Allow the patient to complete their story without interruption!

• Listening earlier on is rewarded by a more efficient and accurate interview later on
• This decreases late-arising problems

Attentive listening allows discovery of more of the patient’s agenda – focusing the later interview

• The components of attentive listening are:

1. Wait Time
   1. Pausing before and after your / your patient’s questions / answers allows…
      1. The Patient: time to think and contribute more
      2. You: time to listen, think and respond effectively
2. Facilitative Response
   1. Neutral facilitative phrases: ‘I see’ ‘go on’ ‘tell me more’
   2. Encourages the patient to say more, demonstrates interest / builds rapport
3. Non-Verbal Skills
   1. Strong clues to our level of interest
   2. Posture, proximity, eye contact, gestures, affect, facial expression, vocal cues (tone, rate, volume)
4. Picking up Verbal and Non-Verbal Cues

Exercise: What is the average time a patient is allowed to continue their opening statement until a physician interrupts them? Why do you think this is?

Exercise: Next interview, make a conscious effort to pause at least 3 seconds when transitioning between your questions and your patient’s answers.  Alternatively, take note of your colleagues’ use of silence and pauses without them knowing.

Exercise: What are some facilitative responses that you use in everyday conversation? What effect do they have?

Exercise: Next time you “time-out” during a standardized patient encounter, take a moment to reflect on your body language, ask your classmates for feedback.

Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (Thrid Edit). London: Radcliffe Publishing.