Effective Listening


You know you are telling patients what to do, it is not a conversation, and you aren’t getting the results you would like.

Desired Result:

Mutual trust, respect, and understanding.  Leading to more credibility, better relationships, and acceptance of care.


How To:

There are three basic modes of listening:

  1. Competitive or Combative Listening happens when we are more interested in promoting our own point of view than in understanding or exploring someone else’s view. We either listen for openings to take the floor, or for flaws or weak points we can attack. As we pretend to pay attention we are impatiently waiting for an opening, so we can say what we know.  The other person does not feel heard or understood.
  2. In Passive or Attentive Listening we are genuinely interested in hearing and understanding the other person’s point of view. We are attentive and passively listen. We assume that we heard and understand correctly but stay passive and do not verify it.  This can lead to assumptions, misunderstandings, and confusion.  It is important to clarify and verify so the other person knows you do understand.
  3. Active or Reflective Listening is the single most useful and important listening skill. In active listening we are also genuinely interested in understanding what the other person is thinking, feeling, wanting or what the message means, and we are active in checking out our understanding before we respond with our own new message. We restate or paraphrase our understanding of their message and reflect it back to the sender for verification. This verification or feedback process is what distinguishes active listening and makes it effective.

Here are the keys:

First, listen without interrupting the speaker, pay close attention, do not let your mind wander.  Other people find this flattering and will think more highly of you and respond to your attentiveness by being more open.  You build trust and respect by listening, not by talking.

In addition to listening without interrupting, give the speaker a few verbal and non-verbal cues every now and then to indicate you are listening. Be active rather than passive. Indicate that you are totally engaged in the conversation.  This can be done through body language (nodding, eye contact, and leaning forward) as well as simple phrases such as, hmmm, really, tell me more…

The third key to effective listening is to question for clarification. Never assume that you understand what the person is saying or trying to say. Instead, ask, “Let me see if I understand you correctly” or “what I heard you say was… If you do not understand or don’t have it right, the speaker will correct you.


Finally, if you are not sure you understand the speaker or want further explanation, say “Can you explain that again?”  This is a powerful question.  It is almost impossible not to answer. When you ask, “Can you explain that again?” the other person cannot stop giving a more expansive, extensive answer.