Rethinking the vaccination interview - Veterinary Practice
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Rethinking the vaccination interview

ON the pre-congress day of the ESFM Congress, Merial organised an innovative interactive forum which explored how communication can overcome vaccination confusion in the consulting room.

The “How’s my driving?” sign you see on vans and trucks is becoming a common sight on our motorways. But have you ever wondered about the veterinary equivalent, “How’s my consulting?” Communication experts at the day-long forum explored this question.

First up was a look at one of the most common client-vet clinical interactions: the vaccination interview. Puppy and kitten vaccinations and boosters are among the main breadand-butter work of the modern vet. However, there is growing evidence that clients are, in many cases, failing to vaccinate adequately – either they do not come back in for boosters or they fail to vaccinate their animal altogether.

There are many reasons for why this happens including a fear of vaccination or confusion regarding duration of immunity. The client may, for example, access inaccurate and frightening information on the internet. In other cases the client has not been convinced on the value of vaccination and, with the recession biting, has decided that spending money on a booster is just not that important.

To address these factors, a new approach to the vaccination interview is necessary. In some instances the event is seen as an annual “jab and go”, but it seems that taking extra time to truly interact with the client has never been more important.

The aim is to use appropriate communication skills to pinpoint what individual vaccination regime would work best for the client and his or her pet. At the forum professional roleplay actors and vet communication experts were brought in to explore what techniques vets can use to best achieve such a goal.

One of the first rules about communication skills is that there are no rules: there is no one-size-fits-all approach. But, say the experts, there are a number of learnable techniques that are recognised as effective in building a rapport with your client.

Alan Radford, University of Liverpool, said: “There’s no script and no rules, you communicate in your own personal style. What we hope you take from this are things that you might do differently or the things that you already do well are reinforced.”

Alan, and Carol Gray, also from the University of Liverpool, facilitated a series of role plays specially selected to illustrate some of the more difficult vaccination scenarios that vets face in practice. After each scenario was played out, the audience was invited to discuss what communication techniques seemed to work, and what didn’t. Following discussion the actors reworked the role play and highlighted what a few small changes in communication style can achieve.

A particularly valuable aspect to the process was that the actors gave the audience feedback about how they had felt in their character’s shoes. “How was it for you?” is not something we generally ask our clients, so the use of role-play actors is as close to the real thing as we can get.

Range of emotions

During the day the client, professional role-play actor Beverley Dean, was able to report a range of emotions and anxieties. Similarly, the vet, in this case played by Bristol veterinary graduate and trained actor Steve Wedd, could also explain why he acted and spoke as he did during the consults.

During the day there were excellent take-home tips for veterinary practitioners. Most vets know the value of an open question such as “How can I help [pet’s name] today?” at the start of a consult. But, especially when we’re busy or stressed, how often do we forget that that question has two parts: the enquiry itself and then actually listening to what the client has said.

The old adage of “It’s not what you say, it’s how you say it” also arose, and attention to body language – achieving good eye contact and open body posture with uncrossed arms and legs – is also vital in creating a healthy rapport with the client.

In one of the scenarios, where the client was worried about her cat producing litter after litter of kittens and the vet was more worried that the cat had never been vaccinated, it was clear that the two had different sets of priorities.

The client is stressed because the credit crunch had led her to working long hours. When the vet tells her that the cat is overdue – complete with a glare – the result is that an already guilty and stressed client becomes extremely upset.

Different agendas

Alan Radford said: “The vet’s agenda was not the same as the client’s. Things go wrong if you don’t deal with that agenda. It may not be the most important point, but the vet needs to deal with it so that the client does not get confused.”

Carol Gray discussed other helpful communication techniques such as “chunking and checking”. This piece of communication terminology is very simple, Carol said. “When you’re giving information it’s a good idea to give a small bit of information in one go and then check that they understand it.” For example: “So we’ve talked about vaccination and we now need to do two vaccines, one today and one in three weeks. How does that sound to you?”

Alan remarked that one of his most favourite lines in a consultation is right at the very end: “Is there anything else?” He added: “It’s a dangerous thing to ask if you haven’t done your consultation right but, if you have, the answer should be ‘no thanks’.”

Yes, a client-centred vaccination consultation will take longer than the “jab and go” approach, but it’s time well spent if the result is that your client sees value in you and your practice.

“After all,” said Alan, “it’s their pet, it’s their money and it’s their consultation.”

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