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Do you know how to be clear when giving instructions?

Clarity of communication is so important

Clarity of communication is so important

The need for clarity

Do you ever find that you have given instruction but it isn’t being followed as you had expected?

For example, you ask a colleague or patient to do something and you find out later they’ve done something different.

Here are a couple of extreme examples:

  • A patient you prescribed an inhaler to while describing it as being ‘for your chest’, returns to say it’s not helping their breathing. On questioning the patient, you discover they have been spraying the inhaler onto their chest rather than into their mouth.
  • A patient who has been prescribed an anal suppository returns to complain of pain and discomfort. On questioning the patient, you discover they have been inserting the suppository still in its foil wrapper.

These may sound extreme but they are real examples of what can happen when the communicated message is not clarified.

Try out this communication challenge

Here’s an example you can try with your friends or colleagues. You will all need one piece of paper – preferably the same size and shape to begin with. You will need to read the following instructions to them but they should have their eyes closed.

  1. Pick up the piece of paper and fold it in half. Rip off one of the corners.
  2. Fold the piece of paper in half again. Rip off one of the corners.
  3. Fold the piece of paper in half again. Rip off one of the corners.
  4. Finally, fold the piece of paper in half one last time. Rip off one of the corners.

You can now ask everyone to open their eyes and unfold their pieces of paper. I guarantee they will all look slightly different. This is despite everyone being given the exact same materials to start with and the same, clear instructions to follow Why? Because we all interpret things in a slightly different way.

While it is obvious to you how to use an inhaler or insert a suppository, for these patients who have never used one before, it is not.

How to improve your clarity

This means two things become really important.

Firstly, that you remember the instructions you are providing your patients (and colleagues) are clear and unambiguous. Avoid medical jargon, speaking quickly without pause or presenting too much information in one go.

Even though you may be giving the same advice to the patient as you have provided to hundreds before, it’s best to imagine this is the first time you have ever given this advice.

Secondly, check your patient’s understanding and not just at the end. There are a number of ways you can do this. You can:

  • ask them if they have understood? (this is of limited use because if they say yes, but haven’t, you won’t know)
  • ask them to repeat back to you what has been agreed or the instructions you provided.
  • get them to demonstrate what they are going to do or practise the action together.

Using one or more of these methods of clarifying understanding should help avoid the problems discussed in our extreme examples but also more routine situations.

Can you tell me three things you learnt from reading this?