what we do, what we take for granted, and how we can do better– in our communities, as professionals, as human beings. And how our organizations and institutions can be reexamined, and possibly transformed.
It is this kind of critical reflection and action that Health Communication Partners was built on, and built for. So today I’m going to show you some of what’s been going on behind the scenes so to speak, when I write for the HCP site and this podcast series. Because reflection and action are both crucial. And any guidance for individuals that doesn’t connect to the larger picture is shortsighted.
This is 10 Minutes to better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel.
It was this time last year, I first started writing and speaking publicly about my framework, which is called building BRIDGES. BRIDGES is an acronym. This approach took me about three years to create. It’s is what I’m about. It’s the fundamentals of what I do. There are a couple elements of this BRIDGES framework that people might find relevant and I’m going to highlight them. This is the “I” in BRIDGES that stands for Inquiry as stance, and the “G” which stands for global and local. I’ll link in the show notes where I explain each of the elements and what they mean, but right now I’m just going to focus on those two, Inquiry as stance and global and local.
Inquiry as Stance is a form of reflective practice, and that was created by my mentor Susan Lytle and her longtime friend and collaborative partner Marilyn Cochran-Smith. I’m not going to try to summarize it right now, just to say that today what I want to focus on is the idea of reflection and action.
The second one is “global” and “local” and those terms have particular meaning in the literacy research traditions I come from. For now, it might be helpful to think of them in terms of “local” meaning at the individual level and “global” meaning at the collective or organizational level. Both are important to keep an eye on, at all times, and it’s the interplay of the global and local that I try to pay special attention to.
So we have reflection and action, then local and global. Right now I’m going to show you how everything on Health Communication Partners is about reflection and action at the local and global levels. I’m just going to break it down, and I’ll give you examples from podcast episodes or from some of the site articles.
So we’re gonna start with reflection at the local level.
Now anytime I put up an episode or article that have the words ‘reflective practice’ in the title it winds up at the top of the charts in terms of popularity. But I’ll let you in on a little secret: every episode and every article is about reflective practice. Everything on this site and series invites you to look at what you’re already doing, to get at your taken-for-granted beliefs and assumptions beneath your words and actions.
How do I do this? in every post and episode I provide structure–research, questions, and ways to unpack the many activities you engage in that are part of your practice, with your patients or clients, specifically the ones related to communication, education and health literacy, right? That’s so that you can reflect on them–and decide for yourself if there’s something that you want to change.
For example, I’m often inviting you to think about your own communication, and the assumptions you hold about yourself, about your patients or clients or the public, and about what you are doing together. We don’t often get a chance to think about or articulate our assumptions. But when we do, we can begin to see places where we’re not living up to our own standards–as well as some opportunities to do better.
This doesn’t have to be complicated or fussy. For instance, in the episode When it feels like a culture gap between you and your patient I ask you to stop and think of one idea, or fact, or process, that you explain often when you’re educating a patient or client or the public. Then I show you ways to reflect on or unpack this one thing, and why this reflection is important to reaching all of your patients, all of your clients, all of the public.
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Now, reflection on a global level. In addition to having you reflect on your own practice, I ask you to acknowledging the status quo where you are, and then start questioning it. I encourage you to question structures, processes, arrangements, and common practices wherever you are. I challenge you to view those current arrangements not as given or natural, but as the result of human action, or inaction, and as politically and historically situated.
There’s political forces that can help maintain status quo in terms of what gets talked about, written about, taught, or funded. And what doesn’t. There’s social pressure from within the profession against any out-of-the-norm ways of practicing, connecting with patients or understanding and enacting your commitment to them. I am grateful to the many health professionals who have spoken frankly with me about these and other issues, issues they tell me that are sometimes wrapped in silence. Overall, when I invite you to reflect at a global level, I’m encouraging you to take a critical view of the customary practices and conventional arrangements in your context–and at how these are related to larger social issues.
Now…let’s turn to action! Because that’s what we do.
Action on a local level. I help you look at what you are already doing, not just so you can look at it, but so that you could see what you could do differently to be more effective in locally meaningful ways. I offer different tools, tactics, tips, and processes for how you can take steps from where you are, to where you want to be.
One episode that’s been popular lately is called “How ordinary conversations in healthcare may contribute to health disparities.” In that episode I discuss research on the subtle ways that well-meaning health care workers can provide unequal treatment without noticing. That’s the reflection part. And then I turn to action and tell you how we can watch out for these subtle ways, so we can catch ourselves in the act of implying negative messages that we don’t intend. Another example is the episode “Do you make these 6 mistakes in your cross-cultural communication? In that episode I take, yep, 6 common pitfalls when it comes to communicating across difference. We look at how they show up, and why they matter – that’s the reflection part. Then I suggest what you can do to avoid them—the action part. Every episode does this turn to action, so I could give 70-something more examples but I won’t. In part because, well–just go listen to them. But also I want to get to action on a global level.
Because individual level efforts must be matched and supported by systems-level action. It would be setting a low bar to give you advice that doesn’t keep an eye on the larger picture. Or to otherwise treat you as passive recipients of the fallout from decisions made elsewhere. You have agency, so do your patients, so does the public. So do I. I encourage you to grasp this agency—including your agency in institutional and organizational contexts.
Everything at HCP is situated in social, cultural, political, economic, and organizational structures and processes. One popular episode that foregrounds organizational level action is called “3 hints for organizations offering implicit bias training where I give you yes 3 things to keep in mind about taken for granted structures and processes at your organization. These can be helpful if you are part of a team planning implicit bias training. These also can be helpful ways to think about any such training that you’re participating in.
Another is Tackling some structural issues in interprofessional communication, where I talk about some institutional-level constraints on successful interprofessional communication. Now, you can probably imagine some right now off the top of your head, and maybe I talk about them, maybe I get into some that you hadn’t thought about. But as usual I turn to action and suggest specific steps you could take to either work within these constraints—or maybe start to get around them and build new structures.
I want to be careful not to oversimplify a very complicated set of problems. But it is possible for health communication, patient education, and health literacy resources to support you in the immediate needs of your day to day practice, and still help you look upstream, at larger issues to which your practice is connected—and act on individual and organizational levels.
Such work is gonna take collaboration, and different kinds of expertise. But I suspect the same is true when dealing with any complex problem in the world. That is part of what I seek to do here, and I invite you to contribute from wherever you are. I want to hear your thoughts and questions. And I want to help. If your organization could use some of the support I’m talking about here, contact me. This is what I do. This is 10 Minutes to Better Patient Communication from Health Communication Partners, and I’m Dr. Anne Marie Liebel.
Image by Patrick Behn