01 - Communication Skills

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COMMUNICATION -psychological factors r/t illness or

-heart of patient care care


DEFINITION: -pt’s beliefs about health and illness
-”communicate” Latin -pt’s expectations of what the doctor
-to impart, to share will do
-imparting, conveying or exchanging ideas How the pt perceives the role of the
and knowledge doctor

METHODS  Doctor related factors


 Lecture -training in communication skills
 Talking -self confidence in ability to
 Phone communicate
 Internet -Personality
 Letters -Physical factors (tiredness)
 Radio/ TV -Psychological factors (anxiety)
 Reading FACTORS THAT MAKE YOU FEEL AT EASE
-comfortable setting
PURPOSES -being greeted by name and a handshake
-to investigate/explore -Being shown where to sit
-to inform/explain -Introduce self and explain the procedure
To influence/motivate -Easy first question
-to explore, explain, negotiate and make -Interviewer appearing interested in your
decisions remarks
-offer support, concern, compassion
GUIDELINES FOR CONDUCTING AN INTERVIEW
GOOD COMMUNICATION BEGINNING:
-warm and sympathetic 1. Greet the pt by name
-easy to talk to 2. Ask pt to sit down
-introduced self 3. Introduce self
-self confident 4. Explain purpose of interview
-Listen and respond 5. Say how much time is available
-asked questions that were easy to 6. Explain need to take notes and ask
understand if that is acceptable
-Did not repeat self DURING:
-Warm manner and good eye contact
IMPORTANCE -use open questions at the beginning
1. Make accurate and comprehensive -Listening carefully
diagnoses -Be alert and responsive to verbal and
2. Detect emotional stress and respond nonverbal cues
appropriately -facilitate the pt verbally and
3. Have patients who are satisfied with nonverbally
the care they have received and less -clarify what the pt has told you
anxious -encourage the pt to be relevant
4. Have patients who agree and follow
advice OPEN STYLE OF QUESTIONING
-more relevant information can be
MOST FREQUENT COMPLAINT ABOUT obtained in a given time
DOCTORS -Patients feel more relaxed and involved in
1. Would not listen the interview
2. Would not give information -Patients can express all the concerns and
3. Showed lack of concern/respect anxieties about their problems
LIMITATIONS OF CLOSED STYLE OF
FACTORS AFFECTING DR-PT COMMUNICATION QUESTIONING
 Patient-related factors - information obtained is restricted to the
-physical symptoms questions asked
-interview is controlled by the interviewer
-little opportunity to express concerns
Be strong and courageous. Do not be afraid; do not be discouraged,
for the Lord your God will be with you wherever you go.
Joshua 1:9 1
-treat patients as individuals and respect
their dignity: treat politely and
NONVERBAL CUES considerately, respect pt’s right to
-eye contact confidentiality
-posture -work in partnership with patients: listen
-gestures and respond to their concerns and
-Facial expressions preferences, give the information they
-The way the voice is used want or need, respect the patient’s
decisions
ACTIVE LISTENING -be honest and open, and act with integrity
-facilitation
-clarification KEY POINTS:
-reflection -Communicating effectively with
-helping the pt to be relevant patients involves the core skills of
-Silence questioning, active listening and
-sign-posting (give the pt an idea what is to facilitating
be done next) -these skills can be learned and need
-summarizing to be practiced
-Asking questions:
ENDING THE INTERVIEW -use open questions
-summarize what the patient has told you and -probing questions
ask if your summary is accurate -Listening: verbal and nonverbal cues
-ask if the patient would like to add anything -summarize
-Thank the patient -close the interview
-professionalism: good
DOCTOR-CENTERED INTERVIEW communication skills are an essential
-doctors play dominant role component of professional behavior
-less attention to patient’s concerns and
understanding of their illness
-patients not involved in decisions about
their treatment

PATIENT CENTERED INTERVIEW


-exploring the patient’s experience of
illness and knowledge of illness
-allowing patients to express their
concerns about the impact of their illness
on their life
-treating the patient as a partner when
discussing treatment

PROFESSIONALISM AND COMMUNICATION


SKILLS
-medical professionalism signifies a set
values, behaviors and relationships that
underpins the trust the public may have in
doctors

DUTIES OF A DOCTOR
-make the care of your patient your first
concern: empathy, patient centered
consultation, professionalism
-protect and promote the health of pts and
the public: lifestyle advice
-provide a good standard of practice and
care

Be strong and courageous. Do not be afraid; do not be discouraged,


for the Lord your God will be with you wherever you go.
Joshua 1:9 2

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