'Asking Questions And Listening' By Gwen Van Servellen Summary

This week’s readings of, “Asking Questions and Listening in Healthcare” written by Gwen Van Servellen discusses the therapeutic use of asking questions and silence. Silence and asking questions are a therapeutic skill. It takes talent to tailor the right question, and interject the right amount of silence for each individual patient in any given situation.

Utilizing the 5W’s as a method for asking questions allows healthcare providers to further engage patients and obtain valuable information which can potentially reduce unnecessary testing and total cost of care. The 5W’s include: who did it, when was it done, where was it done, what happened and why. Servellen provides details and examples of therapeutic and non-therapeutic use of

questions.
Therapeutic use of questions allows providers to collect pertinent information surrounding a patient’s physical, mental health history, socioeconomic status, etc. Adopting a patient’s language by asking questions that are easily understood allows a provider to further clarify and ask specifying questions. For example, “can you please provide more details?”. Ruling out and ruling in are direct questions that assists a provider in obtaining specific concerns.
Nontherapeutic use of questions are used for three purposes: interpretative, self-disclosure or advising.

This is considered non therapeutic as it creates a passive response from patients, making them more dependent upon the provider, and less likely to take accountability for their healthcare choices.

Servellen describes three question formats including: close-ended, open-ended and multiple-choice. Of these three formats, asking and summarizing open-ended questions appears to be the most successful, as they encourage patients to communicate their personal narrative and express themselves through self-disclosure. With that said, open ended questions are not always appropriate and it is the skill of the provider to ask the right question at the right time.

Silence is opposite of asking questions and is defined as the absence of speech, can include a pause, and is a form of listening. It is important for a provider to pause and wait for a response to any of the question formats. This provides a patient time to think and formulate an answer, even if the silence feels uncomfortable. Asking questions and pausing for a response provides a safe environment for the patient to share and communicate personal, intimate and oftentimes sensitive knowledge about

themselves.
The combination of asking the right questions, and incorporating the right amount of silence is therapeutic as it encourages patients to express themselves, it communicates understanding between the provider and patient, and allows the provider to actively listen too appropriately assess a patient’s condition.