Communication 2e - O'Toole - 9780729541008
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This text introduces health sciences students to the various interpersonal communication skills that are commonly used within health settings to establish relationships with clients and fellow ...

This text introduces health sciences students to the various interpersonal communication skills that are commonly used within health settings to establish relationships with clients and fellow professionals, and improve therapeutic outcomes. It focuses on developing self awareness and skills for use in health settings and covers the types of scenarios commonly encountered in health settings that are rarely covered in generic professional communication texts. Perspectives and examples are drawn from a wide range of health professions. The book includes activities that will enable students to reflect on their experiences and practice using the skills.

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Communication 2e - O'Toole - 9780729541008 Document Transcript

  • 1. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. Contents Preface x Acknowledgements xi Reviewers xii SECTION ONE – THE SIGNIFICANCE OF INTERPERSONAL COMMUNICATION IN THE HEALTH PROFESSIONS 1 1 Defining effective communication for health professionals 3 Why learn how to communicate? – Everyone can communicate! 4 Factors to consider when defining effective communication 4 Chapter summary 8 References 9 2 The overall goal of communication for health professionals 11 A model demonstrating the importance of communication 12 A model to guide the general purpose of communication for the health professions 13 Chapter summary 17 References 18 3 The specific goals of communication for health professionals: 1 20 Making verbal introductions 21 Providing information: a two-way process 24 Review questions 26 Chapter summary 28 References 28 4 The specific goals of communication for health professionals: 2 30 Interviewing and questioning to gather information 31 Comforting: encouraging versus discouraging 35 Confronting unhelpful attitudes or beliefs 37 Review questions 39 Chapter summary 42 References 42 SECTION TWO – DEVELOPING AWARENESS TO ACHIEVE EFFECTIVE COMMUNICATION IN THE HEALTH PROFESSIONS 45 5 Awareness of and need for reflective practice 47 The ‘what’ of reflection: a definition 48 The result of reflection: achieving self-awareness 49 The ‘why’ of reflection: reasons for reflecting 50 The ‘how’ of reflection: models of reflection 52 Reflection upon barriers to experiencing, accepting and resolving emotions 56 Review questions 59 C v OToole_Table of contents_main.indd 5 2/15/2012 5:24:56 PM
  • 2. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication. contents Chapter summary 61 References 61 6 Awareness of self 65 Self-awareness: an essential requirement 66 Beginning the journey of self-awareness 67 Individual values 69 Is a health profession an appropriate choice? 69 Values of a health professional 70 Characteristics and abilities that enhance the practice of a health professional 71 Personal unconscious needs 71 Conflict between values and needs 73 Perfectionism as a value 74 Self-awareness of personal communication skills 75 Self-awareness of skills for effective listening 76 Self-awareness about skills for effective speaking 78 Preferences for managing information and resultant communicative behaviours 79 Personality and resultant communicative behaviours 80 Review questions 81 Chapter summary 85 References 85 7 Awareness of how personal assumptions affect communication 88 Reasons to avoid stereotypical judgement when communicating 89 Stereotypical judgement that relates to roles 90 Developing attitudes that avoid stereotypical judgement 92 Overcoming the power imbalance: ways to demonstrate equality in a relationship 93 Review questions 94 Chapter summary 98 References 98 8 Awareness of the ‘Person/s’ 100 Who is the Person/s? 101 The purpose and benefit of an essential criterion: respect 101 Defining respect 101 Demonstrating respect 103 What information will assist the health professional when relating to the Person/s? 104 Review questions 118 Chapter summary 121 References 121 9 Awareness of listening to facilitate person/s-centred communication 124 Defining effective listening 125C The requirements of effective listening 125 vi OToole_Table of contents_main.indd 6 2/15/2012 5:24:56 PM
  • 3. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. contents Results of effective listening 126 Barriers to effective listening 127 Preparing to listen 127 Disengagement 129 Review questions 131 Chapter summary 134 References 134 10 Awareness of different environments that can affect communication 136 The physical environment 137 The emotional environment 143 The cultural environment 144 Environments relating to sexuality 147 The social environment 148 The spiritual environment 149 Review questions 149 Chapter summary 152 References 152 SECTION THREE – UNDERSTANDING AND MANAGING REALITIES OF COMMUNICATION IN THE HEALTH PROFESSIONS 155 11 Communication with the whole Person/s 157 Defining the whole Person 158 Holistic care 159 Holistic communication 162 Review questions 163 Chapter summary 165 References 165 12 Non-verbal communication 167 The significance of non-verbal communication 168 The effects of non-verbal communication 168 The components of non-verbal communication 169 Suprasegmentals: prosodic features of the voice 171 Suprasegmentals: paralinguistic features of the voice 172 Communicating with the Person/s who has limited verbal communication skills 174 Review questions 176 Chapter summary 179 References 179 13 Conflict and communication 181 Conflict during communication 182 Resolving negative attitudes and emotions towards another 184 Patterns of relating during conflict 184 How to communicate assertively 187 Review questions 189 C vii OToole_Table of contents_main.indd 7 2/15/2012 5:24:56 PM
  • 4. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication. contents Chapter summary 191 References 191 14 Culturally competent communication 193 Defining culture 194 Cultural identity affecting culturally competent communication 195 Defining culturally competent communication 195 Why consider cultural differences? 197 A model of culturally competent communication 197 Managing personal cultural assumptions and expectations 202 Strategies for demonstrating culturally competent communication 204 Using an interpreter 206 The culture of each health profession 208 The culture of disease or ill-health 208 Review questions 209 Chapter summary 211 References 211 15 Communicating with Indigenous Peoples 214 Correct use of terms 215 The 4 Rs for reconciliation: Remember, Reflect, Recognise, Respond 215 The complexity of cultural identity 217 Principles of practice for health professionals when working with Indigenous Peoples 218 Factors contributing to culturally safe communication with Indigenous Peoples 224 Barriers to culturally safe communication 227 Review questions 228 Chapter summary 231 References 231 Further reading 232 Websites and/or organisations 233 16 Misunderstandings and communication 234 Communication that produces misunderstanding 235 Factors affecting mutual understanding 235 Causes of misunderstandings 237 Strategies to avoid misunderstandings 239 Resolving misunderstandings 241 Review questions 242 Chapter summary 244 References 244 17 Ethical communication 246 Respect regardless of differences 247 Honesty 248 Clarification of expectations 249 Consent 249C Confidentiality 250 viii OToole_Table of contents_main.indd 8 2/15/2012 5:24:56 PM
  • 5. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. contents Boundaries 252 Ethical codes of behaviour and conduct 254 Review questions 254 Chapter summary 257 References 257 Further reading 259 Useful websites 259 Informed consent 260 18 Remote communication 262 Characteristics of remote forms of communication for the health professional 263 Principles that govern professional remote communication 265 Review questions 273 Chapter summary 276 References 276 SECTION FOUR – THE FOCUS OF COMMUNICATION IN THE HEALTH PROFESSIONS: PERSON/S 279 Person/s experiencing strong emotions 283 Stages of life 291 Particular life roles 302 Long-term conditions 319 Particular contexts 341 References 350 Further reading 350 Glossary 352 Index 359 C ix OToole_Table of contents_main.indd 9 2/15/2012 5:24:56 PM
  • 6. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. 1 The Significance of Interpersonal Communication in the Health Professions C OToole_Section 1_main.indd 1 2/8/2012 7:09:53 PM
  • 7. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication.C OToole_Section 1_main.indd 2 2/8/2012 7:09:53 PM
  • 8. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. Chapter 1  Defining effective communication for health professionals Chapter objectives Upon completing this chapter, readers should be able to: • Explain why it is essential to learn about effective communication • State an underlying principle for effective communication • Describe a model of interpersonal communication relevant to the health professions • Define effective communication • Demonstrate understanding of the importance of effective communication • Identify factors contributing to effective communication • Demonstrate understanding of the importance of considering the ‘audience’ to achieve C effective communication. OToole_Chapter 1_main.indd 3 2/8/2012 7:07:26 PM
  • 9. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication. Communication: core interpersonal skills for health professionals Why learn how to communicate? – Everyone can communicate! Communication occurs constantly throughout the world and most individuals participate in acts of communication every day regardless of their nationality, age or interests. Most people would agree that communicative interactions are unavoidable and usually essential for satisfactory daily life. Even those who are unable to produce speech seek to effectively communicate every day. If everyone already communicates in daily life, then why is it necessary to learn how to communicate in healthcare settings? Simply, in most healthcare settings there are specific required characteristics of communication and particular situ- ations that challenge the communication skills of any communicating person. Effective communication in a healthcare setting requires particular understanding of people and oneself (Zimmerman et al 2007), as well as highly developed communication skills. Individuals do not usually acquire such awareness or skill in everyday life, thus it is ben- eficial if preparing to be an effective health professional to learn about communication. Higgs et al (2005, 2010) indicate that effective communication is an essential core skill of any health professional. In addition, competent communication skills are a requirement to practise in many health professions. Ineffective communication negatively affects health outcomes, thus in New Zealand particularly, failure in communication is repeatedly the cause of complaints made to the Health and Disability Commissioner (Hill 2011a, 2011b). Certainly there is evidence to suggest that communicating after experiencing a health condition increases recovery rates and decreases the incident of further conditions (Davison et al 2000, Pennebaker 1995, 1997). Generally, effective communication ensures positive outcomes for all people relating to health professionals (Hassan et al 2007, Koponen et al 2010). Thus if effective communication skills are vital for successful outcomes of practice in the health professions, it is crucial to understand both communication and what constitutes effective communication. A guiding principle Before defining communication it is important to establish an underlying principle to guide communication for health professionals. Self-awareness and self-knowledge are necessary requirements for successful adherence to this principle. The principle simply states: Do not say or do anything to another person that you would not want said or done to you. Adapted from Hillel around 15 BC Consistent consideration of and adherence to this principle is not always easy, but it will generally produce effective communication in health care practice and in life. Factors to consider when defining effective communication Many dictionaries indicate that communication involves the sending and receiving of messages. They state that communication occurs in auditory/verbal, visual and non-verbal forms. This understanding of communication suggests that the act of communicatingC resembles a game of tennis. In the same way that tennis players hit a ball to each other, 4 OToole_Chapter 1_main.indd 4 2/8/2012 7:07:26 PM
  • 10. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. 1 » Defining effective communication for health professionals communicators send and receive messages in various forms. Initially this metaphor seems appropriate, but tennis players only interact with the ball; they nor- • Does communicating in the health professions require more than mally do not interact with each other. In addition the speech, hearing and sight? If so, tennis ball remains constant, unlike messages, which what does it require? change and develop when communicating. These realities suggest defining communication requires more than a comparison with playing tennis. Effective communication involves more than simply sending and receiving words by producing and receiving sound. As effective communication occurs in many forms, including vocalising without words (e.g. laughing or crying), non-verbal cues (e.g. eye contact, facial expressions, gestures and signing) and material forms (e.g. pictures, pho- tographs, picture symbols, logos and written words) (Crystal 2007), it requires consid- eration of multiple factors. Mutual understanding Each communicative act or interaction is unique, with unique requirements and con- straints. These requirements and constraints influence the effectiveness of the interaction at the time. The combination of these factors along with ongoing discussion determines whether the interaction produces mutual understanding. Successfully negotiating mutual understanding will encourage those communicating to trust their ability to communicate effectively (Stein-Parbury 2009) and thus they will continue to communicate. Every com- munication act requires all communicators to be actively involved, to connect with and understand each other, and to understand the factors affecting the communication act (Brill & Levine 2005, Hassan et al 2007). Effective communication requires the commu- nicating parties to have some basic knowledge about each other and their individual goals (Devito 2009). Send Self/Person aware Vulnerable Receive Health Person/s Professional negotiating mutual understanding Send Receive FIGURE 1.1  A model to guide communication in the health professions. Note: Person/s is used to describe those relating to the health professional during practice. C 5 OToole_Chapter 1_main.indd 5 2/8/2012 7:07:26 PM
  • 11. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication. Communication: core interpersonal skills for health professionals Communication is ineffective, without mutual understanding. Therefore, the sending and receiving of a message achieves nothing unless there is shared meaning and meaning- ful exchange of information. The specific purpose of communication among health pro- fessionals (see Chs 3 & 4) is to share information and fulfil needs. If mutual understanding is not negotiated through words and non-verbal messages (Gietzelt & Jones 2002), there is no appropriate information to guide an intervention and potentially limited fulfillment of needs. For example, if there is no connection (Hassan et al 2007, Horan et al 2011) and exchange of information with mutual understanding when there is a need for a toilet or something in which to vomit, the results can be messy and, more importantly, time consuming. Effective communication in the health professions occurs when the sender and receiver connect with each other for the common purpose of exchanging information and achiev- ing mutual understanding. It is essential for health professionals to negotiate or continue discussion during their interactions until achieving mutual understanding, thereby ensur- ing appropriate interventions and meaningful results. A common understanding of words Mutual understanding is essential for effective com- munication. However, different factors influence the • Consider the different meanings of comprehension of a message. These factors may either the following words: file, stand, form, compress, bracing, crutch and ‘a facilitate or restrict communication. simple case’. Effective communication requires two or more • Can you think of other words or people to have a topic of mutual interest, a mutual combinations of words that might desire, intent or need to communicate about the topic, cause miscommunication? the opportunity to communicate and the means of • What factors might change the communicating. Thus, if there is no common under- meaning an individual assigns to a standing of language or way of communicating there word or combination of words? will be no mutual understanding and thus no exchange of information or effective communication (Nunan 2007). This potentially will restrict health outcomes. Factors external to the sender and receiver The words in the box above (file, stand etc) have meanings that might vary within the context of the situation or environment (Nunan 2007). Thus, if asked for a ‘file’ (e.g. Pass that file please) when there is no obvious folder with pieces of paper inside, the receiver of the request might search for other meanings of the word. They might see an implement used to file nails in the environment and assume that is the required file. In this case, the receiver of the message assumes the meaning because of features of the environment. There are other external factors that affect the meaning an individual might assign to a word. Someone who comes from a particular background (Purtilo & Haddad 2007) or who has particular life experiences might assign a particular meaning to one word. For example, someone with a scientific or nursing background might assume that the word ‘stand’ means a structure used to hold or support something, while someone with a political background might assume it means to run for election. Someone with a military background might assume it means to resist an onslaught without being harmed, while someone with another background or experience might assume it means to position themselves on both legs with a straight back and stay in that position without moving. In this case it is the background and experience of the communicating individuals thatC affect the understanding of the particular word. The background or experience might be 6 OToole_Chapter 1_main.indd 6 2/8/2012 7:07:26 PM
  • 12. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. 1 » Defining effective communication for health professionals particular to a family, socioeconomic group or culture; all of these factors and more can affect and Consider: vary the meaning of messages. It is important when • It is time we had those ATOs in the communicating in the health professions, therefore, store means: Can you put the ATOs to consider related factors that might influence the in the store now? achievement of mutual understanding, effective com- • Have you seen that splinting munication and thus positive health outcomes. material? means: I have asked everyone else – do you know? Factors specific to the sender It is often the emphasis on particular Senders of messages often express their messages words that changes the intended according to their own thoughts, agenda, needs or meaning of a sentence. Compare: feelings at a given time. For example, senders often communicate their intended meaning through • I want a drink of water. emphasis or stress on a particular word, rather than • I want a drink of water. the actual words they use (Crystal 2007). • I want a drink of water. The emphasis changes the meaning of each statement. The first is a statement Factors specific to the receivers of a desire to have a drink of water. or ‘audience’ The second suggests a focus upon In every communicative event someone receives a the speaker; thereby implying the message or information. The audience is the person irrelevance of the desires of others. The or group of people who receive the message or infor- third indicates that the desired drink is mation. In the health professions there are many water and nothing else. In each case people who constitute the audience including col- the emphasis indicates the particular leagues, Person/s and family members. desire of the person sending the There are many factors that influence the effec- message. If the receiver fails to note the emphasis in the last sentence, for tiveness of communication and some of these factors example, the sender of the message are specific to the receiver/audience. When commu- may not receive the desired drink. nicating as a health professional, the potential impact of these audience factors upon communication man- dates their consideration. Every person has particular knowledge and asso- ciated levels of understanding that affect their ability to comprehend particular messages (Milliken & • List all the people with whom a health professional might Honeycutt 2004). Thus, when practising as a health communicate. professional it is important to communicate in ways that acknowledge the level of understanding and/or • For each person or group of people list factors specific to that person or knowledge of the audience. group that might affect their ability to The age of the person is one factor that can influ- understand a sent message. ence the knowledge or level of understanding. There- fore, when talking to a young child it is appropriate to adjust the communication style by using less complex words or sentences. This adjustment of communication style assists the mutual understanding of both the speaker and the child. Using the same simplistic language when talking to an adolescent or adult, however, may cause offence. An additional factor that requires adjustment of language is the cultural/language background of the audience (Fageeh 2011) (see Chs 7 & 14 and Section 4). A further factor that requires consideration is whether or not to use professional jargon. The decision of how and when to use professional jargon requires the health professional to consider the experience and background of the person (Purtilo & Haddad C 7 OToole_Chapter 1_main.indd 7 2/8/2012 7:07:26 PM
  • 13. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication. Communication: core interpersonal skills for health professionals 2007). The use of medical terminology may be appropriate if the person has a medical background and understanding of that particular field of medicine. It may also be appro- priate if they have previous experience with such terminology, but may cause confusion if they do not have the knowledge, understanding or experience of such terminology. When communicating with health professional colleagues about medically related topics, use of non-medical terminology may cause confusion! In order to avoid confusion it is important to consider and sometimes request information about the knowledge and experience of the audience when communicating as a health professional. It is certainly beneficial to ensure there is understanding of all relevant terms. A particular disorder affecting an individual may also influence the success of the communicative event. In some circumstances it may be essential to communicate only one idea or step at a time. For example, individuals with limited cognitive ability and reduced affect require adjustments in the communication style of the health professional and their manner of constructing and delivering a message. It is not only the age, background and experiences of the receiver that can affect their levels of understanding. Receivers of messages often interpret messages according to their own thoughts, ideas, needs or emotions at that given time, which may assist or adversely affect their understanding of the messages (see Chs 5 & 6 and Section 4). Effective com- munication between a health professional and the people seeking their assistance should be an exchange of thoughts, ideas, needs and emotions that has a • List at least six factors that facilitate therapeutic outcome (Paré & Lysack 2004, Seikkula effective communication. & Trimble 2005). A health professional who consid- • State whether these factors are ers and appropriately adjusts to the thoughts, ideas, external or internal to the sender or needs and emotions of the receiver will usually receiver. promote mutual understanding and thus achieve effective communication. Chapter summary Effective communication occurs when people send, receive and understand messages. Such communication produces mutual understanding and is essential for health FIGURE 1.2 C Mutual understanding is essential! 8 OToole_Chapter 1_main.indd 8 2/8/2012 7:07:27 PM
  • 14. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s),Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi-dential until formal publication. 1 » Defining effective communication for health professionals professionals. There are both external and internal factors that influence information exchange through mutual understanding. These factors occur in the environment, in the sender and the receiver. A sound understanding and consideration of these factors con- tributes to effective communication and positive health outcomes. References Brill N I, Levine J 2005 Working with people: the helping process, 8th edn. Pearson, Boston Crystal D 2007 How language works. Penguin Books, London Davison K P, Pennebaker J W, Dickerson S S 2000 Who talks? The social psychology of illness support groups. American Psychologist 55(2):205–217 Devito J A 2009 The interpersonal communication book, 12th edn. Pearson, Boston Fageeh A A 2011 At crossroads of EFL learning and culture. Cross-cultural Communication 7(1):62–72 Gietzelt D, Jones G 2002 Importance of language – single words don’t communicate all that is necessary. In: Bergland C, Saltman D (eds) Communication for healthcare. Oxford University Press, Melbourne, p 18–32 Hassen I, McCabe R, Priebe S 2007 Professional–patient communication in the treatment of mental illness: a review. Communication & Medicine 4(2):141–152 Doi:10.1515/CAM.2007.018 Higgs J, Ajjawi R, McAllister L et al 2010 Communicating in the health sciences. Oxford University Press, Melbourne Higgs J, Sefton A, Street A et al 2005 Communicating in the health and social sciences. Oxford University Press, Melbourne Hill A 2011a Consumer-centred care: seamless service needed. New Zealand Health & Disability Commission, August. Online. Available: http://www.hdc.org.nz/ 10 Jan 2012 Hill A 2011b Recurring themes. Society of Anaesthetists Newsletter, Feb Horan S M, Houser M L, Goodboy A K et al 2011 Students’ early impressions of instructors: understanding the role of relational skills and messages. Communication Research Reports 28(1):74–85 Doi:10.1080/08824096.2011. 541362 Koponen J, Pyööräälää E, Isotalus P 2010 Teaching interpersonal communication competence to medical students through theatre in education. Communication Teacher 24(4):211–214 Doi:10.1080/17404622.2010.514275 Milliken M A, Honeycutt A 2004 Understanding human behavior: a guide for healthcare providers, 7th edn. Thomson Delmar, New York Nunan D 2007 What is this thing called language? Palgrave Macmillan, Basingstoke Paré D, Lysack M 2004 The willow and the oak: from monologue to dialogue in the scaffolding of therapeutic conversations. Journal of Systemic Therapies 23:6–20 Pennebaker J W 1995 Emotions, disclosure & health. American Psychological Association, Washington, DC Pennebaker J W 1997 Opening up: the healing power of expressing emotions. Guildford Press, New York Purtilo R B, Haddad A 2007 Health professional and patient interaction, 7th edn. Saunders, Philadelphia C 9 OToole_Chapter 1_main.indd 9 2/8/2012 7:07:27 PM
  • 15. To protect the rights of the author(s) and publisher we inform you that this PDF is an uncorrected proof for internal business use only by the author(s), editor(s), reviewer(s), Elsevier and typesetter Toppan Best-set. It is not allowed to publish this proof online or in print. This proof copy is the copyright property of the publisher and is confi- dential until formal publication. Communication: core interpersonal skills for health professionals Seikkula J, Trimble D 2005 Healing elements of therapeutic conversations: dialogue as an embodiment of love. Family Process 44:461–473 Stein-Parbury J 2009 Patient and person: interpersonal skills in nursing, 4th edn. Churchill Livingstone Elsevier, Sydney Zimmerman S S et al 2007 Using the power of student reflection to enhance professional development. Internet Journal of Allied Health Sciences and Practices 5(2):1–7C 10 OToole_Chapter 1_main.indd 10 2/8/2012 7:07:27 PM