Be patient-centred
To put the patient first, we:
- introduce ourselves, saying “Hello my name is…” and warmly welcome the person
- state the purpose of our conversation
- do our best to remove physical barriers, for example the desk between our patients and ourselves. We sit at the same level as them and concentrate on the person rather than our computer or other distractions
- make eye contact
- use verbal cues including an appropriate tone
- use positive facial expressions
- put ourselves in our patients’ and service users’ shoes, listening and responding to them: “Is there anything else you need to know?”
Listen and ask open-ended questions
To show we are listening, we:
- give people time to explain and do not finish their sentences
- ask open-ended questions and encourage people to share their concerns
- invite them to ask us questions
Use plain language and check understanding
To try and make sure people understand us, we:
- use plain language to explain complex terms: “Let me explain…”
- do not share too much information that they may find difficult. Share what is necessary for what they need to know or do to look after their health
- can repeat the information if needed in a nice way to try and ensure they understand and can follow our instructions
- demonstrate how to take medicines or exercise as well as telling them how to do it. We can discuss with people if they wish to take short videos of us giving the instructions or doing exercises, on their phone, in an anonymous way
- check and write down the information and show it to them if we feel they have not understood the conversation. We can use a visual to explain it further
Techniques we use to check understanding
Teach-back technique
We can use the teach-back technique to assess and confirm that people understand what we have told them. We ask them 1 or 2 questions to find out if they can repeat back the key information we have told them.
For example, a physiotherapist could ask:
- what are the 3 exercises you are going to do every day?
- how many times will you do these exercises each day?
If the person is not able to respond correctly, we go over the instructions again in a nice way to make it clearer.
Teach-back training - teachbacktraining.org
Chunk and check
You can use the chunk and check technique alongside teach-back. Using this technique, we:
- explain information in small sections (chunks)
- check for understanding after each section using teach-back
- move on to the next section
For example a pharmacist could ask:
Mrs Murphy, I have your tablets here. I have 2 types of tablets. You take these ones 3 times a day, with water after a meal. And these smaller ones twice daily on an empty stomach or several hours after eating. You might find this leaflet useful.
This could be split into smaller chunks, using teach-back between chunks where appropriate.
Pharmacist:
"Mrs Murphy, I have your tablets here. You have 2 types of tablets. You take these white oval-shaped ones 3 times a day, with water after each meal. These instructions are typed on the container."
Ask the patient questions to check for understanding:
- How many times will you take these white tablets?
- When will you take the tablets?
- Where can you find the instructions to remind you?
"You take these orange smaller ones twice a day on an empty stomach or several hours after eating. These instructions are typed on the container. You might find this leaflet useful."
Ask the patient questions to check for understanding:
- How many times will you take these orange tablets?
- When will you take the tablets?
- Where can you find these instructions to remind you?
Chunk and check technique - healthliteracyplace.org
Ask Me 3
Ask Me 3 is another technique we can use. It encourages people to ask us specific questions.
The questions are:
- what is my main problem?
- what do I need to do?
- why is it important for me to do this?
We can encourage the person to ask us the questions:
- at the end of a health appointment
- when preparing for a medical test or procedure
- when picking up medicine