For Teachers & Professionals

Emphatic Communication

The need for specific empathic communication strategies is not a new thing. Its importance has been now underlined for decades. Many recommend the development of systematic approaches to teach healthcare professionals what compassionate care is and when to use empathy. One of the struggles is to define what empathy is. It is broadly defined as the ability to share someone else's feelings or experiences by imagining what it would be like to be in that person's situation. But a more precise vocabulary around specific expressions of empathy (e.g. reassurance or concern) could help clarify how expressions of empathy should be designed depending on the context.

Here are proposed some of the important parts of the construct of empathy in communication.

1. Empathic validation

The most important features of empathic validations are that they (a) demonstrate shared understanding and (b) support the patient’s position regarding the experience at hand. For the first case, simple repeats of what was already said or overly general responses (e.g., yes, I understand) demonstrate only acknowledgement and not shared understanding. Vocalizing some aspect of the patient’s experience, however, does communicate the shared understanding that empathy entails, especially when the validation extends beyond what the patient has already shared. An example of this is if a patient minimizes their condition, but the physician expands on what the patient feels by adding that the condition is distressing or naming other emotions. Furthermore, the assessment of the patient’s health shouldn’t be delivered as one that is based only on the professional evaluation of medical information but also addresses some shared understanding about the patient’s feelings or experiences. Patients should be able to receive empathy regardless of how skilled they are at inviting it.

2. Empathic touch and eye-gaze

Nonverbal empathy is less frequently discussed or taught, but we know that communication is not just about words and that physical language conveys other and more meaning. Physical touch serves as one key tool of empathic, and nonverbal communication. In general, two forms of touch have been described in the physician–patient encounter: diagnostic touch with a clinical aim that serves to help arrive at a diagnosis and healing touch that has social significance or meaning, like for example a hug, a handshake, or pat on the back). 

A physician’s gaze significantly impacts the patient encounter. Yet, there are moments in the clinical encounter that lack eye contact. This is only worsened with a computer in the room, competing for the physician’s attention. The physician’s eye gaze as they exit the room may have unique importance. 

3. Empathic listening

Empathic listening is a structured listening and questioning technique that allows you to develop and enhance relationships with a stronger understanding of what is being conveyed, both intellectually and emotionally. The act of listening, such as “listening to concerns” and “listening carefully to the patient”, conveys sensitivity for the patient and the relationship. Being listened to and understood are important parts of clinician-patient communication.

REFERENCES

Moudatsou M, Stavropoulou A, Philalithis A, Koukouli S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare.; 8(1):26. https://doi.org/10.3390/healthcare8010026 

Lecat, P., Dhawan, N., Hartung, P. J., Gerzina, H., Larson, R., & Konen-Butler, C. (2020). Improving Patient Experience by Teaching Empathic Touch and Eye Gaze: A Randomized Controlled Trial of Medical Students. Journal of Patient Experience, 1260–1270. https://doi.org/10.1177/2374373520916323 

Tietbohl, C. K. (2022). Empathic Validation in Physician–Patient Communication: An Approach to Conveying Empathy for Problems With Uncertain Solutions. Qualitative Health Research, 32(3), 413–425. https://doi.org/10.1177/10497323211056312