Have you ever wondered if anyone is actually listening? Do you feel like there is a breakdown of communication somewhere, and this is inhibiting your ability to get your message across to patients, staff members, and maybe even friends and family?
I have been there, both as a clinician and a patient, as well as a family member and friend. Miscommunication is not only frustrating, but it is also detrimental. Ineffective communication can affect our relationships if we are unable to relay effective messages. So, how can we become better communicators and get our messages across? One of the easiest and quickest ways is practicing active reflective listening and understanding what messages really are.
Filtering Out Noise
In this context, messages are the body of information (verbal or nonverbal) that are passed from one person (the sender) to another person (the receiver). The sending and receiving of messages are constant, and, when appropriate, we assume the role of either the sender or receiver.
Information exchange is active, and it is impossible for us not to receive some kind of message, verbal or nonverbal when engaged with others. Because we consciously and unconsciously receive and send thousands of messages a day, it is critical to be present and to employ active reflective listening when engaging others.
To be present, we must filter out the noise. This includes such things as background noise from TVs, cellphones, other people talking, written material, and anything else that may be distracting. Unfortunately, noise or messages with less importance may make their way into our periphery, making it hard to stay focused. The lack of concentration on the intended message may result in valuable information being missed or misinterpreted. When we focus on others and their feelings, while moving messages back and forth, we are using active reflective listening.
Active Reflective Listening
Active reflective listening is one of the many tools identified in the study of interpersonal communication. Used correctly, appointment confirmations, arrival greetings, treatment needs, and even general discussions and conversations can be facilitated more effectively. However, what does active reflective listening really mean, and what does it look like?
In short, it means focusing and listening intently to the message, extracting the information and the feelings behind the message, paraphrasing the message, and then sending it back to the original sender. This paraphrasing technique gives the original sender an opportunity to agree with the paraphrased message or to offer more information for clarification. Ideally, this dance will go on until the message is appropriately conveyed, and each party believes they have been heard.
Dialogue between the sender and receiver of a message is transferred through eye contact, body positioning, verbal and nonverbal cues, and actively being engaged in the conversation. For example, the receiver may nod their head, verbally affirm they are listening, or use facial cues as a way to show their engagement (raised eyebrows, a smile, an expression of surprise, perplexity, etc.).
As clinicians, we should strive to be acutely aware of the nonverbal cues people, including ourselves, display. For example, many of us have experienced patients with dental fears. They may be embarrassed to disclose this information for numerous reasons.
When their fear is triggered, a patient may put their body in a position for an easy escape from the operatory. You may see them start to breathe heavily, avoid eye contact, sweat, and shake. These signs of nonverbal body language need to be gently addressed even though the patient has not disclosed the fear verbally. Something to be mindful of when engaging in conversation is that nonverbal body language is just as important as verbal.
For some, active reflective listening comes quite naturally. For most of us to feel accustomed, we need to practice and learn new techniques. One of the easiest ways to practice is by role-playing with staff members, friends, and family. During role-play, using messages of information you have had to address in the past will make dealing with these future issues much easier.
One suggestion may be to role play with your co-workers using the presentation of a treatment plan to a patient whose main motivation and concerns are out-of-pocket costs and time. Using the format of active reflective listening, you will continue to paraphrase messages until the patient feels like they have been heard and understood. Paraphrasing is best done when you use your own words to let the receiver know you are listening. The more you practice and role-play, the more comfortable you will become using these important skills.
Role-Play Example
Patient (seated in the dental chair looking anxious): “I am unsure about getting this work done. It’s so expensive, and I don’t know how much my insurance covers. My work hours are long, and it’s already hard to find time for my appointments.”
Clinician (sitting in operatory chair facing the patient using nodding as a nonverbal cue to show active engagement): “It sounds like you have some financial concerns as well as time concerns.
Patient (their body becomes less tense as patient looks relieved): “Yes, I’m really unsure of both the finances and how I will find time to do all of this.”
Clinician (smiling and reassuring): “What if we break down your insurance coverage and out of pocket cost? We can also look at finding a time that works for your schedule as well as ours.” How does this sound to you?”
Patient (nodding their head in agreement): “Sure, let’s look that.”
When active reflective listening is utilized, there is a greater understanding of the intended message. Even though this is a good communication tactic, it is not the end all be all in the art of interpersonal communication. Thankfully, it is one tool in your belt that can be used in almost every situation resulting in an effective outcome.
This outcome may or may not be what you want to hear, but either way, messages will become clearer as you use this tool. When you show that you care about what someone is saying and are invested in understanding their message and the feelings behind it, the communication gap begins to close and creates a bridge to a healthier state of understanding. Not only will your patient feel heard, but by gaining their trust, you will be able to convey your message more effectively as well.
