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In some of the transcripts, genetic counselors did explore the patient’s experiences
and how those experiences informed the patient’s knowledge of Down syndrome:
Genetic counselor: Are you familiar at all with Down syndrome?
Client: Yeah, I drive a bus and some of the kids on my school bus have Down
syndrome.
Genetic counselor: And so kind of tell me about the kids...” (pp. 818–819).The researchers noted, however, that “Only a small fraction of these genetic
counselors directly asked if the client had thought about what life might be like
if they had a child with disabilities. These questions have different aims.
Questioning a client about what she will do with the results from prenatal testing
is aimed at the outcome: will an affected pregnancy be terminated or will the
patient continue with the pregnancy, keeping the child or offering the child up for
adoption? Such a question may provide insight about the client’s perception of
disability, but it does not necessarily facilitate informed decision-making.
Instead, by asking if the client has thought about what it would be like to raise a
child with disabilities, genetic counselors will position themselves to directly
address questions or misinformation about disability” (p. 821).5.1.3 Asking Questions Effectively
Know When to Ask a Question
There are three times when a question can be particularly effective:
- When you have a clear reason for asking a question. The ultimate test of a ques-
tion is whether it will be helpful to your patient (Hill 2014 ). Before asking a
question, consider whether you would know what to say if your patient asked
why you want to know. - When you want to gather more information and/or clarify patient meaning. You
may not have the same definitions as your patients for certain words and
experiences. - When you don’t understand. One of the biggest mistakes you can make is to
assume you understand without checking out those assumptions with your
patient (Spitzer Kim 2009 ). Questions help to clarify your misperceptions.
Know How to Ask a Question
- Use questions strategically. Questions lead the patient, and therefore they are
very directive. For example, if your patient says, “My husband doesn’t agree
with my decision about prenatal testing.” You could respond, “Tell me more
about the discussions you had with your husband about this,” “Is this upsetting
5 Gathering Information: Asking Questions