Your Audience Doesn’t Know What You Know
Helping my son revise recently taught me something important about knowledge gaps.
The subject was maths. He could do the calculations, but some of the terminology meant very little to him. Words such as expand and factorise were stopping him from understanding what the questions were actually asking.
Once we explained those terms, everything changed.
His ability had not changed.
The missing knowledge had.
It got me thinking about how often the same thing happens in healthcare.
A product can be clinically sound. Training can have been delivered. The information can be completely accurate.
And yet:
clinicians still do not explain it confidently
patients still ask the same basic questions
teams communicate different messages
training is completed, but behaviour does not change
uptake is slower than expected
Sometimes the problem is not the product, the evidence or the audience.
Sometimes there is simply a gap in understanding.
When expertise creates a blind spot
The closer we are to a subject, the harder it becomes to remember what it felt like not to understand it.
Health and digital health organisations naturally become familiar with the language, evidence and logic surrounding their products or services. Over time, things that once needed explanation begin to feel obvious.
That familiarity can create a blind spot.
Organisations may start communicating from the point they have reached, rather than the point their audience is starting from.
A patient may receive accurate information without enough context to understand what it means for them.
A clinician may learn how to use a digital tool without feeling confident enough to explain it to a patient.
Training may cover the facts without helping someone apply them in practice.
The deeper risk is that organisations mistake exposure for understanding, and understanding for adoption.
Giving someone information does not mean they understand it.
And understanding something does not necessarily mean they can use it, explain it or act on it.
What looks like resistance may be a knowledge gap
When people fail to understand, trust or adopt something, it can be tempting to blame resistance.
Perhaps the patient is “not engaged”.
Perhaps the clinician is “reluctant to change”.
Perhaps the team is “not ready for innovation”.
But sometimes the audience is not resistant at all.
The explanation simply started in the wrong place.
My son was not incapable of doing the maths or unwilling to learn. He was missing the knowledge needed to interpret the question.
Once we identified that gap, his response changed.
The same principle applies to health communication.
Before assuming an audience is disengaged or resistant, it is worth asking whether they were given the right information, at the right level, in a form they could actually use.
Three questions before you communicate
I use three questions to test whether health information is genuinely usable.
1. What do they already know?
Do not assume the audience shares the organisation’s language, context or starting point.
What knowledge do patients, clinicians or other users genuinely bring to the conversation?
2. What are we assuming they already understand?
This is often where the real gap sits.
What feels obvious internally because the organisation works with the product, evidence or technology every day?
What knowledge might the audience be missing that prevents the rest of the information from making sense?
This could include what a product does, why it is being used, where it fits, its limitations or what its use means for the person on the receiving end.
3. What must they be able to do next?
After reading the content or completing the training, what should the audience actually be able to do?
Make a decision?
Change a behaviour?
Use the product?
Explain it confidently?
Recommend it appropriately?
Ask informed questions?
If they cannot do the thing the communication was meant to support, the information may have informed them without preparing them to act.
Knowing how to use it is not enough
I experienced this gap myself after receiving training on an intraoral scanner.
I could use the scanner competently. I understood how to capture the images and incorporate it into an appointment.
But if a patient had asked where their data would be stored, who could access it or what would happen to it after the scan, I could not have given them a confident answer.
The training had prepared me to use the technology, but not to support an informed conversation about it.
That distinction matters.
A clinician may operate a tool correctly while still feeling unprepared for the patient questions that influence transparency and trust.
When these gaps are overlooked:
patients may agree without being meaningfully informed
clinicians may use technology without feeling confident discussing it
education may increase awareness without changing practice
organisations may interpret poor uptake as resistance
strong products may struggle to earn trust and adoption
These are communication gaps, but their consequences can be clinical, operational and commercial.
Start where your audience is
The answer is not to remove the expertise.
It is to translate that expertise into something people can actually use.
For health and digital health organisations, this means designing communication around the audience’s starting point, not the expert’s finishing point.
Product education should go beyond features and operating instructions. It should prepare clinicians to understand a product’s role, limitations and implications, and answer the questions patients are likely to ask.
Patient information should not simply present accurate facts. It should provide enough context for people to understand what those facts mean for them.
And clinical education should do more than deliver information. It should help people apply that information in the reality of practice.
Sometimes a product is not being adopted because people do not understand where it fits.
Sometimes training is not changing practice because it assumes knowledge that is not there.
Sometimes patients are not taking the next step because the information answered the organisation’s questions rather than theirs.
Before creating more content, more education or more messaging, it is worth finding out where understanding is actually breaking down.
That is the part I am increasingly interested in: identifying why communication is not landing before deciding what needs to be created to fix it.
Because people do not always need more information.
Sometimes they need the missing piece that enables them to understand, trust and move forward.
