CLEAR: Clinical Listening that is Effective And Research-based
Listening: An Essential Skill
Most patient complaints about healthcare encounters are about communication issues and people feeling they were not listened to. Listening affects: relationships, the quality of health care, client outcomes, and client satisfaction.
Effective listening skills are often neglected in the training of clinicians.
Listening in rehabilitation conversations is a core skill or advanced competency—not a ‘soft’ skill with little effect in client outcomes.
King 2022
Listening Misconceptions and Facts
Misconception:
Listening is a simple skill.
Fact:
Listening is a complex process and requires acknowledgment of contextual and relational factors.
It is cognitively demanding, and an advanced skill.
Misconception:
Listening does not involve non-verbal communication.
Fact:
Silence is a powerful form of non-verbal communication and is difficult to do.
What is not said is just as important as what is. Not all listening requires ‘taking action’ or ‘doing’.
Misconception:
Listening is the same as ‘hearing’.
Fact:
Hearing is an automatic process.
Listening requires attentional capacity, energy, and self-regulation.
Why Listening Is Important
Listening is an essential skill for clinicians, affecting relationships in clinical practice, the quality of health care, and client outcomes.
Good clinical listening creates clarity, co-creates a sense of mutual meaning, provides affirmation, and establishes a sense of direction for intervention. Listening and communication are fundamental to best clinical practice.
Being able to listen mindfully, sensitively and with authentic intent enables health care providers to understand clients’ worldviews, needs, priorities, concerns and hopes; thus establishing a common ground that assists clients in making informed decisions and moving forward. King et al., 2012
What is Clinical Listening?
Listening refers to the skills or processes involved in understanding another person, demonstrating this understanding, and achieving listening goals. Clinical listening is a communication approach that involves attentively listening to a patient’s or client’s concerns, feelings, and experiences, without judgment or interruption. The listener aims to understand other's perspectives, build rapport, and foster trust. Clinical listening involves engaged and active listening. It is purposeful, goal-oriented, and involves using relational skills. This approach helps to ensure that the patient or client feels “listened to” and heard, respected, and valued.
Listening is an intentional process, requiring attentional capacity, energy, and self-regulation. King 2022
Clinical listening is a vital skill for healthcare providers. Using good listening and communication skills demonstrates empathy, patience, and a commitment to person-centred care.
Outcomes of Good Listening
- Builds trusting relationships
- Reduces likelihood of miscommunication and misunderstandings
- Improves information exchange
- Increases collaboration on goals/treatment plan that improves follow-through
- Leads to more accurate diagnoses and treatment plans
- Decreases anxiety, stress
- Enhances client/patient satisfaction
Engaged awareness’ refers to how the listener ‘listens’—being actively attentive to the speaker, present in the moment, and engaged on an emotional level. King 2022
Development of Clinical Expertise
Experience alone does not make an expert. One of the key pieces of helping clinicians develop is to focus on enhancing clinicians' core listening and communication skills. In fact, effective clinical listening skills are a key factor in becoming an Expert Clinician and providing the best possible services to clients and families. Listening sounds simple, but to do it well in highly complex and often emotional clinical situations is challenging.
The depth of processing required in healthcare interactions underscores the view that listening can be seen as a cognitively demanding and therefore advanced skill. King 2022
Good listening skills are part of core communication competencies expected by regulatory health care associations and interprofessional practice organizations. Despite the obvious link that good listening has to optimal client/patient outcomes and the requirement by regulatory associations that it be a developed core competency, There is also a lack of evidence-based methods for training this skill.
Clinical Relevance of Good Listening and Communication
- Key factor in becoming an Expert Clinician
- Essential to successful interventions
- Core competency for collaborative practice
- Essential to client satisfaction
- Integral to developing relationships
- Enhances client/patient satisfaction
The Impacts of Poor Listening
- Poor listeners are viewed as arrogant, critical, and distracted
- Poor listening may result in misunderstandings
- Poor listening may result in decreased client satisfaction and reduced client motivation
- A poor listener may be deemed incompetent or not trustworthy
- With poor listening, clients may experience anxiety, stress, or lack of trust
Improving Listening and Communication Skills: The ELICS Tool
The Effective Listening and Interactive Communication Scale (ELICS) is a formal self-assessment tool designed to measure the listening and communication skills of healthcare professionals. The ELICS is a valuable tool for improving the clinical listening and communication skills of clinicians, as it provides a standardized method for assessing and developing these skills. By developing effective listening and communication skills, the ELICS can help to enhance client- and patient-provider relationships, improve health outcomes, and increase client or patient satisfaction.
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