1. Communications in Health Care
Healthcare Core Curriculum
Competency #2 : Active Listening
Dede Carr, BS, LDA
Karen Neu, MSN, CNE, CNP

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3. Competency #2: Active Listening
Objective
Explain how active listening skills can improve client/individual and team communication
Analyze two active listening messages for effective communication & identify components of communication, the communication process, and effectiveness of the message
Discuss the comparison and contrast of two active listening messages

4. Quotes
History repeats itself because no one listens the first time. Anonymous
Conversation: a vocal competition in which the one who is catching his breath is called the listener Anonymous
The most basic of all human needs is the need to understand and be understood. The best way to understand people is to listen to them.
Ralph Nichols

5. Active Listening….. Focus on the person who is speaking
Vital part of the communication process
Way of listening & responding to another person that improves mutual understanding & trust
Builds trust
Reduces tension

6. SIER Hierarchy of Listening
S = Sensing
I = Interpreting
E = Evaluating
R = Responding
Model is hierarchical
Receiver must use all receptive senses during the sensing phase to improve quality of the interpretation, evaluation & response phases so one moves from base upward.
When a misunderstanding occurs, both parties need to restart their analysis at bottom of hierarchy.
(Steil, Baker, & Watson fr0m Proven Models)

7. SIER Hierarchy of Listening
Step1. SENSING
Active listening begins by hearing, seeing & receiving verbal & nonverbal aspects of the message.
Concentration is required in this phase.
Client should not be interrupted so the message can be delivered in full & adequate detail.
Receiver's body language should be positive to help the sender deliver the message
(Proven Models)

8. SIER Hierarchy of Listening
Step 2. INTERPRETING
After receiving the message, the receiver (Health Care Worker) must interpret & place it in meaningful context
Client’s experiences, knowledge & attitudes should be linked to the verbal & non-verbal elements of the message
Interpreting helps insure that the receiver's understanding corresponds to the sender's meaning
(Proven Models)

9. SIER Hierarchy of Listening
Step 3. EVALUATING
Active listening occurs at the evaluation phase after the interpretation phase
Receiver must sort fact from opinion.
Receiver needs to judge the message based on its strengths & weaknesses & how well it is liked or disliked.
Evaluation phase consists of both logical & emotional components.
(Proven Models)

10. SIER Hierarchy of Listening
Step 4. RESPONDING
Two-way communication requires the receiver to respond to the sender
Response provides feedback to the sender on how well the message was understood & encourages further interaction between the two parties
Responses can be both verbal & non-verbal. Rephrasing & reflecting the sender's message shows interest & increases understanding.
Probing questions provide additional detail & clarification (Proven Models)

11. SIER Hierarchy of Active Listening
The SIER Model of Active Listening is hierarchical. The receiver must use all receptive senses during the sensing phase to improve the quality of the interpretation, evaluation and response phases.
When a misunderstanding occurs, both parties (sender & receiver) need to restart their analysis at the bottom of the hierarchy.
(Steil, Baker, & Watson fr0m Proven Models)
See SIER Hierarchy of Active Listening Model on next Slide.

12. SIER Hierarchy of Active Listening
Res- ponding
Evaluating
Interpreting
Sensing
(Steil, Baker, & Watson fr0m Proven Models)

13. Tips for Being a Good Listener
Pay full attention to the person who is speaking. Don't look out the window or at what else is going on in the room.
Make sure your mind is focused
It can be easy to let your mind wander if you think you know what the person is going to say next, but you might be wrong!
If you feel your mind wandering, change the position of your body and try to concentrate on the speaker's words (Gerzon, n.d.)

14. Tips for Being a Good Listener
Let the speaker finish before you begin to talk. Speakers appreciate having the chance to say everything they would like to say without being interrupted. When you interrupt, it looks like you aren't listening, even if you really are.
Let yourself finish listening before you begin to speak! You can't really listen if you are busy thinking about what you want say next.
(Gerzon, n.d.)

15. Tips for Being a Good Listener
Listen for main ideas
The main ideas are the most important points the speaker wants to get across.
Main ideas may be mentioned at the start or end of a talk, and repeated a number of times.
Pay special attention to statements that begin with phrases such as "My point is..." or "The thing to remember is..."
(Gerzon, n.d.)

16. Tips for Being a Good Listener
Ask questions
If you are not sure you understand what the speaker has said, just ask.
It is a good idea to repeat in your own words what the speaker said so that you can be sure your understanding is correct.
For example, you might say, "When you said that no two zebras are alike, did you mean that the stripes are different on each one?"
(Gerzon, n.d.)

17. Tips for Being a Good Listener
Give feedback
Sit up straight and look directly at the speaker.
Now and then, nod to show that you understand.
At appropriate points you may also smile, frown, laugh, or be silent. These are all ways to let the speaker know that you are really listening.
Remember, you listen with your face as well as your ears! (Gerzon, n.d.)

18. Tips for Being a Good Listener
Remember: time is on your side!
Thoughts move about four times as fast as speech.
With practice, while you are listening you will also be able to think about what you are hearing, really understand it, and give feedback to the speaker.
(Gerzon, n.d.)

19. Active Listening Do’s Build atmosphere of trust
Lean forward, make eye contact
Have enough time & energy to listen
Restate, clarify & sum up what you’ve heard
Practice listening
Ask for feedback
(Gerzon, n.d.)

20. Culprits of Non-active Listening
Finishing others thoughts
Tolerating or creating distractions
Faking paying attention
Creating early assumptions without keeping an open mind
Calling the subject uninteresting
Criticizing the speaker or the topic being discussed
(Gerzon, n.d.)

21. Verbal Communication: Listening (Gerzon, n.d.)
Effective Active Listening
Visualize
Encourage
Client to Talk
Make No
Assumptions
Paraphrase
& Repeat
Monitor
Non-Verbal
Pay
Attention

22. You Tube
Effective Listening Skills

23. References
Bascal & Associates. ( ). What are probing questions? Probing questions ask for more information or clarification. Retrieved from
Gerzon, J. (n.d.). Key tips for active listening. Retrieved from
Proven Models. ( ). SIER Hierarchy of active listening. Retrieved from
Ramon, P.R. & Niedringhaus, D. M. (2008). Client Communication. Fundamental nursing care (2nd ed.). (pp ). Upper Saddle River, NJ: Person Prentice Hall
Steil, L., Baker, L., & Watson, K. (1983). SIER Hierarchy of active listening. Proven Models ( ). Retrieved from