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Getting the message across

June 1, 2008
Richard Timmins, DVM

The six principles of adult learning provide a framework for building a protocol for ongoing client education.

The six principles of adult learning provide a framework for building a protocol for ongoing client education.

Last month we discussed the importance of educating clients to help them understand and adhere to needed health-care procedures for the pet.

This article will address customizing education by accommodating each client's preference for a particular learning or communication style.

Although there are a number of theories about learning styles, the one most relevant to client communication identifies three types of learners: visual, auditory and tactile/kinesthetic.

Three learning styles

» Most clients learn through seeing, relying on facial expression, body language, pictures and diagrams. Teaching a new technique or procedure to a visual learner should include drawings, graphs, pictures and other printed material. Research with human patients has shown that pictures closely linked to spoken or written information can increase attention to and recall of health-education information. Maintaining appropriate eye contact and paying special attention to nonverbal language are essential.

» Auditory learners learn through listening, paying close attention to what and how things are said. They benefit from verbal descriptions and from encouragement to ask questions or repeat information.

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» Tactile/kinesthetic learners learn best by doing. Perhaps invite them to perform a task associated with the information being shared or a procedure to be performed, such as giving a pill or a subcutaneous injection. These clients also benefit from looking in the microscope, listening with the stethoscope or holding a model of an organ.

How can you identify a client's learning style?

A visual client may pay closer attention when you show a diagram or picture related to the information. An auditory client may ask repeated questions until she/he hears enough to understand. The kinesthetic client will ask to try performing a task or will respond enthusiastically to an offer to try it.

Sometimes the client's words will reveal the learning style. Visual learners prefer words like see, picture or imagine. ("I don't see how this could have happened." "Can you give me a picture of what to expect?")

Auditory learners tend to use words like hear, sound or think. ("I hear what you're saying." "It sounds like this could be serious.")

Kinesthetic learners favor words like feel, touch or hold. ("I feel that she's going to be OK.")

It's not always easy to identify a client's preference. In that case, effective teaching will involve techniques appropriate for every kind of learner: tell it, show it, have the learner do it.

Often it's best simply to ask the client how they would like to receive the information. ("Would it help if I were to show you a picture of how this worm can damage the heart?" "Would you like me to tell you more about this surgery?" "Would you like to give a pill to Fluffy now that I have shown you how to do it?")

During a busy day, a veterinarian might tend to default to his or her own learning style, which may or may not be effective for the client. That's why it's good for the doctor and hospital staff to identify their own preferred learning styles. (This may also enhance the functioning of the team.)

Other communication styles

Just as different learning styles can promote or inhibit learning in different circumstances, they create challenges, too. Youker describes four different communication styles: action, process, people and ideas.

» Action-oriented communicators like to get things done efficiently, solving problems quickly. They do not like extensive discussion or explanations. When communicating with them, be brief, focus on results and emphasize practicality. An action-oriented client will make their preference known by speaking quickly, asking for immediate action and dispensing with unessential talk.

» A process-oriented client wants things presented in an organized, logical order. Be precise with them, organizing your discussion in a step-wise fashion beginning with the current situation, then specifying the expected performance and finally the expected outcomes.

» A people-oriented client is interested in relationships. He or she wants an excellent rapport with hospital staff and doctors, possibly including conversations about families, pets and jobs.

» Finally, the idea-oriented person looks at the big picture and tends to go off on tangents. Start with an overall concept or idea and relate your key points to that concept. Stress the uniqueness of the situation.

An individual's communication style can be identified by listening carefully to him or her during the interview. Does she/he brush over details and appear to want to move quickly to solutions? Or is she/he methodical, asking questions about details (process)? Perhaps she/he offers personal anecdotes and makes frequent references to relationships (people). Or a client may describe his or her concerns in very general terms, relating them to a broader picture or theory (idea).

Challenges to each style

The action-oriented client may be brusque and demand immediate attention and action, sometimes being perceived as rude and potentially missing important information in the desire to get things done quickly. Acknowledge this client's need for immediate action and explain how you will attempt to accommodate him or her. "I understand that you have some time constraints and we want to be as efficient as possible. Before we can perform the dental on Fluffy, however, we need to complete some blood tests and take an X-ray. Would it be convenient for you to leave Fluffy here with us for the tests? I'll call you as soon as they are done to discuss the results and next steps."

The process-oriented person may take a time asking questions, picking apart details. Acknowledge their need for information and try to deliver it efficiently. "I can see you have a lot of important questions about Fluffy's condition, and I want to make sure you get all the answers. Right now, however, we really need to do some blood work, so we can figure out what to do next. Let me answer any questions you may have about the blood work, and we can discuss this after we have the results. Is that OK?"

The people person may distract office staff or veterinarians with personal stories or inquiries. Always bring this client back to the problem at hand. What does the patient need right now? "I can see that Fluffy has played a very important role in your life. Now we need to pay attention to what she needs to feel better. May I have your permission to have our technician draw some blood from her so we can figure out what to do next?"

The idea-oriented person may be so caught up in generalities that it is difficult to bring him or her to focus on the problem. The same strategy of focusing on the pet's needs is appropriate. "Yes, it is astonishing how poorly some people treat their animals, but you obviously want the best care for Fluffy. Can you tell me again about her appetite?"

Almost no individual is 100 percent one type of learner or communicator. Rather, people operate on a continuum, with a preference for one style over another that may change with circumstances. It is important for the veterinary team to recognize a client's preferred styles of learning and communicating. This will allow team members to take steps to accommodate that style and avoid succumbing to its potential downside.

Recognizing a client's preferred learning and communication styles and adapting to them is the a key component of effective client education.

Dr. Timmins is president of the Association for Veterinary Family Practice and director of the Center for Animals in Society at the University of California-Davis.

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