Patient understanding in practice

The patient in the previous step was showing understanding, but not demonstrating understanding. This means that the doctor cannot be sure that her patient actually understood everything she explained. If you are sensitive to these signals, you can adapt your communication accordingly.

The doctor in the previous example could ask a question to check their patient’s level of understanding, such as:

• What questions do you still have for me?
• Could you explain to me when you would use your inhaler?
• Could you explain what you need to do in your own words?

The first question encourages the patient to ask questions to clarify possible misunderstanding. However, a passive patient or a patient who thinks he or she understands, but actually doesn’t, can easily say that he or she does not have any questions. With the second question the doctor explicitly asks for a demonstration of understanding from the patient’s side about a specific topic, using the chunk-and-check method. The third question does the same, but now the patient is asked to demonstrate understanding of everything the doctor told the patient, which is the teach-back method.

In the next activity you will learn more about chunck-and-check and teach-back, communication tools that healthcare professionals can use to elicit demonstrations of understanding from their patients.