Exploring the patient’s existing understanding (Explanatory Model)

Every patient brings their own knowledge, beliefs, and assumptions about their condition and their management. Some may be accurate, others less so. Some patients may be well-informed, while others may have little understanding or have very unhelpful beliefs. Exploring the patient’s current knowledge and beliefs helps us tailor education, address misconceptions, and start at an appropriate level. The patient interview is often the best time to do this.

Example questions to ask to explore a patient’s understanding:

• “Can you tell me what you understand about your condition?”
• “What is your understanding about what is going on after speaking with your previous health professionals?”
• “Why do you think this issue started or hasn’t improved?”
• “What do you understand is the best way of managing your condition?”
• “Why do you think these management approaches have not helped?”

Tip: Avoid assuming that a patient has no prior knowledge or that their beliefs are incorrect. Instead, explore their perspective with curiosity and without judgment, using their responses to guide the conversation.

This step is especially important for patients with long-standing conditions or previous unsuccessful treatments. By understanding their perspective, we are in a better position to clarify misconceptions and frame education in a way that resonates with them.