The skill of Listening (It’s always active)

I haven’t written a blog for a while but I thought I would turn one of my twitter threads into a blog due to it’s importance clinically, plus I get fed up with seeing the term ”active listening” on twitter. LISTENING is always active, it requires you to pay attention and use your brain, whilst hearing is passive and is a function of the ears.

Hearing is reception
Listening is action of the brain

To listen you have to be a receptive participant, listening takes part whist you are SILENT (not surprisingly LISTEN is made up of the same six letters) and another speaks. It is important not to feign listening, whist simply preparing to ask your next question. Listen with the intent to seek to understand (PATHOS).

I have recently proposed that changing our paradigm from ”taking” a person’s history to ”receiving” a person’s history will allow clinicians to listen to the persons narrative without frequent interjection.

I have proposed the simple INTENT/RELEVANCE cycle as an exercise clinicians can practice to allow receptive listening. Basically as a clinician you must ask a question with INTENT (knowing WHY you are asking) the questions should more than likely be open ended. The listen to the person and their answer. Your next question can only be asked about the persons response. it’s a fun game to play with colleagues, and I use it on my courses.

Another useful clinical tool to utilize with listening to a persons narrative is the process of paraphrasing. After listening clinicians should be able to reflect back to the person, in a brief summary, what they think they have listened to, using their own words paraphrase back to the person, the essence their story.

Utilising phrases such as ”Have I understood you correctly? It appears that you are saying that……..”

Narrative medicine , listening and trusting the (patient) persons narrative is part of the essence of good patient (person) focused care. Listening is an essential skill i narrative medicine.

Listening is an essential clinical skill, are you a good listener?

As always thanks for reading and good luck with listening, in silence, actively receiving, not preparing to ask another question, but willing to formulate your next question based on what you just received, or even paraphrase back.

Your patients and clients with thank you for listening.

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