1. You are going to read two scripts of health professional-patient interactions. You need to evaluate the interactions and assess both poor and good listening strategies. Reflect on the impact of the listening strategies of both the patient and the healthcare provider.
Active Listening Script A
C= clinician
P= patient
P – Enters
C – (On the phone). Looks up, motions patient to come in and sit down
P – Patient gingerly sits down
C – Finishes telephone conversation and turns to patient, glances back and forth from computer screen and patient. Through the entire interview, C works between the patient chart and the computer screen.
C – How are you today Mrs./Mr. Perez? How have you been since we last met?
P – Fine thank you.
C – Good. Are you following the diet sheets we gave you?
P – I’m trying to.
C – How is your wound healing?
P – The nurse comes to see me only once a week now.
C – Good. Any problem with your medications?
P – Yes, I think my medication is upsetting my stomach.
C – Yes, that sometimes happens, most of the time it goes away. Are you taking your meds with food?
P – Well, I try.
C – Good. How is the rehab program working out for you?
P – This getting better is hard work.
C – Yes, it is and you are quite capable. You are doing well.
P – Thank you.
C – Good, well, it looks like you are making good progress, let me examine you now.
Respond to the following questions:
a. Did the provider demonstrate good or poor listening skills?
b. Did the provider learn everything he or she needed to know to provide care?
c. How did the patient feel during the interaction?
d. How could the provider have improved his or her listening in this scenario?
Now that you have completed the questions on the first script, please read the next script.
Active Listening Script B
C – (talking on phone)
P – Enters
C – Looks up, and motions patient to come in and sit down.
P – Patient gingerly sits down
C – Finishes telephone conversation and turns to patient
C – How are you today Mrs./Mr. Perez? How have you been since I last saw you?
P – Fine thank you.
C – That’s good to hear. Tell me how you are making out following the diet sheets.
P – Well, I’m finding them hard to follow. I seem to be nauseous and have lost my appetite.
C – That can’t be good, tell me more.
P – Well, like I said, I’m having trouble following the diet because when it is time to eat, I’m either not hungry or nauseous, and by the time that goes away it is past the time the sheet says to eat my meals.
C – It sounds a bit like a scheduling nightmare. Tell me more about your nausea and loss of appetite. Does it occur all the time or just certain times of the day?
P – I think it’s about a half hour after I take my medication.
C – So you feel nauseous after your medication.
P – Yes.
C – Your medication could be upsetting your stomach. Could you try taking your medication a half hour after your meals instead of before?
P – Yes, I could try that.
C – Okay, good. Now, how is your wound healing?
P – The nurse is coming only once a week now.
C – And she is satisfied with your progress?
P – Yes, she seems to be.
C – That’s great. Have you started rehab yet?
P – Yes, I have.
C – And how is that going?
P – Well . . .
C – Waits for patient to continue.
P – They’re making me work awfully hard!
C – In what way?
P – Well, just a lot of repetitions.
C – Do you feel that it’s too much for you at this point?
P – Quite honestly, I do doctor. I didn’t want to say anything to them because I’m sure they know what they’re doing. But the day after physio, sometimes I feel like I’ve been in a train wreck.
C – Well, that’s not good. I want you to feel free to let the therapist know your limits.
P – Thank you, doctor. I’ll do that.
C – Is there anything else you wanted to discuss?
P – No, I think that’s all.
C – Good, then let’s examine you now.
Respond to the following questions:
a. What did the provider do differently?
b. What was the impact on the patient and on the provider?
c. Explain the concept of active listening.
d. What is the purpose of active listening?
e. What are some strategies for active listening?
2. Approach either a family member or friend to practice this active listening skill. Share these instructions with your family member or friend, as they will be the speaker.
“As the speaker, you will talk about a success that you have experienced in your life. Answer the following questions as you talk: What was your success? What challenges did you face? How did you meet those challenges? Why was it important to you? What factors account for your success?”
You (student of this course), as the active listener, will encourage the speaker to talk by using active listening techniques: appropriate body language, minimal responders, requesting clarification and expansion, summarizing/paraphrasing what the speaker has said, and expressing empathy. You need to time the conversation ensuring that you keep the speaker talking for a full 3 minutes, using the active listener techniques that you have learned.
Now that you have had the conversation with your family member or friend, write down the exact words that you used to keep the conversation going. You can ask your partner in the conversation to help you recall everything that you did to ensure you respond fully to this activity.
a. Record what body language you used.
b. Record any minimal responders that you used.
c. Record any requests for clarification.
d. Record any requests for expansion.
e. Record any expressions of empathy.
3. Case Study
You are a manager in your Canadian workplace. One of your staff members commits an error that has an impact on patient safety, and the patient is admitted to the intensive care unit. How would you let the staff member know what happened? The other members of your staff?
a. Write a script of the above scenario with speaking parts for the manager and employee. Include in your script the specific error that the health provider made.
b. Describe how it felt for the employee to receive the feedback (imagine you are the employee and the manager is sharing the information with you). What other emotions did you experience?
c. Now imagine yourself as the manager. Is it difficult to give feedback (as the manager in this scenario)? If yes, what makes it difficult? If no, why was this easy to do?
4. Provide examples of patient safety issues from your prior experience? What happened?
Was there a culture of patient safety?
5. Briefly describe one innovation in technology from your own profession.
Module 8 – Ethics and Liability
6. Review the code of ethics for your profession to determine how it relates to the ethical principles identified in module 8.
a. Are they aligned?
b. Are some missing?
7. Read the following three ethical dilemmas. Propose solutions to each of the ethical dilemmas. Identify the ethical perspectives you used in your solutions. Respond to these questions after each case study.
a. Case Study
A person with drug-resistant tuberculosis and a history of non-compliance arrives at the airport. Should they be quarantined?
b. Case Study
You notice your colleague has a lot of bruises on her arm when she pushes up her sleeves to wash her hands. When you mention them, she quickly hides her arms and says she was playing with her very active children. You have never heard her describe her children in that way before.
c. Case Study
You are a massage therapist. You have a long-time client with whom you developed a friendly relationship. You share many interests, especially hockey. She won tickets to a hockey game and invited you to accompany her.
8. Review each liability case study and establish the criteria for negligence in each case by answering the questions.
a. Case Study
A woman was helping her husband change position in bed after his surgery. As she was doing so, she noticed a sharp pain in her hand. She looked down and found a 22-gauge needle was stuck in her hand. She brought this to your attention.
• What was the duty of care owed to the patient?
• Did the professional carry out that duty? If not, what exactly did the professional fail to provide?
• Was the patient injured?
• Did the professional’s failure to carry out the duty cause the injury?
• In conclusion, through application of the criteria for determining negligence, was the professional negligent?
b. Case Study
A patient undergoes surgery for spinal decompression to alleviate pain. Before surgery, the patient demonstrated that he understood the risks and benefits of the surgery and was capable of giving consent. Nothing unusual happened during the course of care. The surgery did not resolve the issue and in fact made the condition worse.
• What was the duty of care owed to the patient?
• Did the professional carry out that duty? If not, what exactly did the professional fail to provide?
• Was the patient injured?
• Did the professional’s failure to carry out the duty cause the injury?
• In conclusion, through application of the criteria for determining negligence, was the professional negligent?
Module 9 – Pathways to Successful Employment
9. What are some of the skills that have been described in the Employability Skills Profile?
a. Fundamental skills:
b. Personal management skills:
c. Teamwork skills:
10. Given the techniques and information that you have learned in this module, prepare a resumé that you would give to a Canadian employer. Submit your resumé as a separate document attached to an email to your instructor.
11. How are the concepts highlighted in these three modules different from your experience and education?
12. How does this difference challenge you?
13. What do you have to know or do differently to be successful in the Canadian health care system, culture, and context?
