In over 25 years of practice, I have witnessed the importance of recognizing patient learning styles. As a physician and now as a practice consultant, I have found that communication is of strategic importance. As physicians, we must educate our patients first through effective communication. Only then will our patients understand their condition and agree to our recommended course of treatment. “If teachers teach exclusively in a manner that favors the students’ less preferred learning style, the students’ discomfort level can interfere with their ability to learn and memorize,” notes Richard M. Felder, who is with the Department of Chemical Engineering at North Carolina State University. Therefore, in our medical practices, to be a good communicator is critical for doctors to learn and understand their patients’ learning style. Some patients say, “You are the doctor, do what you need to do. I trust you.” Other patients question your degree, experience and ancestry. In order to facilitate good patient chemistry, you need to listen to determine your patients’ learning style and then communicate to their dominant learning style. Patients learn best when they are being communicated to in their personal learning styles. In his book Experimental Learning, D.A. Kolb says it is imperative for you as an educator to know your own personal learning style. Kolb’s studies show that we tend to teach predominantly using our personal learning style. As educators, patients respond appropriately when we use the learning style that they are most comfortable with in receiving new information. How To Reach The Auditory Learner How do you determine your own memory or learning style and that of your patients? In her book The Way They Learn, Cynthia Ulrich-Tobias presents a sample questionnaire that gives insights into memory styles. Most of us learn and memorize using a combination of methods, but one style will dominate. This predominant style facilitates faster and more permanent memory. When you are attempting to learn or memorize, you are more comfortable and learn faster with your dominant learning style. My curiosities led me back to Tobias and her memory styles. These memory styles are visual, auditory and kinesthetic. Most people have a combination of styles but all of us have a dominant preference. Auditory. An auditory learner will respond positively when you ask, “Do you understand?,” or “Do you hear me?” These patients may ask you to repeat what you have just said. Auditory people learn best through verbal communication as they hear and remember. As an educator of auditory patients, you must speak clearly, repeat important points and look directly at them when you speak so they can read your lips. These patients memorize best with recorded cassette tapes they can take home. An auditory learner often puts what he or she needs to know into rhyme or song. Auditory learners: • need to hear themselves say it in order to remember it; • often need to talk through a problem aloud in order to solve it; • memorize best by repeating the information aloud or to themselves over and over; • remember best when the information fits into a rhythmical or musical pattern; and/or • would rather listen to a recording of a book than sit and read it. Getting The Attention Of Visual And Kinesthetic Learners Visual. Visual learners are pictorial learners. To help determine if patients are visual learners, ask them if they can see their condition as you point to a picture or an X-ray. A visual learner will give you feedback such as “I see” or demonstrate appreciation to a drawing or pamphlet depicting his or her condition. One can facilitate learning via surgical drawings and X-rays. Visual learners are fascinated with their X-rays and will nearly always ask you to explain the existence of their sesamoid bones. Always send these patients home with appropriate pamphlets or drawings in their hands. Utilize treatment recommendation sheets so you can write down their diagnosis in print. Indicate any X-ray abnormalities and list treatment recommendations. These should all be spelled out in layman’s terminology on the treatment recommendation sheet the patient takes home. If you are not communicating effectively with the visual learning, patients will tell you they cannot “see” what you are trying to say. Visual learners: • need to see an illustration of what they are being taught before they understand it; • are drawn to flashy, colorful, visually stimulating objects; • almost always prefer books which include pictures or illustrations; • look like they are daydreaming when they are trying to get a mental picture of what is being said; and/or • usually remember better when they can actually see the person who is talking. Kinesthetic. The last and least prevalent memory style is a kinesthetic learning style. These individuals respond to movement. Not only are they active, action-oriented people but they enjoy skeletal models, feeling a bone spur, examining an orthotic and experiencing how a taping feels on their feet. Kinesthetic learners have short attention spans. They want action so involve them in the learning process with short bursts of information coupled with models they can touch. These patients respond best to being involved in their healing process, whether it’s via exercise, stretching, massage therapy, taking medication or utilizing topical patches such as Lidoderm. Make these patients part of the team by placing responsibility on them to perform these modes of self-treatment to facilitate improvement. Kinesthetic learners: • have difficulty sitting still for more than a few minutes at a time; • usually learn best by physically participating in a task; • almost always have some part or their bodies in motion; and/or • prefer to read books or hear stories that are full of action. This self-evaluation will give you insight as to your personal memory preference. Once you ascertain your predominant memory style, you can work on the less dominant styles to improve your appreciation and facilitate the use of other methods to help communicate more effectively with those who have memory styles different than your own. Mastering Communication With More Challenging Patients Having practiced in Seattle, I treated a significant number of engineers from Boeing. I did not take me long to see that I wasn’t receiving the compliance with my engineer patients that I was getting with other patients. This failure stimulated me to search for better methods of communication. Equally enigmatic were the patients who agreed with all phases of my treatment plan, but did not follow through with our agreed upon course of therapy. Lastly, the high activity, high maintenance patients were particularly challenging and I vowed to understand and communicate with them more effectively. If you cannot decide what type of learner you are dealing with, use all three memory methods. Show pictures, X-rays and drawings. Repeat and emphasize key points. Facilitate the patient’s tactile sensations. Once you adapt these styles in your communication with patients, you’ll be on your way to better rapport, better compliance of your recommendations and a more enjoyable practice. Dr. Vance is a practice management consultant in Seattle and is board-certified by the American College of Foot and Ankle Surgeons. He practices with Gordon Nishimoto, DPM, at Northwest Foot And Ankle Specialists in Everett, Wa.
References 1. Felder RM: Matter of style. Department of Chemical Engineering, North Carolina State University, Raleigh, NC. 2. Kolb DA: Experiential learning: experience is the source of learning and development. Englewood Cliffs, NJ, Prentice Hall, 1984. 3. Ulrich-Tobias C: The way they learn. Focus on the Family Publishing, Colorado Springs, CO 1994.