What are the best techniques to facilitate group discussions between patients and healthcare providers?

Co-creating rules with participants ensures buy-in and commitment, while emphasizing confidentiality creates a safe space for open dialogue. Active listening should be encouraged, with facilitators appointed to guide discussions and ensure adherence to the rules. Flexibility is key, allowing for adjustments as needed to suit the group dynamics. Leading by example, celebrating diversity, and promoting mutual respect further enhance the discussion environment.

If patient advocacy is to be an authentic process, it must allow both the patient's real feelings and the clinical professional's empathy for these feelings to simultaneously shine through to empower the patient behind the disease. I have found that the best way to defeat the fear and anxiety of an illness is by creating a safe environment and setting appropriate ground rules including mutual respect, uninterrupted time for effective communication, and empathetic skills on all sides of the table.

Group discussions between patients and healthcare providers hinges on active listening, a skill vital for fostering empathy and understanding. To achieve this, facilitators should create a supportive environment where participants feel valued, using techniques such as reflective listening, clarifying questions, and validation of emotions. Through active engagement and encouragement of participation, facilitators ensure all voices are heard, promoting deeper insights. Additionally, providing constructive feedback and summarizing key points help guide the discussion towards actionable outcomes. By incorporating these, facilitators can facilitate meaningful dialogues that lead to improved healthcare outcomes and patient satisfaction.

There are a few phrases I have found that elicit more detail from patients and builds trust simultaneously. When patients ask follow up questions I often reply with "Thats a good question. I'm glad you asked that..." This validates their concern and encourages them to ask more questions about their condition. When a patient uses a lay or personal term for one of their symptoms, I will clarify with "I want to go back to something you said earlier when you said XYZ. Can you tell me more about that experience?" When you use their terms, they know you are listening and will speak more openly going forward. As always, how you say things is more important than what you say. A few changes of words is worth the depth of conversation it provides.

Human beings often just want to be heard and to have their feelings validated. The fear and anxiety of having an illness can be just as debilitating as the actual illness itself. It seems paradoxical that more effective communication in this setting involves saying fewer words. However, engaging in active listening is an incredibly active process which may be harder than saying words. It involves body language, eye contact, nodding or acknowledging with a "yes" or "I understand" statement, repeating or paraphrasing statements, and resisting the temptation to interrupt the other person. This form of communication builds trust, empathy, and mutual understanding to defeat fear together.

To be clear on goals of that session . Explain to each participant the decorum you expect from the session, give opportunity to each to express their share of thoughts, let the session not to digress and help arrive at a consensus

Open-ended questions serve as catalysts for meaningful dialogue, fostering empathy, understanding, and collaboration. Begin by acknowledging emotions and concerns, prompting participants to share personal stories and perspectives. Encourage reflection and exploration of solutions while emphasizing the importance of collaboration in enhancing the healthcare experience. By utilizing open-ended questions effectively, facilitators create a supportive environment where both patients and providers feel empowered to engage openly and constructively in discussions aimed at improving patient care.

One of my favorite open ended questions is “what do you think is causing all these symptoms?” The patient will often explain all the possible causes they have heard from those around them. This is helpful to understand what preconceptions to address going forward. Based on how they discuss this will also point to their biggest concern. Does their voice change when mentioning the word surgery or other medical terms? These are clues to hone in on for the rest of the visit.

Though more often used with one-on-one situations, I use a version of Teach-Back methodology in groups. I ask the patient or family group to summarize our conversation and tell me what we discussed in their own words. By listening to their interpretation I can identify gaps, misinformation, and can provide clarification. I can also reinforce important points that were interpreted as intended to highlight an informational point. This cycle can continue until message delivery and receipt match well enough to move on. This technique is helpful in identifying barriers to message delivery and message understanding. It allows me to support the family group with what they may need to make informed decisions.

This is one of the most difficult skills to master but one of the most important. To have an effective outcome, one must not approach an uncomfortable situation as a "zero sum" game. In the presence of conflict, there is tremendous discomfort in addressing the "elephant in the room" without expressing some raw, unfiltered emotion. I feel that this is a healthy expression of underlying fear/anxiety which should not be suppressed, as long as it is done with respect. A technique that I have used is to summarize the key issues on all sides by saying, "What I'm hearing is that..." or "Am I correct to say that what you are feeling is..." These sorts of impartial, validating statements help to both diffuse and address the conflict with empathy.

Conflicts are inevitable in orthopedic surgery. Patients are in pain, same day appointments are rare so they are told they have to wait, and often hear contradictory opinions from friends and family in the meantime. With that in mind, its important to understand that any anger directed at you is often more about the whole situation. If you brush it away, you risk deepening the conflict and turning the patient's ears all the way off. In my experience, the best practice is to acknowledge it and refocus the conversation. "I can understand how it can be frustrating to wait in pain without much direction. My goal is to find a plan we can all agree on that gets you past this injury." This often calms the emotions enough to complete the visit.

Be open to alternative points of view. By being open, one can better identify when gaps in compliance, misunderstandings, or struggles around decision making, might be related to cultural difference from the healthcare team. In some cultures, decisions are made by family consensus, in others decisions are made by the patient without regard to the family unit. Some families identify a member of a certain rank or role who must be consulted in big decisions. Just because the family may not match the culture of the healthcare provider or the facility, their cultural needs are important in creating a healing environment for the patient.