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What Factors Affect Patient Recall of Counseling

Brian Urban, AuD

May 9, 2011



What factors affect a patient's ability to remember information from our counseling session, and what factors can I control? It seems that I am repeating myself too often from session to session with my patients.


Great question. Margolis (2004) found that in a typical healthcare counseling session, patients forget approximately 50% of the information immediately and remember another 25% wrong. That means they're only correctly remembering 25% of our counseling. Fortunately, we are able to predict what information is most likely to be remembered. In a learning situation, people remember best what is presented first, and then second best what is presented last;this is known as primacy and recency effects (Sousa, 2006). He also looked at factors affecting recall, and there were some interesting findings. A patient's level of education, intelligence, and the severity of the diagnosis did not have an effect on the ability to remember information from counseling. Their familiarity with the topic did have an effect;if they were familiar with the subject they had better recall. Likewise, their expectation had an effect;if the diagnosis was expected they had better recall of the information than if it was unexpected. Denial, not surprisingly, had a negative impact on recall.

I would recommend focusing on communicating the most important information at the beginning of the counseling session and then summarizing at the end. While many of us were taught to thoroughly explain every test that was performed and "teach" the audiogram, this large amount of information will likely make it more difficult for your patient to understand and remember your core message. So, consider putting down the audiogram or a least using it strategically (e.g. use familiar sounds audiogram or only review it if the patient expresses an interest in the X's and O's). If it feels that you are repeating yourself in counseling sessions, you are probably on the right track. Repetition is essential for conveying key results and recommendations. Verify that your patients understand their overall results by checking for comprehension before moving on to the next topic and keep track to see if they are following through with your recommendations. This will help you gauge whether you need to readjust your counseling to improve your patient's experience. Also consider simplifying your message, avoiding jargon, and initially focusing your counseling on the patients' needs and questions (i.e. the reasons that brought them in).

Finally, be sure to provide colorful, personalized summaries of information for them to take home. Many studies have shown that providing written materials to patients post consultation can have a significant, positive influence upon their recall of clinical information and advice. Focusing on these areas can quickly improve your patient's level of satisfaction, ensure that your recommendations are being followed, and ultimately decrease your tested-not-sold rate.

Thanks for your question. Please visit for information about a tool we have developed to assist with patient retention of clinical information.

Or Click Here to view a sample Patient Report.


Margolis, R.H. (2004). Informational counseling in health professions: What do patients remember? Retrieved on February 21, 2011, from

Sousa, David A. (2006). How the Brain Learns. 3rd Ed., Thousand Oaks, CA: Corwin Press.
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Brian Urban, Au.D. is the President and co-founder of CounselEAR: Audiologist's Online Report Writer and owner of Advanced Hearing and Balance Center in Evanston, Illinois. He can be contacted at or at 888-516-4281. You may also learn more about CounselEar at the CounselEar web channel on AudiologyOnline.

brian urban

Brian Urban, AuD

co-founder and President of CounselEAR, LLC.

Brian Urban, Au.D., is the co-founder and President of CounselEAR, LLC.  CounselEAR is an online tool that enables audiologists to rapidly create customized counseling summaries as well as professional reports.  He is also the founder of Advanced Hearing and Balance Center in Evanston, Illinois.  Dr. Urban has a Master's degree in Audiology from the University of Minnesota and an Au.D. degree from Salus University.  He has presented on the topic of counseling techniques at state and national conventions and is an Adjunct Faculty member for Rush University.  Dr. Urban also currently serves as Treasurer on the ADA Board of Directors and recently participated in the AAA Future Leaders of Audiology Conference (FLAC).

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