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• Exhibiting cultural humility as well as cultural competence.
• Acknowledging the wealth of experiences that the patient brings to the
discussion.
• Regarding your patient as a colleague who is equal in life experience.
• Encouraging expression of ideas and feedback at every opportunity.
The implication of these principles of learning styles and adult education is that certain
instructional designs produce more effective learning outcomes for adults than other designs.
For example, adults crave programs that offer the possibility of experimentation and creativity.
Learning also should be as task-centered as possible, giving adults the ability to solve
problems that they frequently face in their lives, to realize their goals, and to bring about
change for their own needs.
Remember too – adults may be fatigued. Therefore, they appreciate any teaching devices
that add interest and a sense of liveliness such as audio-visual aids, change of pace, and
sense of humor!
IMPROVING COMMUNICATION IN ORDER TO ENHANCE SHARED
DECISION-MAKING
In order to engage patients and families in shared decision-making, it is imperative to create
a culture of trust.
In 1983, Berlin and Fowkes
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proposed a teaching framework to enhance
cross-cultural communication between patients and providers that they designated as the
LEARN model. The intent of LEARN is to help clinicians focus on patients’ perceptions and
comprehension of their illness and to understand patients’ viewpoints and preferences toward
the goal of reaching a shared understanding in making decisions about treatment. The
LEARN model may help identify and address barriers to weight management.
Improving Communication:
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L
Listen with sympathy and understanding to the patient’s perception of the
problem; maintain eye contact throughout and use appropriate gestures
such as nodding or light touching to indicate you are listening (ie, practice
‘active listening).
E
Explain your perceptions of the problem (ie, practice active listening).
A
Acknowledge and discuss the differences and similarities.
R
Recommend treatment.
N
Negotiate agreement.
Remember, people of all cultures want to be treated in ways that: