The focus of Unit 5 is on active listening and nonverbal awareness.
Learning Objectives:
By the end of this unit, you will be able to:
- Apply active listening techniques (paraphrasing, summarizing, reflecting, clarifying, and asking open-ended questions).
- Enhance clarity in your explanations to ensure understanding.
- Recognize the role of nonverbal communication, both in its perception and production.
Active listening is a communication technique where the listener focuses entirely on the speaker, showing understanding, providing feedback and avoiding distractions.
Key active listening techniques include:
Paraphrasing: Restate what the speaker has said in your own words. This shows that you are listening and helps confirm your understanding. For example, “So what you’re saying is that you’re concerned about the side effects of this medication?”
Summarizing: Provide a brief recap of what has been discussed so far. This can help ensure that everyone has understood the discussed matters in the same way. For example, “Let’s go over what we’ve talked about: you’re worried about the medication, and you would like more information on its potential side effects.”
Reflecting: Reflect the speaker’s feelings back to them. This can help the speaker feel understood and validated. For example, “It sounds like you’re feeling anxious about this treatment.”
Clarifying: Ask questions to clear up any confusion or ambiguity. This ensures that you have understood the speaker correctly. For example, “Can you clarify what you mean when you say the pain is unbearable?”
Asking open-ended questions: Encourage further discussion and ensure understanding by asking questions that cannot be answered with a simple ‘yes’ or ‘no.’ For example, “Can you tell me more about how you’re feeling right now?” These types of questions invite more thoughtful, detailed responses and help foster a deeper understanding of your interlocutor’s thoughts and feelings.
Refer to the Reflecting, Paraphrasing Phrase Guide and the Active Listening Phrase Guide in the Extra Resources section.
Pause for Thought
In a multicultural healthcare setting, culture significantly influences how active listening is practiced and interpreted.
How can active listening in healthcare be adapted to account for cultural nuances in non-verbal communication, emotional expression, eye contact and decision-making processes to create a more inclusive and empathetic environment for patients?
Refer to the Cultural Misunderstandings file in the Extra Resources section.
Clarity in explanation
Clear explanations are critical in healthcare to avoid misunderstandings and ensure patients and families make informed decisions.
Use simple, non-technical language: Avoid jargon or overly complex medical terms. For example, instead of saying hypertension say high blood pressure, dyspnea – shortness of breath, etc.
Break down information: Present information in small, manageable chunks to avoid overwhelming the listener. Use simple sentences and provide one piece of information at a time.
Ask for feedback: To ensure the person has understood, ask them to repeat the information in their own words. For example, “Can you tell me what you understand about the treatment plan?”
Linguistic point: Be careful to pronounce clearly/write down critically important numbers. Some nationalities (e.g. Polish) may have problems with distinguishing between long and short vowels, including between numerals ending in “-een” and those ending in “-y” (for example fourteen/forty).
Pause for Thought
Think how you would break down the explanation of, for example, gastroscopy (or other procedure), into clear, manageable chunks, easy to understand for the p,atient.
„Nonverbal behavior is a key component of communication. Nonverbal behaviors are the elements of an interaction besides the spoken word, including gestures, facial movement, body position, interpersonal distance, appearance cues, vocal cues, and even characteristics of the environment. In essence, nonverbal behavior includes everything but the words; it’s not what is said but how people sound and behave while saying it, and what is conveyed even when not speaking at all. As in all interpersonal communication, in clinical communication between patients and healthcare providers, a great deal of information is conveyed through nonverbal behaviors. It is impossible NOT to communicate nonverbally, because observers will draw inferences about the meaning of one’s nonverbal behavior whether one intends them to or not.”1
Being aware of nonverbal cues can help you better understand a patient’s emotional state, needs or level of understanding.
Pay attention to the patient’s:
- Body language – posture, gestures and overall body movement.
- Facial expressions – watch for subtle changes in facial expressions to gauge a patient’s emotional state.
- Tone of voice and eye contact.
Practicing nonverbal self-awareness in everyday work involves being mindful of your body language and how it influences your interactions with patients.
Before or after patient interactions, take a moment to reflect on how you were presenting yourself. Were your posture and facial expressions aligned with the message you intended? Regular self-reflection can help you become more conscious of your body language.
Mirroring the patient’s body language subtly can build rapport and make them feel understood. For example, if they lean forward, you can do the same, which often makes the interaction feel more connected. Ensure it’s done naturally.
Be aware of personal space. In some cultures, standing too close can feel intrusive, while others may expect closer proximity.
Be conscious of your tone of voice and speed of speech.
Key Takeaways
By the end of this unit, you should have a deeper understanding the importance of
– effective communication in healthcare, focusing on active listening
– understanding of nonverbal cues
– self-awareness of own nonverbal expression
Next Steps
- Do the exercises.
- Participate in Role-play Simulation 5, practicing effective communication skills.
- Share reflections and key takeaways during debrief.
D. Blanch-Hartigan, et al., Measuring nonverbal behavior in clinical interactions: A pragmatic guide, Patient Educ Couns (2018), https://doi.org/10.1016/j.pec.2018.08.013