From the Guidelines
Open-ended questions are the most effective physician communication tactic for collecting accurate information during a difficult medical interview. By asking questions that require more than a simple yes or no answer, such as "Can you tell me more about what happened before you came to the office?" or "How would you describe your symptoms?", you encourage patients to share their experiences in their own words 1. This approach allows patients to provide a narrative of events without the physician imposing preconceived ideas or leading them toward particular responses. Open-ended questions create space for patients to reveal important details they might otherwise omit if only responding to specific, closed questions. Additionally, this technique builds rapport and demonstrates that you value the patient's perspective, which can help overcome communication barriers and increase the patient's comfort in sharing sensitive or complex information. Some key strategies to enhance information collection during a medical interview include:
- Avoiding unnecessary delays in providing information 1
- Communicating with consultants and others involved in the patient’s care to ensure coherent recommendations and information 1
- Using simple language tailored to the patient’s educational level and avoiding jargon 1
- Providing information in small doses, stopping frequently, and checking for comprehension 1
- Checking for understanding by using a “teach back” or “talk back” method 1 When patients feel heard and respected, they're more likely to provide comprehensive and accurate accounts of their medical concerns. Allowing patients to speak without interruption or redirection can also help gather important information, as they are likely to express multiple concerns per office visit 1.
From the Research
Effective Communication Strategies
To collect accurate information during a medical interview with a patient who is having difficulty recalling events, the following physician communication tactics can be employed:
- Using visual aids 2
- Writing down key words while speaking 2
- Using gestures 2
- Eliciting the patient's agenda with open-ended questions 3
- Engaging in focused active listening 3
- Expressing empathy and understanding the patient's perspective 3
- Using the "ask-tell-ask" approach to provide small chunks of information 3
Barriers to Effective Communication
Several barriers can impede effective patient-provider communication, including:
- Difficulty physically accessing the nurse call system 4
- Communicating about pain and other needs 4
- Underlying chronic disability or admitting condition 4
- Institutional, communication, environmental, and personal/behavioural related barriers 5
Facilitators of Patient-Centered Communication
To promote patient-centered care and communication, healthcare professionals can:
- Identify and address barriers to effective communication 5
- Use augmentative and alternative communication (AAC) strategies 4
- Work with other members of the health care team to build a "culture of communication" 4
- Engage patients and their companions in defining their preferences for patient-centered communication strategies 2