High quality health reporting

The Milwaukee Journal Sentinel was recognized today with a Pulitzer Prize for explanatory reporting for its series on a rare medical case at the Medical College of Wisconsin. The series, "One in a Million," told the story of a little boy with a mysterious illness, and the researchers at the Medical College of Wisconsin who eventually sequenced the boy's entire genome to find a diagnosis. The Journal Sentinel team used a mix of written and multimedia pieces to explain the complexities of this emerging science. This piece not only tells a compelling story, but also serves as an example of quality health reporting. It is not enough just to tell the story, but effective reporting, explains the story and places the story within a broader scientific context. I am very proud to work at a university where such innovative research is taking place. And I'm proud to subscribe to a newspaper that is willing to invest the time and effort to tell these compelling science stories.

Soliciting questions

One of the most effective communication behaviors can engage in to assure patient understanding is to simply ask if the patient has any questions. There are a couple different techniques one could employ to accomplish this task, some of which more effective than others. The first is to simply ask: Do you have any questions? But this is what is called a close-ended question, one that can be answered with a yes or no. To solicit more than a one word answer, use an open-ended question: What questions do you have for me? An especially effective technique, though more time-consuming, is a request for teach-back, in which the physician asks the patient to repeat back what was just said, as a way of soliciting patient understanding and any underlying questions. "You may have to explain this result to your spouse or family members when you get home, just to make sure I did a good job explaining this, can you repeat back to me what we just talked about. Making the effort to encourage questions effectively engages the patient in the conversation and enables them to be an active participant in their own health care. Meanwhile, the Agency for Healthcare Research and Quality, contends questions are the answer.

Managing anxiety when talking about clinical research

I am looking forward to presenting later this month on the topic of communication and informed consent at the Association of Clinical Research Professionals Global Conference. I am going to be presenting on several different communication behaviors and theories, but I think one aspect of my presentation that may initially be surprising, though I hope will resonate, is the idea of Anxiety-Uncertainty Management. Anxiety-Uncertainty Management is actually an intercultural communication theory that examines communication between members of a given cultural group, and a "stranger" to that culture. Anxiety-Uncertainty Management contends that communication is effective when someone is able to effectively interpret the words and actions of the other person. But when a person is a stranger to the culture, they may not understand the words and actions of the other person, and thus may become anxious and unable to process the new information that they are receiving. A little bit of anxiety can be OK, and it may in fact be helpful. But when anxiety becomes overwhelming, communication suffers. It is pretty easy to see how this might play out in clinical research encounters. A potential research participant, who is new to the world of clinical research, may not be able to interpret the words and actions of the research coordinator, and because they do not understand what is going on, they may become so anxious, they are unable to process new information, such as an informed consent discussion. So what can research coordinators do? In order to create an environment where effective communication can take place, coordinators should help potential research participants manage their anxiety. They can do that by explaining who people are, what their jobs are, and what's going to happen. Take the mystery out of the clinical research experience. Because if they are able to manage their anxiety about the situation, then they will be able to have an effective conversation about participating in research.