‘Yarn with me’: applying clinical yarning to improve clinician–patient communication in Aboriginal health care

TLDR

Communication between Aboriginal patients and health practitioners remains problematic, representing a major barrier to effective care. The study proposes a framework to reorient clinician–patient communication through clinical yarning. Clinical yarning comprises a social yarn to build rapport, a diagnostic yarn to elicit and interpret the patient’s health story, and a management yarn that uses stories and metaphors to facilitate collaborative care. Evidence indicates that clinical yarning can improve outcomes for both patients and practitioners.

Abstract

Although successful communication is at the heart of the clinical consultation, communication between Aboriginal patients and practitioners such as doctors, nurses and allied health professionals, continues to be problematic and is arguably the biggest barrier to the delivery of successful health care to Aboriginal people. This paper presents an overarching framework for practitioners to help them reorientate their communication with Aboriginal patients using 'clinical yarning'. Clinical yarning is a patient-centred approach that marries Aboriginal cultural communication preferences with biomedical understandings of health and disease. Clinical yarning consists of three interrelated areas: the social yarn, in which the practitioner aims to find common ground and develop the interpersonal relationship; the diagnostic yarn, in which the practitioner facilitates the patient's health story while interpreting it through a biomedical or scientific lens; and the management yarn, that employs stories and metaphors as tools for patients to help them understand a health issue so a collaborative management approach can be adopted. There is cultural and research evidence that supports this approach. Clinical yarning has the potential to improve outcomes for patients and practitioners.