November 6, 2025 • 22 mins
Ever have a client drop a “by the way” just as their hand hits the doorknob? We tackle the fix: agenda setting that captures every concern upfront, keeps appointments on track, and strengthens trust without adding time. With guests Drs. Jane Shaw, Kat Sutherland, and Natasha Janke, we map the science and the steps behind a small change that delivers big wins for veterinary teams and clients alike.
We walk through the practical anatomy of a better visit: start with a solid introduction, gather the client’s full list using open-ended questions, resist premature problem solving, summarize the agenda aloud, then triage together. You’ll hear how this approach anchors relationship-centered care, improves client satisfaction, and supports adherence—key predictors of better outcomes. Our guests explain how to insert the veterinary agenda transparently for topics like dental care, weight management, behavior, and nutrition, all without sidelining what the client values most.
From classroom to clinic, we cover training that sticks: scripting that sounds natural, team roles that share the workload, and habits that prevent doorknob disclosures. We unpack common pitfalls—closed questions, one-and-done lists, and diving too deep too soon—and offer simple replacements you can try today. Plus, we spotlight current research, where the evidence is strong, and what’s next for measuring appointment efficiency, client and veterinarian satisfaction, and late-rising concerns.
Ready to try it? Start every appointment with a complete agenda, confirm it, and choose what fits today. Subscribe for more conversations that sharpen clinical communication, share this episode with your team, and leave a quick review to help others find the show.
JAVMA article: https://doi.org/10.2460/javma.25.06.0377
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_00 (00:00):
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SPEAKER_04 (00:35):
Welcome to Veterinary Vertex, the AVMade
Journal's podcast, where wedelve into behind-the-scenes
look with manuscript authors.
I'm editor-in-chief LisaFortier, joined by associate
editor Sarah Wright.
Today we're discussing how touse agenda setting with authors
Kat, Natasha, and Jane.
Thank you guys so much for yourrepeat appearance and for being
(00:56):
here today.
SPEAKER_01 (00:57):
It's our pleasure.
SPEAKER_04 (00:58):
Thanks for having us.
SPEAKER_02 (00:59):
Happy to be here.
Before we dive in, can you sharea little about your background
and what brought you toveterinary communication
research?
SPEAKER_05 (01:06):
Sure, I can jump first.
So I guess my path to veterinarycommunication teaching and
research started back when I wasdoing my master's studying
animal nutrition, specificallylooking at owner factors related
to dog obesity.
And so, of course, we know thatobesity in pets has a human
component to it.
And it's important for the vetteam to have effective
(01:28):
communication with clients.
So it kind of snowballed fromthere into my PhD and my
postdoctoral studies inveterinary clinical
communication, still always withthe focus on pet obesity before
spending some time at CSUColorado State, and then
returning to Ontario VeterinaryCollege.
SPEAKER_04 (01:45):
Ooh, Go Rams, CSU 91.
Sarah knew that was coming.
Your guys' JAMA technicaltutorial video discusses how
agenda setting can enhanceappointment efficiency, which is
really important when we're allso busy and trying to uh enhance
our work-life balance.
Please walk us through themotivation cat behind this
(02:06):
teaching this communicationskill.
SPEAKER_05 (02:13):
She really pioneered teaching us in the curriculum.
SPEAKER_04 (02:15):
Turf it over to Jane.
SPEAKER_01 (02:17):
It was a great question because it really got
me thinking.
It was about eight years agowhen Jason Cole and I started
outlining a textbook.
And so, as part of outliningthat textbook, we were
determining what skills to focuson.
And we were, in particular,thinking about the beginning of
the interview.
And I was realizing we werereally missing teaching agenda
(02:38):
setting to our students.
And so in the past eight yearshas been quite a big focus,
actually, of our curriculum inmaking sure that every um
interview in our laboratory andthen in community practice
service, students are gettingthe client's agenda right up
front in the visit.
SPEAKER_04 (02:55):
That's really I didn't receive any sort of
teaching like that.
That's really amazing.
Kat, have you received anyfeedback from practitioners who
tried applying these findings?
SPEAKER_05 (03:05):
For sure.
Yeah.
I mean, I think the feedbackthat we hear is, oh, hey, this
actually works when you do itand when you're intentional
about integrating agenda settinginto their day-to-day practice
from both clinicians andstudents as well, once they get
the hang of it.
They do see that it does helpuncover multiple items the
clients would like to address.
(03:26):
And it also gives them anopportunity really early on to
further develop rapport andcreate a real sense of
partnership with the client.
And then I think the other pieceof feedback is it works.
And once you do practice it andget comfortable and efficient
with it, it really doesn't takehuge amounts of time and it is
worth the time that it takes.
SPEAKER_04 (03:47):
Very good.
You really teed up my nextquestion, which I was going to
ask Natasha.
How might this agenda settinginfluence client satisfaction or
even patient outcomes?
SPEAKER_03 (03:56):
Yeah, that's a great question, Lisa.
Um, agenda setting itselfdefinitely fosters an
opportunity for clients to havetheir concerns heard and early
on in the visit too, so thatthose concerns can be addressed.
And like Kat mentioned, it alsocreates an opportunity for a
partnership to start developingbetween the veterinary
professional and their clientright up front in the
(04:18):
appointment.
And we've seen from previousresearch that both being heard
or having their concerns heardand working in partnership with
their veterinarian is somethingthat clients are looking for
when they attend veterinaryappointments, which definitely
has an impact on theirsatisfaction.
And then if we consider thatagenda setting more broadly is
(04:39):
related to enhancedrelationship-centered care
within appointments, we've seenthat relationship-centered
communication is associated withclient satisfaction as well as
client adherence.
So we could use that as a proxywhen estimating the impact on
patient outcomes, but certainlythere's more opportunity for us
to look into the direct impactof agenda setting on patient
(05:02):
outcomes.
SPEAKER_04 (05:04):
That's fabulous.
Jane, if you could look inhindsight and redesign the
appointment experience entirelyfrom scratch, what would it look
like?
SPEAKER_01 (05:12):
Yeah.
So we actually teach it this wayright now.
Um it would start with a solidintroduction.
Um, and then after theintroduction is complete, the
next step the practitioner wouldgo through is getting the
client's agenda.
And then the tricky thing iscompleting the client's agenda
before going on to history.
So what happens is they hearabout a problem during the
(05:37):
agenda setting, and our clinicalmind goes to, I want to learn
more about that.
So it takes a little bit ofdiscipline to like, I say, pull
on the reins until um, and knowthat you get to explore
everything the client says, butget everything out up front um
early on.
SPEAKER_04 (05:54):
We don't pull on the reins, we just collect the
horse, we just make contact.
Make contact.
Yes.
Well, good clarification, Lisa.
SPEAKER_02 (06:05):
That does sound tricky though, Jane.
Like I that's the first thing Ithought of when you said as soon
as you hear a problem, your mindinstantly goes to, ooh, here's
some diagnostics I can do.
Here's some maybe differentialsI'm thinking of.
So really teaching your brainhow to work.
Yeah.
This is a great video, though.
I hope people watch it and theycan learn and implement this in
their practice.
So, Natasha, what are the keytake-home messages you hope
(06:25):
veterinarians will remember?
SPEAKER_03 (06:27):
So there are a few key take-home messages that I
would say, but if there's onlyone take-home message that
you're gonna remember from thispodcast or from the technical
tutorial video, um, I would saythat setting an agenda early in
the visit can help reduce theodds of weight-rising concerns
from clients later in the visitor those doorknob concerns where
they're about to leave theappointment and say, oh, by the
(06:50):
way, I wanted to bring this up.
And so ultimately that's gonnaimpact the efficiency of your
appointments.
Um, beyond that, I would alsosuggest that agenda setting can
involve multiple team members,especially if you're using a
team-based approach to yourappointments.
And so with that in mind, Ithink it's really important for
practices to consider reallyinvesting in communication
(07:11):
training for all team members,not only their veterinarians.
SPEAKER_04 (07:14):
Fantastic.
Natasha, well, we have you,let's talk about your journey
here.
What initially sparked yourinterest in veterinary
communication?
SPEAKER_03 (07:23):
Yeah, Lisa, I would say it was more than a spark.
It was love at first sight.
So after I completed mymaster's, um, Dr.
Jason Coe, who Jane mentionedearlier, had approached me about
completing a PhD with him.
And I knew that I wanted toconduct research that would
ultimately have an impact onanimal outcomes.
(07:43):
And it wasn't until I starteddigging into the literature
around clinical communication,both in human medicine and in
veterinary medicine, that Irecognized it was an opportunity
to impact both human and animaloutcomes.
So we have opportunities toimpact outcomes related to the
veterinary professionals workingwith animals, as well as the
caregivers of those animals, andof course the animals
(08:05):
themselves.
And very early on, I attendedthe International Conference of
Communication in VeterinaryMedicine, and it was such a
welcoming environment.
Um, I could see the opportunitythat existed in this field, and
so that really drew me in.
SPEAKER_04 (08:20):
Well, have not heard of that conference.
Jane, were there anycommunication theories that
resonated with you early on?
SPEAKER_01 (08:28):
Yes, and Natasha already mentioned it, um,
relationship-centered care.
So, relationship-centered careis an approach where we can
think of meet, we call it maybethe meeting of experts or a
collaborative partnership, wherewe view the expertise of the
client as the kind of theirexpertise in the animal.
They, and that's the challengeof our profession, right?
(08:50):
Is that we can't speak directlyto our patients and we rely
highly on our clients to tell uswhat they're seeing.
And so it's valuing thatclient's expertise as well as
the client has the opportunityto hear and share our expertise.
And so where agenda settingfalls into that is um when we
(09:10):
know the client's agenda upfront, we can really partner
with them in achieving the goalsthat they're wanting to achieve
in this appointment time.
And so it's it's really arelationship-centered
communication skill to do agendasetting appropriately up front
in the visit.
SPEAKER_04 (09:26):
Yeah, fantastic.
Natasha, what are the mostcommon communication pitfalls in
veterinary settings right now?
SPEAKER_03 (09:33):
Yeah, Lisa, I think I'll focus within even agenda
setting itself, um, with thatbeing the topic of our technical
tutorial.
And Jane covered a huge oneearlier, which was that tendency
for veterinary professionals towant to jump to um problem
solving or gathering historywhen they hear that problem.
Um, and so I won't go you knowfurther into that, but one of
(09:56):
two other pitfalls that we seein relation to agenda setting
are the tendency to want to useclosed-ended questions.
So asking, do you have anyconcerns for your animal today,
versus an open-ended question,like what concerns do you have
today?
And we do see that clients umtend to share more concerns when
(10:17):
an open-ended question is used,whereas that closed-ended
question, we tend to hear morecan more clients who have zero
concerns to share.
So we're getting moreinformation up front with that
open-ended question.
And then the other pitfall I seefrequently is to assume that if
we have heard a concern from theclient, that that's all of their
concerns.
(10:38):
So continuing to follow up withquestions like, what else would
you like to discuss today, orwhat other concerns do you have
until you've really heard theclient say, that's everything
for today, or that's all myconcerns.
SPEAKER_04 (10:50):
Yeah, what you guys are amazing.
Kat, there must be aspects ofagenda setting that are still
misunderstood.
For sure.
SPEAKER_05 (10:58):
Yeah, I think several.
I think the two big ones thatcome to mind for me is, you
know, what we hear sort of asthe main um objection to agenda
setting, which is that I don'thave time to do this.
It's gonna take way too long.
Um, the other piece would bethat clients are gonna be
bothered or upset or offended insome way if we sort of keep
(11:19):
repeatedly asking what's ontheir list and on their agenda.
So, you know, as the others havesaid, there is a bit of a
research gap here that we haveto acknowledge, but we do have
evidence that agenda setting isgonna help efficiency, not hurt
it, especially once you areskilled and comfortable with the
process and being reallyintentional about using it.
(11:41):
And I'll say that we don't havea lot of feedback at this point
from clients on how they feelabout agenda setting being used
by their veterinary team.
I wouldn't expect that many ofthem would be upset or bothered
by it, but we do need to spendsome time exploring their
perceptions as well.
SPEAKER_02 (11:58):
And if you're listening to this episode or
watching it and you want towatch this in practice, you can
do so.
I'm gonna link to their video inthe show notes.
And it is open access.
So you'll be able to look at itand see how you can implement
this in your practice.
So, Kat, looking ahead, what arethe next steps for research in
this area?
SPEAKER_05 (12:13):
Yeah, I mean, it's a great question because we
definitely do recognize thatthere is this gap in the
research around agenda setting.
Um, so going forward, I thinkone of the most important things
we need to do is really explorethe relationship between agenda
setting and those appointmentlevel outcomes so we can really
build on the evidence thatalready exists for the use of it
in practice.
(12:35):
Um, we do, as a team, actuallyhave a proposal for an in-clinic
project looking at agendasettings.
Some of the outcomes that we'dbe interested in are client
satisfaction, veterinariansatisfaction, appointment
lengths.
So, so again, that efficiencypiece, um, the presence of
doorknob disclosures, the laterising concerns.
And then as Natasha mentionedearlier, I think down the line,
(12:57):
what we really want to see isthe relationship between this
and patient outcomes.
SPEAKER_02 (13:02):
Very cool.
Well, we hope that comes tofruition so that we can see it
in the future.
And Kat, how do you plan tomeasure success or impact the
next phase of this research?
SPEAKER_05 (13:12):
For sure.
Yeah.
So I mean, promising results ofthe project itself would be
great to see.
So we would expect and hope thatagenda setting would improve the
satisfaction and appointmentefficiency.
Um, I also think that for us incommunications, sort of a
measure of success or somethingthat tells us that what we're
teaching and researching ishaving an impact is when we see
(13:34):
it being picked up and taught atother schools and their
curriculum or spoken about atconferences or continuing
education events.
Um, so not an exact metric, butwhen we're now in the audience
and seeing others really promoteand encourage the things that
we've been teaching andresearching, um, that to me
speaks to the impact that it'shaving on the profession and
(13:56):
that people are really seeingthe value of it.
SPEAKER_02 (13:59):
Natasha, how do you envision your findings being
translated into practical toolsor training for veterinary
teens?
SPEAKER_03 (14:06):
Well, one of the ways that I think we've all been
already doing is incorporatingit into veterinary curricula.
And I love doing podcasts likethis because it's actually the
first time I've heard thatorigin story from you know Jane
and Jason working together andhow that led to agenda setting
being more integrated into thecurriculum at CSU.
And I know it's also at OBC aswell.
(14:28):
Um the other way that I haveseen, and we've all the three of
us have seen agenda setting beincorporated into training is
through Colorado StateUniversity's Frank communication
workshops, and that's acontinuing education series of
workshops for veterinaryprofessionals to improve their
relationship-centeredcommunication skills, including
(14:49):
agenda setting.
And what I've noticed about theattendees in those workshops
over the last few years is thatwe're seeing more diversity in
the roles of participants.
So while there's, I'd saythere's still predominantly
veterinarians attending, we seea lot of veterinary technicians,
practice managers, veterinaryassistants, even in larger
(15:11):
practice groups, the regionaloperations directors or managers
are getting involved in thistraining.
So when it comes to this beingtranslated into training for
veterinary teams, I love to seethat diversity in the roles that
are coming to communicationtraining, because that's how
everyone can get on the samepage and use these skills and
(15:31):
practice together.
Because, like we mentioned,agenda setting is a team sport.
And um I also hope that everyonehas a look at the technical
tutorial video to see how youcan implement agenda setting in
your own practice, regardless ofyour role.
SPEAKER_02 (15:45):
And Jane, what long-term changes would you like
to see in veterinary practice asa result of this research?
SPEAKER_01 (15:51):
It it comes down to a simple line setting the
agenda, every appointment, everytime.
And it's really an incrediblytransformative skill for the
veterinary appointment.
And also the three of us haveworked very closely together.
And we start every singleconversation and meeting with
agenda setting.
And so it's a skill for justefficiency in day-to-day life,
(16:14):
even in social conversations, tobe able to say, what are you
hoping that we can do today?
Like it's a Saturday, it's abusy day for the family, right?
What's all on our to-do list tohave a good day, a good weekend,
right?
So it's a skill that's a life uhthat has turned out to be a
pretty powerful life skillbeyond just a professional
skill.
SPEAKER_04 (16:34):
That's a really great point.
And Gene, how did all thatprevious work that you've done
prepare you to create thisspecific technical tutorial
video?
SPEAKER_01 (16:44):
Oh, it's been a journey of 20 years now that
I've been teaching these skills.
And um, it has been a process.
We started at CSU first focusingon client agenda.
Um, so um, and only in like onepart of the curriculum.
And then we added in theprofessional veterinary, the
(17:04):
veterinary professionals'agenda.
So let me back up.
We started with one part ofagenda setting, which is really
focusing on the client's agenda.
And then we built over timeadding the veterinary
professionals' agenda, becausesometimes we have topics that
are not on the client's radar,like dental care or weight
(17:25):
management or behavioral issues,uh, nutrition, that we might
need to insert um into theagenda that's not on the
client's awareness.
So we also teach how do youinsert your agenda items as well
as um still respect what theclient has on their agenda.
And so it was a process ofteaching those two pieces.
And then over time, weintegrated it into now it will
(17:49):
be in every aspect of ourcurriculum, all the modules.
Um, so our communicationcurriculum is integrated through
all four years, and studentsusually have two courses per
semester in the first threeyears.
And so agenda setting will be inevery single pre-course before
they hit the clinics.
And so they'll have a lot ofpractice with that skill before
(18:11):
they even um see a real clientin community practice.
SPEAKER_02 (18:15):
That's fantastic because you really grow as a
clinician in those for thatfirst year of practice when
you're out.
Some people even argue that'show you're gonna practice
potentially for the rest of yourcareer, that first year of
training.
So I think it's really excellentthat's be incorporated early
into your training.
So hopefully you can continue tobuild nipple on that skill.
So now we get to move on to ourvery important set of questions
here.
(18:35):
We're gonna boil all this greatinformation that you've shared
in the last like 18 minutes orso into one piece of information
for both the veterinarian andthe client.
So, Jane and Kat, what is onepiece of information the
veterinarian should know aboutusing agenda setting and
clinical practice?
SPEAKER_01 (18:51):
I don't mean to be repetitive, but just do it.
SPEAKER_05 (18:56):
Yeah, I agree.
It's not gonna take you too muchtime.
It will save you time later.
Go slow to go fast.
Just do it up front.
Excellent.
SPEAKER_02 (19:06):
And Natasha, for the clients, what's one thing you
wish more people understoodabout this topic?
SPEAKER_03 (19:11):
Yeah, I wish more clients understood that it's
okay to come to your veterinapwith a list of questions that
you've prepared or a list ofconcerns that you have that
you've written down ahead oftime because ultimately that's
going to be incredibly usefulfor the veterin and even make
that agenda setting process evenmore efficient.
Um, so I know that I'vedefinitely left appointments
(19:35):
thinking, oh, I wish I had askedthis, and I completely forgot
even something important that Iknew I wanted to ask in advance.
So there's nothing wrong withwriting down your concerns and
questions beforehand andbringing that in.
Um, ultimately it's gonna helpyour veterin team help you and
your pet.
SPEAKER_04 (19:51):
Yeah, I agree with that, Natasha.
I do the same thing for when I'ma client, right?
And I put them on my phone and Idon't uh, because then I'm gonna
forget that dang piece of papersomewhere.
Exactly.
And then yeah, and then just sayto the doctor or whoever I'm
with, you know, it could be theauto technician, right?
Sorry, I'm not being rude.
I'm just looking at my list ofthings that I'd like addressed.
Absolutely.
Uh before we wrap up, we like tohave a little fun.
(20:13):
Uh so from each of you, we'llstart maybe with Natasha while I
have you.
What do you think is the mostbeautiful animal and why?
SPEAKER_03 (20:21):
So the most beautiful animal to me is the
cheetah.
And I can't exactly pinpoint whyit is.
It might be their unique facialmarkings, but ever since I was a
kid getting National Geographicmagazines in the mail, I just
loved seeing cheetahs andlearning about them.
So that would be what I wouldconsider the most beautiful
animal.
SPEAKER_04 (20:41):
Wonderful.
SPEAKER_03 (20:42):
Kat, how about you?
SPEAKER_05 (20:45):
Yeah, this was a tough one.
I'm gonna go with really any ofthe birds of paradise, just the
colors and feather designs andand their songs, like so much
variety in nature.
It's really incredible.
SPEAKER_04 (20:56):
Yeah, we uh we've just started asking this
question.
We've gotten birds a coupletimes, but nobody brought in
their beautiful song.
So thank you for adding that.
Jane, how about you?
SPEAKER_01 (21:06):
I have a tie between the giraffe and the zebra.
And I think it's it's theirincredible, the incredible
colors and patterns of theircoats, you know, that's
fascinating.
That also has evolutionaryadvantages, right, to help them
be camouflaged.
Um, but they're just incrediblybeautiful looking animals.
SPEAKER_02 (21:28):
Yeah, all super great answers.
Actually, this all of youranswers reminded me that I just
saw the Lion King, the musicalon Saturday.
You know, all those animals werein the musical, and they're all
very cool to look at.
It was a wonderful show.
But thank you so much, Chaincatand Natasha, for being here
today, also for sharing yourvideo with us as well.
I think it's gonna be a greatteaching tool.
SPEAKER_05 (21:46):
Well, thank you so much for having us, and we're
excited to have this technicaltutorial out there for people to
learn from.
SPEAKER_03 (21:52):
Yeah, it's always a pleasure to be here.
SPEAKER_01 (21:54):
Thank you for asking us to join you again.
SPEAKER_02 (21:57):
For our listeners, you can watch the full JabMa
technical tutorial video onYouTube or our website.
I'm Sarah Wright here at LisaFortier.
Be sure to tune in next week foranother episode of Veterinary
Vertex, and don't forget toleave us a rating and review on
Epo Podcast or wherever youlisten.
From the makers of FET recommended Green East
(00:02):
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Green East Smart Essentials DryFood delivers complete balanced
nutrition with science-backedrecipes.
Green East Supplements,developed by a team of PhD
animal nutritionists, offersoptions to help support healthy
joints, digestion, and more.
(00:24):
Whether it's meal time ormobility support, Green Eats
helps you care for your dog fromthe inside out.
Learn more at greenies.com.
SPEAKER_04 (00:35):
Welcome to Veterinary Vertex, the AVMade
Journal's podcast, where wedelve into behind-the-scenes
look with manuscript authors.
I'm editor-in-chief LisaFortier, joined by associate
editor Sarah Wright.
Today we're discussing how touse agenda setting with authors
Kat, Natasha, and Jane.
Thank you guys so much for yourrepeat appearance and for being
(00:56):
here today.
SPEAKER_01 (00:57):
It's our pleasure.
SPEAKER_04 (00:58):
Thanks for having us.
SPEAKER_02 (00:59):
Happy to be here.
Before we dive in, can you sharea little about your background
and what brought you toveterinary communication
research?
SPEAKER_05 (01:06):
Sure, I can jump first.
So I guess my path to veterinarycommunication teaching and
research started back when I wasdoing my master's studying
animal nutrition, specificallylooking at owner factors related
to dog obesity.
And so, of course, we know thatobesity in pets has a human
component to it.
And it's important for the vetteam to have effective
(01:28):
communication with clients.
So it kind of snowballed fromthere into my PhD and my
postdoctoral studies inveterinary clinical
communication, still always withthe focus on pet obesity before
spending some time at CSUColorado State, and then
returning to Ontario VeterinaryCollege.
SPEAKER_04 (01:45):
Ooh, Go Rams, CSU 91.
Sarah knew that was coming.
Your guys' JAMA technicaltutorial video discusses how
agenda setting can enhanceappointment efficiency, which is
really important when we're allso busy and trying to uh enhance
our work-life balance.
Please walk us through themotivation cat behind this
(02:06):
teaching this communicationskill.
SPEAKER_05 (02:13):
She really pioneered teaching us in the curriculum.
SPEAKER_04 (02:15):
Turf it over to Jane.
SPEAKER_01 (02:17):
It was a great question because it really got
me thinking.
It was about eight years agowhen Jason Cole and I started
outlining a textbook.
And so, as part of outliningthat textbook, we were
determining what skills to focuson.
And we were, in particular,thinking about the beginning of
the interview.
And I was realizing we werereally missing teaching agenda
(02:38):
setting to our students.
And so in the past eight yearshas been quite a big focus,
actually, of our curriculum inmaking sure that every um
interview in our laboratory andthen in community practice
service, students are gettingthe client's agenda right up
front in the visit.
SPEAKER_04 (02:55):
That's really I didn't receive any sort of
teaching like that.
That's really amazing.
Kat, have you received anyfeedback from practitioners who
tried applying these findings?
SPEAKER_05 (03:05):
For sure.
Yeah.
I mean, I think the feedbackthat we hear is, oh, hey, this
actually works when you do itand when you're intentional
about integrating agenda settinginto their day-to-day practice
from both clinicians andstudents as well, once they get
the hang of it.
They do see that it does helpuncover multiple items the
clients would like to address.
(03:26):
And it also gives them anopportunity really early on to
further develop rapport andcreate a real sense of
partnership with the client.
And then I think the other pieceof feedback is it works.
And once you do practice it andget comfortable and efficient
with it, it really doesn't takehuge amounts of time and it is
worth the time that it takes.
SPEAKER_04 (03:47):
Very good.
You really teed up my nextquestion, which I was going to
ask Natasha.
How might this agenda settinginfluence client satisfaction or
even patient outcomes?
SPEAKER_03 (03:56):
Yeah, that's a great question, Lisa.
Um, agenda setting itselfdefinitely fosters an
opportunity for clients to havetheir concerns heard and early
on in the visit too, so thatthose concerns can be addressed.
And like Kat mentioned, it alsocreates an opportunity for a
partnership to start developingbetween the veterinary
professional and their clientright up front in the
(04:18):
appointment.
And we've seen from previousresearch that both being heard
or having their concerns heardand working in partnership with
their veterinarian is somethingthat clients are looking for
when they attend veterinaryappointments, which definitely
has an impact on theirsatisfaction.
And then if we consider thatagenda setting more broadly is
(04:39):
related to enhancedrelationship-centered care
within appointments, we've seenthat relationship-centered
communication is associated withclient satisfaction as well as
client adherence.
So we could use that as a proxywhen estimating the impact on
patient outcomes, but certainlythere's more opportunity for us
to look into the direct impactof agenda setting on patient
(05:02):
outcomes.
SPEAKER_04 (05:04):
That's fabulous.
Jane, if you could look inhindsight and redesign the
appointment experience entirelyfrom scratch, what would it look
like?
SPEAKER_01 (05:12):
Yeah.
So we actually teach it this wayright now.
Um it would start with a solidintroduction.
Um, and then after theintroduction is complete, the
next step the practitioner wouldgo through is getting the
client's agenda.
And then the tricky thing iscompleting the client's agenda
before going on to history.
So what happens is they hearabout a problem during the
(05:37):
agenda setting, and our clinicalmind goes to, I want to learn
more about that.
So it takes a little bit ofdiscipline to like, I say, pull
on the reins until um, and knowthat you get to explore
everything the client says, butget everything out up front um
early on.
SPEAKER_04 (05:54):
We don't pull on the reins, we just collect the
horse, we just make contact.
Make contact.
Yes.
Well, good clarification, Lisa.
SPEAKER_02 (06:05):
That does sound tricky though, Jane.
Like I that's the first thing Ithought of when you said as soon
as you hear a problem, your mindinstantly goes to, ooh, here's
some diagnostics I can do.
Here's some maybe differentialsI'm thinking of.
So really teaching your brainhow to work.
Yeah.
This is a great video, though.
I hope people watch it and theycan learn and implement this in
their practice.
So, Natasha, what are the keytake-home messages you hope
(06:25):
veterinarians will remember?
SPEAKER_03 (06:27):
So there are a few key take-home messages that I
would say, but if there's onlyone take-home message that
you're gonna remember from thispodcast or from the technical
tutorial video, um, I would saythat setting an agenda early in
the visit can help reduce theodds of weight-rising concerns
from clients later in the visitor those doorknob concerns where
they're about to leave theappointment and say, oh, by the
(06:50):
way, I wanted to bring this up.
And so ultimately that's gonnaimpact the efficiency of your
appointments.
Um, beyond that, I would alsosuggest that agenda setting can
involve multiple team members,especially if you're using a
team-based approach to yourappointments.
And so with that in mind, Ithink it's really important for
practices to consider reallyinvesting in communication
(07:11):
training for all team members,not only their veterinarians.
SPEAKER_04 (07:14):
Fantastic.
Natasha, well, we have you,let's talk about your journey
here.
What initially sparked yourinterest in veterinary
communication?
SPEAKER_03 (07:23):
Yeah, Lisa, I would say it was more than a spark.
It was love at first sight.
So after I completed mymaster's, um, Dr.
Jason Coe, who Jane mentionedearlier, had approached me about
completing a PhD with him.
And I knew that I wanted toconduct research that would
ultimately have an impact onanimal outcomes.
(07:43):
And it wasn't until I starteddigging into the literature
around clinical communication,both in human medicine and in
veterinary medicine, that Irecognized it was an opportunity
to impact both human and animaloutcomes.
So we have opportunities toimpact outcomes related to the
veterinary professionals workingwith animals, as well as the
caregivers of those animals, andof course the animals
(08:05):
themselves.
And very early on, I attendedthe International Conference of
Communication in VeterinaryMedicine, and it was such a
welcoming environment.
Um, I could see the opportunitythat existed in this field, and
so that really drew me in.
SPEAKER_04 (08:20):
Well, have not heard of that conference.
Jane, were there anycommunication theories that
resonated with you early on?
SPEAKER_01 (08:28):
Yes, and Natasha already mentioned it, um,
relationship-centered care.
So, relationship-centered careis an approach where we can
think of meet, we call it maybethe meeting of experts or a
collaborative partnership, wherewe view the expertise of the
client as the kind of theirexpertise in the animal.
They, and that's the challengeof our profession, right?
(08:50):
Is that we can't speak directlyto our patients and we rely
highly on our clients to tell uswhat they're seeing.
And so it's valuing thatclient's expertise as well as
the client has the opportunityto hear and share our expertise.
And so where agenda settingfalls into that is um when we
(09:10):
know the client's agenda upfront, we can really partner
with them in achieving the goalsthat they're wanting to achieve
in this appointment time.
And so it's it's really arelationship-centered
communication skill to do agendasetting appropriately up front
in the visit.
SPEAKER_04 (09:26):
Yeah, fantastic.
Natasha, what are the mostcommon communication pitfalls in
veterinary settings right now?
SPEAKER_03 (09:33):
Yeah, Lisa, I think I'll focus within even agenda
setting itself, um, with thatbeing the topic of our technical
tutorial.
And Jane covered a huge oneearlier, which was that tendency
for veterinary professionals towant to jump to um problem
solving or gathering historywhen they hear that problem.
Um, and so I won't go you knowfurther into that, but one of
(09:56):
two other pitfalls that we seein relation to agenda setting
are the tendency to want to useclosed-ended questions.
So asking, do you have anyconcerns for your animal today,
versus an open-ended question,like what concerns do you have
today?
And we do see that clients umtend to share more concerns when
(10:17):
an open-ended question is used,whereas that closed-ended
question, we tend to hear morecan more clients who have zero
concerns to share.
So we're getting moreinformation up front with that
open-ended question.
And then the other pitfall I seefrequently is to assume that if
we have heard a concern from theclient, that that's all of their
concerns.
(10:38):
So continuing to follow up withquestions like, what else would
you like to discuss today, orwhat other concerns do you have
until you've really heard theclient say, that's everything
for today, or that's all myconcerns.
SPEAKER_04 (10:50):
Yeah, what you guys are amazing.
Kat, there must be aspects ofagenda setting that are still
misunderstood.
For sure.
SPEAKER_05 (10:58):
Yeah, I think several.
I think the two big ones thatcome to mind for me is, you
know, what we hear sort of asthe main um objection to agenda
setting, which is that I don'thave time to do this.
It's gonna take way too long.
Um, the other piece would bethat clients are gonna be
bothered or upset or offended insome way if we sort of keep
(11:19):
repeatedly asking what's ontheir list and on their agenda.
So, you know, as the others havesaid, there is a bit of a
research gap here that we haveto acknowledge, but we do have
evidence that agenda setting isgonna help efficiency, not hurt
it, especially once you areskilled and comfortable with the
process and being reallyintentional about using it.
(11:41):
And I'll say that we don't havea lot of feedback at this point
from clients on how they feelabout agenda setting being used
by their veterinary team.
I wouldn't expect that many ofthem would be upset or bothered
by it, but we do need to spendsome time exploring their
perceptions as well.
SPEAKER_02 (11:58):
And if you're listening to this episode or
watching it and you want towatch this in practice, you can
do so.
I'm gonna link to their video inthe show notes.
And it is open access.
So you'll be able to look at itand see how you can implement
this in your practice.
So, Kat, looking ahead, what arethe next steps for research in
this area?
SPEAKER_05 (12:13):
Yeah, I mean, it's a great question because we
definitely do recognize thatthere is this gap in the
research around agenda setting.
Um, so going forward, I thinkone of the most important things
we need to do is really explorethe relationship between agenda
setting and those appointmentlevel outcomes so we can really
build on the evidence thatalready exists for the use of it
in practice.
(12:35):
Um, we do, as a team, actuallyhave a proposal for an in-clinic
project looking at agendasettings.
Some of the outcomes that we'dbe interested in are client
satisfaction, veterinariansatisfaction, appointment
lengths.
So, so again, that efficiencypiece, um, the presence of
doorknob disclosures, the laterising concerns.
And then as Natasha mentionedearlier, I think down the line,
(12:57):
what we really want to see isthe relationship between this
and patient outcomes.
SPEAKER_02 (13:02):
Very cool.
Well, we hope that comes tofruition so that we can see it
in the future.
And Kat, how do you plan tomeasure success or impact the
next phase of this research?
SPEAKER_05 (13:12):
For sure.
Yeah.
So I mean, promising results ofthe project itself would be
great to see.
So we would expect and hope thatagenda setting would improve the
satisfaction and appointmentefficiency.
Um, I also think that for us incommunications, sort of a
measure of success or somethingthat tells us that what we're
teaching and researching ishaving an impact is when we see
(13:34):
it being picked up and taught atother schools and their
curriculum or spoken about atconferences or continuing
education events.
Um, so not an exact metric, butwhen we're now in the audience
and seeing others really promoteand encourage the things that
we've been teaching andresearching, um, that to me
speaks to the impact that it'shaving on the profession and
(13:56):
that people are really seeingthe value of it.
SPEAKER_02 (13:59):
Natasha, how do you envision your findings being
translated into practical toolsor training for veterinary
teens?
SPEAKER_03 (14:06):
Well, one of the ways that I think we've all been
already doing is incorporatingit into veterinary curricula.
And I love doing podcasts likethis because it's actually the
first time I've heard thatorigin story from you know Jane
and Jason working together andhow that led to agenda setting
being more integrated into thecurriculum at CSU.
And I know it's also at OBC aswell.
(14:28):
Um the other way that I haveseen, and we've all the three of
us have seen agenda setting beincorporated into training is
through Colorado StateUniversity's Frank communication
workshops, and that's acontinuing education series of
workshops for veterinaryprofessionals to improve their
relationship-centeredcommunication skills, including
(14:49):
agenda setting.
And what I've noticed about theattendees in those workshops
over the last few years is thatwe're seeing more diversity in
the roles of participants.
So while there's, I'd saythere's still predominantly
veterinarians attending, we seea lot of veterinary technicians,
practice managers, veterinaryassistants, even in larger
(15:11):
practice groups, the regionaloperations directors or managers
are getting involved in thistraining.
So when it comes to this beingtranslated into training for
veterinary teams, I love to seethat diversity in the roles that
are coming to communicationtraining, because that's how
everyone can get on the samepage and use these skills and
(15:31):
practice together.
Because, like we mentioned,agenda setting is a team sport.
And um I also hope that everyonehas a look at the technical
tutorial video to see how youcan implement agenda setting in
your own practice, regardless ofyour role.
SPEAKER_02 (15:45):
And Jane, what long-term changes would you like
to see in veterinary practice asa result of this research?
SPEAKER_01 (15:51):
It it comes down to a simple line setting the
agenda, every appointment, everytime.
And it's really an incrediblytransformative skill for the
veterinary appointment.
And also the three of us haveworked very closely together.
And we start every singleconversation and meeting with
agenda setting.
And so it's a skill for justefficiency in day-to-day life,
(16:14):
even in social conversations, tobe able to say, what are you
hoping that we can do today?
Like it's a Saturday, it's abusy day for the family, right?
What's all on our to-do list tohave a good day, a good weekend,
right?
So it's a skill that's a life uhthat has turned out to be a
pretty powerful life skillbeyond just a professional
skill.
SPEAKER_04 (16:34):
That's a really great point.
And Gene, how did all thatprevious work that you've done
prepare you to create thisspecific technical tutorial
video?
SPEAKER_01 (16:44):
Oh, it's been a journey of 20 years now that
I've been teaching these skills.
And um, it has been a process.
We started at CSU first focusingon client agenda.
Um, so um, and only in like onepart of the curriculum.
And then we added in theprofessional veterinary, the
(17:04):
veterinary professionals'agenda.
So let me back up.
We started with one part ofagenda setting, which is really
focusing on the client's agenda.
And then we built over timeadding the veterinary
professionals' agenda, becausesometimes we have topics that
are not on the client's radar,like dental care or weight
(17:25):
management or behavioral issues,uh, nutrition, that we might
need to insert um into theagenda that's not on the
client's awareness.
So we also teach how do youinsert your agenda items as well
as um still respect what theclient has on their agenda.
And so it was a process ofteaching those two pieces.
And then over time, weintegrated it into now it will
(17:49):
be in every aspect of ourcurriculum, all the modules.
Um, so our communicationcurriculum is integrated through
all four years, and studentsusually have two courses per
semester in the first threeyears.
And so agenda setting will be inevery single pre-course before
they hit the clinics.
And so they'll have a lot ofpractice with that skill before
(18:11):
they even um see a real clientin community practice.
SPEAKER_02 (18:15):
That's fantastic because you really grow as a
clinician in those for thatfirst year of practice when
you're out.
Some people even argue that'show you're gonna practice
potentially for the rest of yourcareer, that first year of
training.
So I think it's really excellentthat's be incorporated early
into your training.
So hopefully you can continue tobuild nipple on that skill.
So now we get to move on to ourvery important set of questions
here.
(18:35):
We're gonna boil all this greatinformation that you've shared
in the last like 18 minutes orso into one piece of information
for both the veterinarian andthe client.
So, Jane and Kat, what is onepiece of information the
veterinarian should know aboutusing agenda setting and
clinical practice?
SPEAKER_01 (18:51):
I don't mean to be repetitive, but just do it.
SPEAKER_05 (18:56):
Yeah, I agree.
It's not gonna take you too muchtime.
It will save you time later.
Go slow to go fast.
Just do it up front.
Excellent.
SPEAKER_02 (19:06):
And Natasha, for the clients, what's one thing you
wish more people understoodabout this topic?
SPEAKER_03 (19:11):
Yeah, I wish more clients understood that it's
okay to come to your veterinapwith a list of questions that
you've prepared or a list ofconcerns that you have that
you've written down ahead oftime because ultimately that's
going to be incredibly usefulfor the veterin and even make
that agenda setting process evenmore efficient.
Um, so I know that I'vedefinitely left appointments
(19:35):
thinking, oh, I wish I had askedthis, and I completely forgot
even something important that Iknew I wanted to ask in advance.
So there's nothing wrong withwriting down your concerns and
questions beforehand andbringing that in.
Um, ultimately it's gonna helpyour veterin team help you and
your pet.
SPEAKER_04 (19:51):
Yeah, I agree with that, Natasha.
I do the same thing for when I'ma client, right?
And I put them on my phone and Idon't uh, because then I'm gonna
forget that dang piece of papersomewhere.
Exactly.
And then yeah, and then just sayto the doctor or whoever I'm
with, you know, it could be theauto technician, right?
Sorry, I'm not being rude.
I'm just looking at my list ofthings that I'd like addressed.
Absolutely.
Uh before we wrap up, we like tohave a little fun.
(20:13):
Uh so from each of you, we'llstart maybe with Natasha while I
have you.
What do you think is the mostbeautiful animal and why?
SPEAKER_03 (20:21):
So the most beautiful animal to me is the
cheetah.
And I can't exactly pinpoint whyit is.
It might be their unique facialmarkings, but ever since I was a
kid getting National Geographicmagazines in the mail, I just
loved seeing cheetahs andlearning about them.
So that would be what I wouldconsider the most beautiful
animal.
SPEAKER_04 (20:41):
Wonderful.
SPEAKER_03 (20:42):
Kat, how about you?
SPEAKER_05 (20:45):
Yeah, this was a tough one.
I'm gonna go with really any ofthe birds of paradise, just the
colors and feather designs andand their songs, like so much
variety in nature.
It's really incredible.
SPEAKER_04 (20:56):
Yeah, we uh we've just started asking this
question.
We've gotten birds a coupletimes, but nobody brought in
their beautiful song.
So thank you for adding that.
Jane, how about you?
SPEAKER_01 (21:06):
I have a tie between the giraffe and the zebra.
And I think it's it's theirincredible, the incredible
colors and patterns of theircoats, you know, that's
fascinating.
That also has evolutionaryadvantages, right, to help them
be camouflaged.
Um, but they're just incrediblybeautiful looking animals.
SPEAKER_02 (21:28):
Yeah, all super great answers.
Actually, this all of youranswers reminded me that I just
saw the Lion King, the musicalon Saturday.
You know, all those animals werein the musical, and they're all
very cool to look at.
It was a wonderful show.
But thank you so much, Chaincatand Natasha, for being here
today, also for sharing yourvideo with us as well.
I think it's gonna be a greatteaching tool.
SPEAKER_05 (21:46):
Well, thank you so much for having us, and we're
excited to have this technicaltutorial out there for people to
learn from.
SPEAKER_03 (21:52):
Yeah, it's always a pleasure to be here.
SPEAKER_01 (21:54):
Thank you for asking us to join you again.
SPEAKER_02 (21:57):
For our listeners, you can watch the full JabMa
technical tutorial video onYouTube or our website.
I'm Sarah Wright here at LisaFortier.
Be sure to tune in next week foranother episode of Veterinary
Vertex, and don't forget toleave us a rating and review on
Epo Podcast or wherever youlisten.
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