Abstract ID: 1106

Primary Topic: Clinical skills-building
Secondary Topic: Interprofessional education

Words that Harm, Words that Heal: How to Transform Language to Improve Clinical Encounters
Dawn M Bellanti, MSN, FNP, MedStar Institute for Innovation, Kensington, MD, United States

Late Breaker: No

Purpose

The purpose of this presentation is to:

1) Illustrate the key lessons learned from placebo, nocebo, and hypnosis research;

2) Bring awareness to how our use of language in the field of healthcare has the power to both harm and heal; and

3) Provide practical ways to reframe our choice of words from the negative to the positive to improve encounters in our professional and personal encounters. 

This presentation seeks to translate key findings from integrative medicine research into clinically relevant actions, in alignment with the conference’s goals to improve interprofessional collaboration.

Objectives

Following this presentation, attendees will be able to:

  1. Paraphrase the lessons learned from placebo, nocebo, and hypnosis research in order to interpret the key message: that our choice of words deeply influences others in both positive and negative ways.

  2. Appraise whether they have been unknowingly using negative languaging in personal and professional conversations in order to judge the relevance of this information to them as individuals and healthcare providers.

  3. Interpret the personal meaning and value of the information learned in order to implement more positive languaging in the future.

Time Frame

Hour 1:

  • Introduction 

  • How “medical-eze” unintentionally harms (high-tech terminology, fear-inducing metaphors, outdated insensitive language, gallows humor)

  • Why Our Words Matter: The Nocebo Response

  • Leveraging Lessons from Placebo Research

Hour 2:

  • Top 8 “Words to Lose” & “Words to Use”

  • Therapeutic Languaging during Patient Encounters

Hour 3:

  • Putting it into Practice: Two role-playing scenarios demonstrating  “words that harm” and “words that heal” 

Time built into each of the 3 sections to ask attendees for their responses and observations and group discussions.

Faculty

I will be presenting the workshop.

My background is as a clinician (Family Nurse Practitioner), researcher (past 20 years conducting research in the field of integrative medicine at Georgetown University Medical Center, NCCAM, Samueli Institute), and mind-body practitioner in private practice (certified in hypnotherapy, interactive guided imagery).  

I am also completing my Doctor of Nursing Practice degree with a concentration in Integrative Health and Healing at the University of Minnesota where Dr. Mary Jo Kreitzer is my faculty advisor.  

I developed this presentation as part of a recent doctoral course assignment (Scholarly Teaching and Learning at the University of Minnesota) and received excellent feedback from the faculty instructor.

Teaching/Learning Strategies

This workshop will use the following teaching strategies:

  • Presentations of content via PowerPoint slides

  • Verbally reciting phrases that represent negative languaging and ways to rephrase them positively

  • Engaging the audience to respond with reactions and observations frequently throughout the workshop

  • Role-playing simulation with volunteer from audience 

  

I will use PowerPoint slides as talking points, presenting only several slides with overall summaries of the relevant placebo/nocebo studies for the initial part of the presentation. 

Then, I plan to verbally give examples of negative and positive phrasing which will stimulate attendees to critically self-reflect on their own language patterns. 

By pausing frequently and asking audience members to react and respond at key points, I hope to engage them in critical dialogue. 

Finally, the role-playing simulation at the end of the workshop presents two versions of the same patient interaction to demonstrate two scenarios during an IV insertion as an example of an uncomfortable medical procedure. Modeling a healthcare provider, I will first demonstrate “what not to do” (use language that is dismissive, blaming, minimizing, patronizing, commanding).  Next, I will model the use of more therapeutic positively worded language that also incorporates brief mind-body skills and purposeful suggestions.   This format of delivery provides a real-life application in which learners can visualize how the information learned has applicability for them as healthcare providers.  I plan to demonstrate this in a somewhat exaggerated way (e.g., the “what not to do” scenario includes multiple “wrong” ways to converse with an anxious patient) so that it hopefully introduces some levity, as humor is a vehicle to make information more memorable.

Outline

Presentation Overview:

  1. Introduction and learning objectives

  2. How “medical-eze” unintentionally harms (high-tech terminology, fear-inducing metaphors, outdated insensitive language, gallows humor)

  3. Why Our Words Matter: The Nocebo Response

  4. Leveraging Lessons from Placebo Research

  5. Top 8 “Words to Lose” & “Words to Use”

  6. Therapeutic Languaging during Patient Encounters

  7. Putting it into Practice: Two role-playing scenarios demonstrating  “words that harm” and “words that heal” 

If the program committee feels your presentation would be better suited for a different presentation type, such as a symposium (shorter format during the main meeting), would you be willing to adapt your presentation to fit the new format?

Yes

Who is the target audience of the workshop? Are there particular skills or background that are recommended as pre-requests?

Ideally, this workshop is targeted for healthcare professionals who interact with clients and/or patients. It would be most relevant to physicians, nurses, and other health professionsl.

Is this workshop proposed by an organization?

No

If yes, please name

NA

Organization's website

NA

Has the content (or substantial parts) of this workshop been previously presented or published (note: previous experience presenting the material may be considered a strength as long as continued interest is anticipated)?

Yes

Please provide Location of Presentation and/or Publication Information and date of each presentation

I presented a 1 hour version of the workshop as a Grand Rounds presentation to medical students, residents, and faculty at a military treatment facility in the Washington, D.C. area. 

It was very well-received and generated a lot of discussions and interactions among the physician attendees.  One faculty member suggested that I lengthen it, create more interactive experiences, and include a role-playing scenario.  I have implemented these suggestions in the currently submitted 3 hour workshop.