Active Listening in Healthcare

1. Non-listener
2. Marginal listener
3. Evaluative listener
4. Active listener.

(Hunsaker et al. 2008 as cited in Jahromi et al. 2016)

Active listening is the highest attainable listening category. At its core, active listening has three main criteria:

1. Demonstrating clear interest in a speaker’s message through non-verbal signals.
2. Refraining from judgment and reflecting the speaker’s message using verbal paraphrasing: e.g. ‘Correct me if I’m wrong, but what you’re saying is…’
3. Asking the speaker to elaborate on their beliefs, feelings, and experiences.

(Weger Jr. et al. 2014)

How to be an Active Listener

The role that active listening plays in effective communication is to signify to another person that what they’re saying is important. This is achieved through using verbal and non-verbal cues.

Verbal Cues

• Verbal encouragement (non-obtrusive words such as ‘I see’)
• Attentive silence
• Reflecting a speaker’s feelings and content
• Intelligently summarising the speaker’s words and purpose.

(Jahromi et al. 2016)

Non-Verbal Cues

Using body language to show involvement through:

• Attentive posture
• Facial expressions
• Maintaining eye contact.

(Jahromi et al. 2016)

What is the Evidence for Active Listening?

A 2014 study on the effectiveness of active listening used 115 participants to test the impact of three types of responses used in conversation: active listening, advice and simple acknowledgements.

The results indicated that participants who received active listening responses felt more understood than participants who were provided with advice or acknowledgements. Additionally, rates of satisfaction in the conversation were considered higher in participants who received active listening or advice (Weger Jr et al. 2014).

Furthermore, participants who scored highly on a measurement called the Active Empathetic Listening scale (AEL) positively aligned with other attributes including social expression, social sensitivity, emotional sensitivity and social control. These measures are interlinked with a wide range of positive interaction and relationship outcomes (Weger Jr et al. 2014).

Phrases to Embrace

‘Tell me more about that.’

‘How did you feel when that happened?’

Points to Consider

• It's estimated that although listening accounts for a significant amount of our communication, we retain less than 25% of the information we hear.
• You can’t fully focus all your attention on the speaker when you are multitasking.
• Try not to pontificate - instead, go into a conversation with the mindset that you have something new to learn, which you do.
• Use open-ended questions rather than telling the speaker how they feel.
• Focus on the context of the speaker without thinking about your own feelings and experiences.
• It’s not that you shouldn’t give advice, it’s that if you’re waiting for a break in the conversation to give advice, you’re being a poor listener.
• In a clinical setting, it may be inappropriate to draw parallels from the speaker’s experience to your own - studies have found that patients do not find this helpful.

(Ahern 2017)

Conclusion

Listening attentively and responding empathically so a person feels heard is crucial in healthcare settings, as patients are in a vulnerable position and therefore might have difficulty voicing their concerns.

As you are in the position of power as a healthcare worker, you should a) create an environment that feels safe to talk in, b) encourage the other person to talk openly, and c) listen actively.

Watch the following Ted Talk - Celeste Headlee’s: ‘10 Ways to Have a Better Conversation’: