Healthcare Core Curriculum
Competency #2 : Active Listening
Dede Carr, BS, LDA
Karen Neu, MSN, CNE, CNP
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2
Objective
 Explain how active listening skills can improve
client/individual and team communication
Analyze two active listening messages for effective
communication & identify components of
communication, the communication process, and
effectiveness of the message
Discuss the comparison and contrast of two active
listening messages
History repeats itself because no one listens the first
time. Anonymous
Conversation: a vocal competition in which the one
who is catching his breath is called the listener.
Anonymous
The most basic of all human needs is the need to
understand and be understood. The best way to
understand people is to listen to them.
Ralph Nichols
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Focus on the person who is speaking
Vital part of the communication process
Way of listening & responding to another person
that improves mutual understanding & trust
Builds trust
Reduces tension
S = Sensing
I = Interpreting
E = Evaluating
R = Responding
Model is hierarchical
 Receiver must use all receptive senses during the sensing
phase to improve quality of the interpretation, evaluation &
response phases so one moves from base upward.
 When a misunderstanding occurs, both parties need to restart
their analysis at bottom of hierarchy.
(Steil, Baker, & Watson fr0m Proven Models)
Step1. SENSING
 Active listening begins by hearing, seeing &
receiving verbal & nonverbal aspects of the
message.
 Concentration is required in this phase.
 Client should not be interrupted so the message can
be delivered in full & adequate detail.
 Receiver's body language should be positive to help
the sender deliver the message
(Proven Models)
Step 2. INTERPRETING
 After receiving the message, the receiver (Health
Care Worker) must interpret & place it in
meaningful context
 Client’s experiences, knowledge & attitudes should
be linked to the verbal & non-verbal elements of the
message
 Interpreting helps insure that the receiver's
understanding corresponds to the sender's meaning
(Proven Models)
Step 3. EVALUATING
 Active listening occurs at the evaluation phase after the
interpretation phase
 Receiver must sort fact from opinion.
 Receiver needs to judge the message based on its
strengths & weaknesses & how well it is liked or
disliked.
 Evaluation phase consists of both logical & emotional
components.
(Proven Models)
Step 4. RESPONDING
 Two-way communication requires the receiver to
respond to the sender
 Response provides feedback to the sender on how
well the message was understood & encourages
further interaction between the two parties
 Responses can be both verbal & non-verbal.
Rephrasing & reflecting the sender's message shows
interest & increases understanding.
 Probing questions provide additional detail &
clarification
(Proven Models)

The SIER Model of Active Listening is hierarchical. The
receiver must use all receptive senses during the sensing
phase to improve the quality of the interpretation,
evaluation and response phases.

When a misunderstanding occurs, both parties (sender
& receiver) need to restart their analysis at the bottom
of the hierarchy.
(Steil, Baker, & Watson fr0m Proven Models)
See SIER Hierarchy of Active Listening Model on next Slide.
Responding
Evaluating
Interpreting
Sensing
(Steil, Baker, & Watson fr0m Proven Models)
Pay full attention to the person
who is speaking. Don't look
out the window or at what else
is going on in the room.
Make sure your mind is
focused
 It can be easy to let your mind
wander if you think you know
what the person is going to say
next, but you might be wrong!
 If you feel your mind
wandering, change the
position of your body and try
to concentrate on the
speaker's words (Gerzon, n.d.)
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Let the speaker finish before you begin to talk.
Speakers appreciate having the chance to say
everything they would like to say without being
interrupted. When you interrupt, it looks like you
aren't listening, even if you really are.
Let yourself finish listening before you begin to
speak! You can't really listen if you are busy
thinking about what you want say next.
(Gerzon, n.d.)
Listen for main ideas
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The main ideas are the most important points the
speaker wants to get across.
Main ideas may be mentioned at the start or end of a
talk, and repeated a number of times.
Pay special attention to statements that begin with
phrases such as "My point is..." or "The thing to
remember is..."
(Gerzon, n.d.)
Ask questions
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If you are not sure you understand what the speaker has
said, just ask.
It is a good idea to repeat in your own words what the
speaker said so that you can be sure your understanding is
correct.
For example, you might say, "When you said that no two
zebras are alike, did you mean that the stripes are different
on each one?"
(Gerzon, n.d.)
Give feedback
 Sit up straight and look directly at the speaker.
 Now and then, nod to show that you understand.
 At appropriate points you may also smile, frown,
laugh, or be silent. These are all ways to let the
speaker know that you are really listening.
 Remember, you listen with your face as well as
your ears!
(Gerzon, n.d.)
Remember: time is on your side!
 Thoughts move about four times as fast as speech.
 With practice, while you are listening you will also
be able to think about what you are hearing, really
understand it, and give feedback to the speaker.
(Gerzon, n.d.)
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Build atmosphere of trust
Lean forward, make eye contact
Have enough time & energy to listen
Restate, clarify & sum up what you’ve heard
Practice listening
Ask for feedback
(Gerzon, n.d.)
◦ Finishing others thoughts
◦ Tolerating or creating distractions
◦ Faking paying attention
◦ Creating early assumptions without keeping an
open mind
◦ Calling the subject uninteresting
◦ Criticizing the speaker or the topic being
discussed
(Gerzon, n.d.)
Pay
Attention
Monitor
Non-Verbal
Make No
Assumptions
Effective Active
Listening
Paraphrase
& Repeat
Encourage
Client to Talk
Visualize
Effective Listening Skills
Bascal & Associates. (2008-2010). What are probing questions?
Probing questions ask for more information or clarification.
Retrieved from
http://work911.com/communication/skillsprobing.htm
Gerzon, J. (n.d.). Key tips for active listening. Retrieved from
http://web.mit.edu/hr/oed/learn/comm/art_active.html
Proven Models. (2005-2011). SIER Hierarchy of active listening. Retrieved
from http://www.provenmodels.com/554
Ramon, P.R. & Niedringhaus, D. M. (2008). Client Communication.
Fundamental nursing care (2nd ed.). (pp. 226-242). Upper Saddle
River, NJ: Person Prentice Hall
Steil, L., Baker, L., & Watson, K. (1983). SIER Hierarchy of active listening.
Proven Models (2005-2011). Retrieved from
http://www.provenmodels.com/554