When the Ida Institute presents the Motivation Tools to a group of participants for the first time, we often feature the short video titled “The Color of My Hair” very early in the presentation. The video depicts an audiologist who, according to her own reflections, is not paying as much attention to her patient’s concerns as she thought she was. The point of this compelling video is not to point fingers, but to illustrate the gap that sometimes exists between what audiologists say they do and what they actually do in patient encounters. More importantly, the video allows us to open a dialogue about patient-centered care with the participants. Most participants can immediately identify things that they think the audiologist in the video should have done. We use it to encourage participants to think about their own practice experience and of times when they may have missed opportunities to be more attuned and sensitive to their own patients’ concerns.
Professional Development for Patient-Centered Practice
Patient-centered care is central to the Ida Institute’s mission of fostering a better understanding of the human dynamics of hearing loss. While hearing care practitioners may adopt patient-centered measures and believe they are running a patient-centered practice, everyone – regardless of their profession – can experience gaps like the audiologist in the video. Professional development, especially in the area of patient-centered care, is a continuous process. That is why the Ida Institute offers tools and resources to help hearing care professionals re-examine their own self-awareness and empathy and actively engage with their colleagues for practical ideas and support.
Patients at the Center
Ida Tools for Self-Development
· Dilemma Game · Reflective Journal · Time and Talk · Video Library
“Anyone who thinks they are doing fine is an ideal candidate for reflection!” says Christine DePlacido, a trained audiologist, counselor and senior lecturer at Queen Margaret University in Edinburgh, Scotland. Christine contributed her expertise in humanistic counseling, psychodynamic counseling, cognitive behavioral therapy, and hypnotherapy to the development of Ida’s Reflective Journal Tool. “We can always improve our practice by reflecting, particularly on the routine things we do without really having to think about them,” she explains. “That is where there is a danger of becoming stale and losing empathy. Ultimately, there is a risk of reduced job satisfaction and burn out.” In a 2010 article on "Reflective Practice in Audiology" in the Hearing Journal, Christine noted that reflecting on their own practice can help clinicians to acquire new perspectives on the challenges and issues they encounter on a daily basis and gain insight into assumptions and responses they might otherwise take for granted. The result can be improved judgment and more informed actions that benefit the patient and help to build a relationship of trust and confidence. “At its core, reflection is a way to look at relationships, to explore what happened in the interaction between patient and practitioner and to reflect or think about how you can use that information to improve your relationship with your patient,” Christine says. Reflection requires practitioners to examine their current practice and look critically at their own behavior. In audiology, we ask patients to consider where they are successful in dealing with their hearing loss and where they struggle so they can apply their strengths to difficult scenarios. In the same way, hearing care professionals can benefit by reflecting on the day’s appointments.
Reflecting on Day-to-Day Practice
Anyone who thinks they are doing fine is an ideal candidate for reflection!
— Christine DePlacido
How can professionals in a busy practice who see patients in quick succession make time to become more self-aware and assess the soundness of their patient-centered care? “Most professionals are self-aware to a certain degree, but there is always room for more reflection,” says Christine. “An easy way to self-check is to set an alarm on your watch to go off every hour and then check if you were aware of how you were feeling just before the alarm went off. A body check is a good way to do this. Most of us are too busy ‘doing’ to tap into our feelings - until something upsets us - and therefore are not self-aware!” The Reflective Journey Tool takes practitioners through a series of questions that help formalize the reflecting process. By posing key questions, the Journal facilitates the reflective process following an encounter with a patient. Questions include: What was happening for me in the encounter? What went right or wrong? What can I do differently? The eight-question checklist can be downloaded and printed in multiple copies to keep in the office for use throughout the day.
Making Time for Reflection
If a demanding pace is affecting staff on a larger scale, group activities can be used as team building exercises to generate new ideas while showing the different strengths and abilities of individual clinicians.
Reflection as Team Building
Audiologists discuss the benefits they gained from using the Time and Talk tool with their colleagues.
Ida’s Time and Talk Tool, developed in collaboration with Lesley Jones, Honorary Senior Lecturer in Social Science at Hull York Medical School, is one such teaching tool. The online tool uses scenarios and role-plays of mock consultation sessions to teach practicing hearing care professionals valuable skills that can be applied in clinical practice. The tool helps both experienced and new professionals to draw insightful connections between clinical and communication skills. This enables them to see how new ways of asking open-ended questions or using personal reflection can lead to a more efficient, personable and patient-centered appointment. It also gives supervisors an opportunity to observe clinicians’ techniques directly, make suggestions, and open a dialogue with their direct reports. “A good supervisor will help you offload and unpick difficult sessions so that you can see beyond your reflection and build your reflexivity,” says Christine. “This helps the patient and audiologists to examine what is behind these difficult sessions. The supervisor can challenge practitioners in a way that they may not challenge themselves, so there is an opportunity for deeper self-reflection and growth.” Christine notes that in her experience, this type of supervision is not routinely available. Most audiologists adapt by talking to colleagues informally about practical ways to handle these situations or by setting up small peer support groups.
7 Easy Ways to Improve Your Professional Development
· Bring the Dilemma Game to play at your staff meetings · Do a self-awareness check once a week · Watch an Ida ethnographic film on your lunch break · Create or join a Facebook group where you can start discussions using the Dilemma Game · Arrange a Time & Talk workshop day with colleagues · Do a mini role-playing session with a colleague on your break · Fill out the Reflective Journal once a week
If structured support for strengthening patient-centered care isn’t available in a hospital or clinic, Ida’s Dilemma Game Tool can help guide informal sessions among colleagues. The game consists of a series of dilemma cards that each describe a challenging scenario in a clinical setting and offer multiple solutions for them. The game is a low-pressure way to stimulate conversation and knowledge sharing among colleagues. With no right or wrong answers, game play encourages reflection, critical thinking and analysis of the potential consequences that a practitioner’s choices may have on the patient and a variety of stakeholders. “Ida tools are designed collaboratively, so it is natural that we have tools and activities that can be used collaboratively,” says Ida Institute Managing Director Lise Lotte Bundesen. “Patient centered care begins with practitioners who are able to empathize with their patient’s concerns. Our tools for self-development encourage audiologists at every stage of their careers to continue to explore how a holistic approach can benefit them and their patients.”