Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Practicing the Art of Listening


Listening is essential for humanistic patient care. Listening without interrupting may strengthen the patient-clinician relationship.

Connecting with Patients | September 28, 2020 | 2 min read

By Jeffrey Millstein, MD, Penn Medicine


“In the silence of our listening we hear the heartbeat of another.” -Cynthia Davis, chaplain


There’s an exercise often used as an icebreaker. Participants pair up and take turns telling each other a two-minute story about a problem they’re facing. When it’s your partner’s turn to talk, you must listen without uttering a word and then paraphrase your partner’s story back to them. When the storytellers are asked how this exercise made them feel, the responses are often striking and memorable. Comments like, “I’ve never felt so completely heard,” and, “I had no idea what I’ve been missing,” are typical. The listeners often remark that their role is at first challenging and unnatural, yet they finish with a feeling of accomplishment. If the story being shared and received is dense with emotion and vulnerability there’s potential for feelings elicited in storyteller and listener to reach a transformative level.


We know from years of patient satisfaction survey data that presence and quality of listening top the list of behaviors that engender trust in a healthcare professional. Further, when clinicians complete training in relationship-centered communication, validated measures of empathy, patient satisfaction, and clinician emotional exhaustion improve. The Penn Medicine Listening Lab shares what clinicians and patients tell us is meaningful in their clinical encounters.


The Listening Lab is an archive of three to five-minute recorded stories contributed by patients, caregivers, clinicians, support staff. Beyond striving to improve clinician-patient relationships and patient experience, the Lab aspires to strengthen well-being, presence, and compassion. Common to all of the collected stories is the understanding that fear and illness are experiences that may shatter one’s sense of dignity. This amounts to a form of suffering that often occurs invisibly and creates the opportunity to verbalize and share. There’s the story of a surgeon who must quarantine away from his family after he discovers that he’s been exposed COVID-19 days before his wife is due to deliver their second child. There’s the patient who realizes that her nurse, who cares for her with warmth and empathy, is the same nurse who this patient had confronted years before about her callous insensitivity. Then we have the story of a man whose partner, is present for him as he sees his new face revealed after surgery for oral cancer. Listening to these stories may elevate otherwise unacknowledged histories and examples of dedication, sacrifice, compassion, and struggle.


The Listening Lab teaches us about the importance of effective communication and listening. It’s reveals the challenges of telling a personal story, along with the variety of emotional responses stories can elicit. It’s a process which requires effort and risk.


Here’s how you can practice these critical skills:


1. Listen without interruption for at least two minutes at the start of each patient visit.


2. Repeat back what you heard. This shows you’re listening closely and tests your understanding of the patient’s story.


3. When listening to colleagues, family, and friends, practice not interrupting.


4. Reflect on how you listened every day. Note ways to improve for tomorrow.