January 2023 Communication Tip

January 2023 Communication Tip

Open Ended Questions

 

Happy New Year.

 

For our Communication Tip this month, I am so excited to welcome a special guest writer, Greg Merrill, LCSW.

Greg is an extraordinary palliative care social worker in the UCSF Division of Palliative Medicine and his wonderful advice is below.   His advice applies to all of us involved in patient care.

I’m sure we are all resolved to get more sleep and exercise in 2023.  Today, let’s also resolve to ask better questions!

 Best,

Mike

Happy 2023 and welcome to our next 365!

This month’s communication tip relates to asking more open-ended questions. What is an open-ended question, you ask? Well, that is both a good and an open-ended question.

Closed or Open?

Closed ended questions tend to yield static, factual, and rote – closed –responses. By contrast, open ended questions require deeper thought and reflection. As the patient answers in the fullness of our presence, they often discover and share hidden insights. This is referred to as “natural speech” or “free narrative” and feels qualitatively different than closed responses to the asker and answerer alike.

 
  Good questions outrank easy answers. – Paul Samuelson

 

Open Formation

When you are trying to ask more open-ended questions, it can be helpful to start with phrases like “what,” “how,” and “tell me about . . .” The best open questions are brief and are followed by silence and compassionate witnessing, both of which support the patient in constructing a thoughtful answer.

Example: Open Questions About Behavioral Health

  1. In addition to physical symptoms, many patients experience strong, unwanted emotions that won’t go away. What can you tell me about that?
  2. When those strong emotions come, what happens? How do you handle them? How do they resolve?
  3. What are the losses that are hardest to accept or think about?
  4. What are the things you tell yourself that are most upsetting?
  5. What are the people, activities, or things that tend to make you a bit happier?
  6. What brings you comfort or strength?
  7. What are the things you tell yourself that are most reassuring?
 
  A prudent question is one half of wisdom. – Frances Bacon

 

Sample Questions Handout: It’s not Cheating, It’s Learning

Attached please find a 4-page handout that includes sample open questions for most major domains palliative care providers inquire about. Please edit the document, make these questions your own, and artfully insert them into conversation as you see fit. Try out questions you’ve never asked before, see how they land, and refine from there. Reframe: using a sample sheet for inspiration is not cheating, it’s learning. When you insert new questions into the conversation, you are likely to get new answers, yielding new co-discoveries.

When we listen, they talk. When they talk, they discover. – Anonymous

Happy questioning and happy new year!

Sincerely,

Greg

Greg Merrill, LCSW Outpatient Palliative Care Service