Goals:

• Provide explanations that relate to your patient’s perspective
• Discover your patient’s thoughts and feelings regarding the information given
• Encourage an interaction with your patient (not a one-way transmission)

Relate your explanation to your patient’s perspective

• Patient’s perspective: previously elicited ideas, concerns, and expectations
• Understanding, satisfaction, and compliance will all suffer if your explanation does not address your patient’s concerns

‘You mentioned early that you were concerned about angina. I can see why you might have thought that, but in fact I think you are having muscular pain. Let me explain why…”

Exercise: How might your patient react if you make the correct diagnosis and provide treatment, but fail to explicitly address their main concern? Brainstorm the many possible outcomes.

Provide opportunities and encourage your patient to participate

• Encourage/prompt your patient to ask questions, seek clarification, or express doubts regarding the information you are providing them
• Respond supportively

‘What questions does that leave you with? Is there something I haven’t covered or explained? … Yes, that’s an important question and I’m glad you asked it. I’ll try to explain that for you’

Pick up and respond to verbal and non-verbal cues

• Most patients use oblique or indirect hints to express their doubts or questions
• E.g. patient’s need to contribute information or ask questions, information overload, distress

‘You seem unhappy, are you worried about the possibility of having surgery?’

Elicit your patient’s beliefs, reactions, and feelings regarding the information you’ve given

• Acknowledge and address these supportively

‘Does that leave you with any concerns or doubts?’