Verbal and Non-Verbal Techniques

Communication extends beyond words. Patients often judge the quality of care by how information is delivered as much as by what is said. Tone, pace, posture, eye contact, and even silence shape whether people feel respected, understood, and confident in advice.^[1][4]

Tone of voice

Tone signals professionalism and empathy. A calm, steady voice reassures those worried about possible vision loss, whereas a rushed or overly technical delivery can heighten anxiety and reduce comprehension. Useful habits include using a calm and measured voice for results and next steps, varying emphasis to highlight key safety information, and avoiding a monotone, which may suggest disinterest.^[2][7]

Pace of speech

People process information at different speeds depending on age, emotional state, or familiarity with health terms. Effective pacing supports understanding by slowing down for complex or safety-critical instructions, breaking information into smaller sections with pauses, and allowing time for questions before moving on.^[3][4]

Body language and positioning

Non-verbal cues strongly influence whether patients feel listened to. Practical adjustments include:

• facing the patient directly and nodding to show attentiveness^[4]
• sitting at the same eye level rather than standing over them^[4]
• avoiding signs of distraction, such as looking at the computer while they are speaking^[5]

Eye contact

Appropriate eye contact builds trust and signals full attention. In practice, alternating between the computer and the patient helps avoid appearing disengaged. Ensuring good visibility of the clinician's face supports patients who lip-read, and cultural preferences should be respected, as some may find sustained eye contact uncomfortable.^[7][4]

Managing silence

Silence can encourage patients to elaborate.

After asking, "What is worrying you most about your eyes?" pausing before speaking again gives space for a response. This is especially helpful when people feel embarrassed, upset, or unsure how to describe symptoms. Resisting the urge to fill pauses promotes openness and honesty.^[5][6]

References (numbered in text) Why we include references

1. Good medical practice — Domain 2: Patients, partnership and communication. General Medical Council (GMC). Find (opens in a new tab)
2. Voice and tone — NHS Service Manual. NHS (service-manual.nhs.uk) (updated November 2019). Find (opens in a new tab)
3. Use the Teach-Back Method: Tool 5. Health Literacy Universal Precautions Toolkit. Agency for Healthcare Research and Quality (AHRQ). Find (opens in a new tab)
4. Patient experience in adult NHS services: improving the experience of care for people using adult NHS services (Clinical guideline CG138). National Institute for Health and Care Excellence (NICE). Published 2012; last updated 17 June 2021. Find (opens in a new tab)
5. Gibbings-Isaac D, Iqbal M, Tahir MA, Kumarapeli P, de Lusignan S. The pattern of silent time in the clinical consultation: an observational multichannel video study. Fam Pract. 2012. Find (opens in a new tab)
6. Bartels J, Rodenbach R, Ciesinski K, Gramling R, Fiscella K, Epstein R. Eloquent silences: A musical and lexical analysis of conversation between oncologists and their patients. Patient Educ Couns. 2016. Find (opens in a new tab)
7. Hillen MA, de Haes HCJM, van Tienhoven G, Bijker N, van Laarhoven HWM, Smets EMA. All eyes on the patient: the influence of oncologists’ nonverbal communication on breast cancer patients’ trust. Breast Cancer Research and Treatment. 2015. Find (opens in a new tab)