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  • Sarah Barter

The Art of Conversation

Now, more than ever, it is imperative to provide person-centred care. The COVID-19 response has resulted in reduced face-to-face interaction and physical contact in care and service provision making it even more important the remaining interactions are personal and meaningful. Meanwhile, the international Black Lives Matter movement has demonstrated the criticality of moving beyond platitudes about diversity and cultural safety and towards demonstrating a true commitment to understanding the experience of minority groups living with structural racism and systemic inequality. Our care systems and service providers can use this situation as a catalyst to transform care in a way that is truly centred around people’s individual values, needs and preferences. Managing and implementing this change is a journey that starts with identifying the core elements of person-centred care to drive training, assessment, evaluation and continuous improvement.

While recognising that I am a young woman in a position of privilege, I have reflected on my recent experiences of virtual and face-to-face health consultations to share and discuss what I consider to be the foundation of consistent person-centred care. And that is creating the time and space to master the art of conversation, not just communication. Embarking on a conversation provides the opportunity to develop trust, show respect and gather information essential to enable person-centred care. It allows you to elicit the person’s story; identify their diverse needs and preferences; consider literacy and effective communication strategies; to support informed choice and shared decision-making.

What then are the features of a good conversation? In my opinion, they are as follows:

  • Genuine curiosity about the person and interest in their life experiences and perspectives

  • Open-ended questions with appropriate follow-up/ probing questions that encourage a person to share what’s important to them

  • Validation and reflection on the person’s feelings, experiences and reality

  • Smile. Use actions and body language that reinforce your genuine interest in the person

  • Attention to the physical environment e.g. how are the chairs positioned? Is the space welcoming, quiet and private? Is it furnished and decorated in a way that embraces diversity?

  • Consideration of cues to support conversation. Are there YouTube clips, photos, translated materials or decision support tools you can use to aide the conversation? Do you need to have a computer, paper or table serving as a barrier between you and the person you are speaking with?

  • Eye contact with consideration of whether this is culturally appropriate and if the person appears comfortable with it

I think most of the above still applies and is perhaps even more important when organising and facilitating virtual consultations or using Telehealth! Obviously the more you can incorporate video as well as audio the better.

At the end of the day, I would encourage people to reflect on whether your current systems and processes for seeking information from consumers show the consumer that “I see you, I hear you, and I value you”.

Do you agree? What do you think are the hallmarks of a great conversation? What are the barriers and enablers to encouraging conversation in health and aged care, and how might we systematically address these?

I would love to work with a client to explore the above in more detail in practice. If this interests you, please get in touch!

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