About eight months into my first year of medical school, an incoming student asked me how to prepare for the upcoming journey. I could relate to the panicked, excited feeling of the duty to prepare for medical school after an intense visit day. Yet, instead of defaulting to my ingrained answer of, “Nothing can prepare you for medical school,” which I believe was not in the student’s interest to hear, I carefully considered her question and answered, “It’s very important to be a good listener.”
Watching her face relax, I saw that my answer provided relief, since listening was something she was already familiar with.
“What do you mean?” she asked.
Good listening is a noble and valuable skill in any profession, but it is particularly crucial for the medical field. A highly proficient clinical skills professor whom we all admire once shared with us that he remembers details about and stories told by his patients without having to write down these facts — a cumulative result of his intense focus during the patient interview. He urged us to remember that proper listening can yield fruitful results in the clinical setting. To help train this skill, the first-year clinical skills exams at my school consist of standardized patient interview sessions where the student asks a series of specific questions to generate a patient’s complete history. The twist is that no note-taking is allowed during the 35-minute interview session. In the end, students must summarize back to the patient (and the grader) all the pertinent information from memory. This early exposure to the importance of listening has the goal of producing doctors who are able to focus on the patient and turn their back to the computer screen. A medical professional who is adept in doing this thus can use listening to show both respect and competency.
Outside the clinic and in the classroom, the ability to listen is also linked with efficacy and results. In educational settings, information is often shared once with the expectation that students listen and absorb the requested tasks and necessary information the first time. Thus, listening closely the first time saves time that is later spent trying to track down information and recollect it. It follows that students who are good listeners — who bring their full attention and presence to lectures and daily events — may be happier students because they have more free time and more energy as a result of having to do less “mental clean-up” throughout the day. The very nature of being a better listener implores the habit of being better prepared, making success the result of strategy and intention, not a speculation that we somehow expect to stumble upon.
By practicing good listening skills, we show humility and service to our patients. It is too easy to interrupt someone who is wrong, to “save” them from their mistakes and set them straight. By listening and following up with an empathic statement such as, “You are right to be worried about this,” or, “I can see how this can be uncomfortable,” we legitimize our patients’ concerns and help them build confidence in not only themselves, but also in us as a physician who is truly committed to their well-being.
Another way to increase our listening acuity is to engage our senses that same way that we may read a captivating story. But with our patients, we are not allowed the luxury of skimming pages in want of knowing how the story ends. Pronouns, verbs, adverbs and adjectives flavor the sentences we speak, and the strongest flavors are those that come to our attention more because we choose to react more strongly towards them. Therefore, enter conversations with the intent to pick up both the strong flavors and the subtle ones. Pay attention to the word choices that others use, and non-judgmentally understand how it fits into the larger puzzle of their current condition. Mark Twain once said, “The difference between the almost right word and the right word … [is] the difference between the lightning bug and the lightning.” The words our patients use to describe their feelings and their condition are important to both the patient and to the history-taker. Adopt an investigative approach to your listening strategy. Good writers can spend hours musing about word choice, the sequence of the story and the way to bury literary treasure in mundane characters. Similarly, like close readers of a delicately wrought text, good doctors too can pick up and synthesize the hints dropped by patients that have accumulated over the years.
Finally, good listening skills are a form of daily success. By creating a learning objective to become a better listener, we ultimately create a reason to congratulate ourselves on accomplishments each day. The abundance of interactions in which
we may show dedication and interest to others generates many opportunities to ascertain our positive traits to ourselves. In the daily hustle of medical school, these positive affirmations will help establish both gratitude and an inner eye for navigating the rugged terrain of our personalities. The ever-mounting collection of self-criticisms provoked by the stressors of school and beyond must (and can!) be combated with high self-esteem and the momentum to transform the heaviness of difficulty into the sweetness of success.