Central yet overlooked: engaged and person-centred listening in rehabilitation and healthcare conversations

Abstract

Purpose

Listening in healthcare practice is often overlooked. This article addresses the misconception that listening in rehabilitation and healthcare is a simple skill, and proposes a conceptual framework of effective listening in healthcare conversations, based on conceptualizations, attributes, and outcomes associated with listening.

Method

A critical review was conducted, encompassing literature on listening in everyday and healthcare conversations. Articles were retrieved through database and hand searching.

Results

Although various types of listening have been proposed, they share common attributes, including being attentive, emotionally involved, and non-judgmental. A conceptual framework is proposed in which listening in healthcare is seen as a relational process fostered by the ‘engaged and person-centred listener’, leading to relational outcomes (e.g., mutual engagement, collaboration) and client-specific outcomes. Listening in healthcare conversations can be difficult due to situational conditions and the level of self-regulation required.

Conclusions

Effective listening in healthcare differs from everyday listening with respect to its attributes, intentionality, and challenges. In healthcare, listening is essential to mutual engagement and other relational outcomes that mobilize the client towards pursuing goals. There is a need for greater understanding of the centrality and challenges to effective listening in healthcare conversations. Implications for rehabilitation practice are discussed.

Implications for Rehabilitation

• Listening in rehabilitation conversations is a core skill or advanced competency—not a ‘soft’ skill with little effect on client outcomes.

• Effective listening is essential to mutual understanding, engagement, relationship building, and collaboration, which mobilize the client towards pursing goals in rehabilitation.

• Listening effectively in rehabilitation conversations involves deliberately adopting a person-centred perspective.

• Effective rehabilitation professionals have several listening intentions in mind in addition to understanding, including engaging the other person in the therapy session, building relationship, and collaborating.

• Rehabilitation professionals can deliberately adopt the intention to be an “engaged and person-centred listener” who is with and for the client.

Keywords:

• Attunement
• communication
• engagement
• health care
• relational perspective

Acknowledgements

Thanks are extended to Madhu Pinto for assisting with the initial scoping review, to members of the Integrated Clinical Education Research Team (ICERT), including Colleen Willoughby and Deborah Strachan, and also to Patricia Baldwin and Laura Thompson.

Disclosure statement

The authors alone are responsible for the content and writing of this paper.

Additional information

Funding

This study was supported by the Canadian Institutes of Health Research. Gillian King holds the Canada Research Chair in Optimal Care for Children with Disabilities, funded by the Canadian Institutes of Health Research. This chair is supported by matching funds from the Kimel Family Opportunities Fund through the Holland Bloorview Kids Rehabilitation Hospital Foundation.