Questioning & Listening Skills

Question 1

Differentiate between attentive, reflective, & empathetic listening

Answer 1

Attentive:
-Gathering Information for careful consideration
Ex: Listening to answers on the medical history questions
-A way to focus on relationships, not just facts or behavior
“Listening to” body language and actions as well as words.
The speaker may have inferred a feeling from words, tone of voice, actions or body language but not actually stated the feeling.

Reflection
-Reflection (repeating something the patient has said) can help the clinician obtain more specific information.

-Reflection is a way of indicating that you are listening.

Empathy
- Responding to patient concerns with genuine sympathy and support.

Reflect on what you think the patient is feeling:
“You seem concerned.”
“Most patients are anxious before having a root canal.”
“Flossing is frustrating you.”
Encourage the patient to express his or her concerns:
“You don’t think that x-rays are needed?”
“Are you concerned that x-rays are not safe?”

Question 2

Differentiate between open-ended and closed-ended questions and give examples of both.

Answer 2

Open Ended Questions:
Facilitates rapport, shows the clinician is interested in what the patient has to say
Requires more than 1-2 word answers
Questions often include:
What 
When 
Where
How 
NEVERRRRR WHY
How do you control your diabetes? 

Closed Ended Questions
-Requires short, 1-2 word direct answers for specific bits of information
Can be answered with a “yes” or “no” , #, date or a 1-2 word response
May be needed after a series of open-ended questions
Does NOT provide an opportunity for the patient to elaborate
Limits the development of rapport
Use to obtain facts & focus in on specific information
Do you have diabetes

Question 3

Contrast reflecting and clarifying and give examples of both.

Answer 3

Reflecting:
Open-ended statements (not ?) that repeat most of what the patient said are called reflecting responses
Confirms that you received the message but leaves room for more information
You were saying the pain started last week when you were eating dinner; the patient may then supply the missing information

Clarifying:
Clarifying is essential for open & effective communication.

We need to clarify what patients say to us
You ate breakfast before coming in; what did you eat for breakfast today?
We need to clarify what we say to patients
You have pockets of 5-6mm

Question 4

Explain the importance of clarifying in an interview.

Answer 4

Clarifying is essential for open & effective communication.

Question 5

Give examples of leading the interview and explain how this is different from asking leading questions.

Answer 5

If the conversation lags, or if the patient seems to drift from the topic you need to pursue, you may bring the focus back by using leads such as:

You were saying…
And then what happened?

Question 6

Explain why silences should be encouraged in an interview.

Answer 6

Use silences to:
Form new thoughts
Organize ideas
Remember events
Decide how we feel about a topic
Summarize in our minds where we are in the conversation
Observe the patient quietly without dividing your attention

Encourage silence if the patient seems particularly scattered and confused

Question 7

Explain why summarizing information is important.

Answer 7

Restating and summarizing the information gives the patient a chance to correct him/herself and you, and to clarify concerns.

Example: “You don’t think you have the time to take care of your teeth. Do I have this right?”

Question 8

Explain the difference between hearing and listening.

Answer 8

Hearing
can be passive
Simply hearing sounds in passing
Can be easily ignored
Differs for different people, at different times

Listening includes watching body language and actions as well as words

Question 9

List ways to enhance active listening.

Answer 9

leaning in
nodding
ect