Physicians, Nurses Rate Their Listening Skills High in Poll

Marcia Frellick

December 04, 2018

Most physicians, nurses, and advanced practice registered nurses (APRNs) in a recent Medscape poll said they always or often make a conscious effort to listen to their patients without interrupting them.

Eighty-seven percent of physicians and 89% of nurses/APRNs characterized their listening skills that way. But among nurses, there was some variation within specialties. Those in geriatrics were most likely to say they always or often make a conscious effort to listen (95%) and 85% of those in general practice answered that way.

The poll, first posted August 15, drew responses from 1215 nurses/APRNs and 172 physicians.

It followed the release of a study published online July 2 in the Journal of General Internal Medicine that found clinicians rarely ask patients to explain the reasons for their visit, that the patient's agenda was addressed only 36% of the time and in 67% of visits, and it took only an average of 11 seconds before physicians interrupt. Patients who did share concerns did so in an average of 6 seconds.

However, in this poll, physicians and nurses/APRNs overwhelmingly thought they were good listeners: 89% of nurses/APRNs and 87% of physicians gave themselves high marks in the skill, although 9% of nurses/APRNs and 10% of physicians admitted they were unsure.

Confidence in strong listening skills varied among nursing specialties but was consistently high. In psychiatry/mental health, 96% of nurses/APRNs said they had good listening skills. Critical care/intensive care gave the lowest response, with 87% saying they had good listening skills.

Strategies for Better Listening

When given a list of ways to improve listening skills (they could check more than one), physicians put more time for visits at the top of the list, with 59% checking that box. Next came increasing their focus on listening (40%), followed by communications training (34%).

Nurses/APRNs put increased focus on listening at the top of their list (51%), followed by less interaction with the electronic health record (EHR) during patient appointments (38%), longer appointments with patients (37%), and fewer tasks overall (37%).

Other choices given of ways for clinicians to improve listening skills included less stress and better prepared patients.

In response to a story by Medscape Medical News about the Journal of General Internal Medicine study, a physician responded, "I have had to interrupt a lot, otherwise we would never find out why the patient is really here. Besides, believe it or not, there are other people waiting patiently."

A registered nurse who commented on the poll urged clinicians to "take the time to sit down, look your patient in the eye and say, 'tell me what's going on.' Discuss the situation with them and then act upon it. The patient's perception of care is all important. If they perceive that they are receiving good care, then they are. And they are much more compliant."

Several commenters described what's keeping clinicians from using active listening and a common theme was preoccupation with EHR documentation.

Others cited lack of time during increasingly shorter patient visits.

A registered nurse who commented wrote, "In the hospital setting, the answer to every issue seems to be to create another protocol or another scale to fill out. That takes time. If we really want to improve patient care, which includes authentically listening, we need to prioritize time for staff interaction with the patient, rather than staff interaction with the patient record."

A physician in pulmonary medicine shared a strategy: "Preparing the patients with asking them to prepare their own list of concerns with THEIR most important ones first and asking them for their goals of the visit are very helpful to focus. Address the primary issues and make plans to address the others on future visits."

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