Dr Anne Arber & Dr Andrew Hoy University of Surrey, Guildford, UK Advanced Communication Skills
Aims/objectives <ul><li>Evaluate the ability to elicit and respond to patients’ problems, worries and concerns </li></ul><...
Face to face communication <ul><li>Interpersonal communication is the process of information exchange among patients, care...
Rational for the course <ul><li>Communication skills do not reliably improve with experience alone  (Cantwell and Ramirez ...
Patients with cancer give priority to:  <ul><li>Being treated with humanity, dignity and respect </li></ul><ul><li>Good co...
<ul><li>What are the barriers to communication? </li></ul><ul><li>What facilitates communication? </li></ul>Barriers to co...
Barriers to communication <ul><li>Fears </li></ul><ul><li>Unleashing strong emotions </li></ul><ul><li>Upsetting patients/...
Facilitating communication Gathering information <ul><li>Open questions </li></ul><ul><li>Open directive questions </li></...
Listening skills <ul><li>Reflection  (acknowledgment) </li></ul><ul><li>Paraphrasing  (acknowledgement and checking) </li>...
Cues <ul><li>“ A verbal or non verbal hint which suggests an underlying unpleasant emotion and would need clarification fr...
Importance of cues <ul><li>Open questions linked to a cue are  4.5 times  more likely to lead to further significant discl...
Types of cues <ul><li>Words/phrases suggesting vague or undefined emotions </li></ul><ul><li>Verbal hints to hidden concer...
Outcomes <ul><li>Reflect upon and appraise one’s own and others’ communication skills </li></ul><ul><li>Demonstrate skill ...
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MON 2011 - Slide 18 - A. Hoy / A. Arber - Plenary session - Introduction to communications skills

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MON 2011 - Slide 18 - A. Hoy / A. Arber - Plenary session - Introduction to communications skills

  1. 1. Dr Anne Arber & Dr Andrew Hoy University of Surrey, Guildford, UK Advanced Communication Skills
  2. 2. Aims/objectives <ul><li>Evaluate the ability to elicit and respond to patients’ problems, worries and concerns </li></ul><ul><li>Reflect on the effectiveness of one’s communication skills </li></ul><ul><li>Implement effective strategies to enhance practitioner-patient communication </li></ul><ul><li>Appreciate the need for professional support </li></ul>
  3. 3. Face to face communication <ul><li>Interpersonal communication is the process of information exchange among patients, carers and health and social care professionals. It is underpinned and enhanced by mutual understanding, respect and awareness of individuals’ roles and functions, and is the process through which patients and carers are helped to explore issues and arrive at decisions. </li></ul><ul><li>NICE (2004) Supportive and Palliative Care Guidance </li></ul>
  4. 4. Rational for the course <ul><li>Communication skills do not reliably improve with experience alone (Cantwell and Ramirez 1997) </li></ul><ul><li>They can be taught (Wilkinson et al 2008 , Razavi et al 2000, Fallowfield et al 2001) </li></ul><ul><li>And maintained over time (Maguire et al 1996, Fallowfield et al 2003) </li></ul>
  5. 5. Patients with cancer give priority to: <ul><li>Being treated with humanity, dignity and respect </li></ul><ul><li>Good communication with health care professionals </li></ul><ul><li>Being given clear information about their condition </li></ul><ul><li>Receiving the best possible symptom control </li></ul><ul><li>Receiving psychological support where they need it </li></ul><ul><li>NHS Cancer Plan 2000 </li></ul>
  6. 6. <ul><li>What are the barriers to communication? </li></ul><ul><li>What facilitates communication? </li></ul>Barriers to communication
  7. 7. Barriers to communication <ul><li>Fears </li></ul><ul><li>Unleashing strong emotions </li></ul><ul><li>Upsetting patients/relatives </li></ul><ul><li>Patient refusing treatment </li></ul><ul><li>Difficult questions </li></ul><ul><li>Damaging the patient </li></ul><ul><li>Working Environment </li></ul><ul><li>No support/supervision </li></ul><ul><li>Lack of time/privacy </li></ul><ul><li>Staff conflict </li></ul><ul><li>No referral pathway </li></ul><ul><li>Beliefs </li></ul><ul><li>Emotional problems are inevitable </li></ul><ul><li>Not my role </li></ul><ul><li>Talking raises expectations </li></ul><ul><li>Patient will fall apart </li></ul><ul><li>Will take too long </li></ul>
  8. 8. Facilitating communication Gathering information <ul><li>Open questions </li></ul><ul><li>Open directive questions </li></ul><ul><li>Psychological focus </li></ul><ul><li>Pauses </li></ul><ul><li>Screening questions </li></ul><ul><li>Negotiation </li></ul><ul><li>Exploration </li></ul><ul><li>Clarification </li></ul><ul><li>Picking up cues </li></ul><ul><li>Acknowledge </li></ul><ul><li>Clarify </li></ul><ul><li>Explore </li></ul>
  9. 9. Listening skills <ul><li>Reflection (acknowledgment) </li></ul><ul><li>Paraphrasing (acknowledgement and checking) </li></ul><ul><li>Summary </li></ul><ul><li>Empathy </li></ul><ul><li>Educated guesses </li></ul><ul><li>Pauses/silence </li></ul><ul><li>Minimal prompts </li></ul>
  10. 10. Cues <ul><li>“ A verbal or non verbal hint which suggests an underlying unpleasant emotion and would need clarification from the health provider” Del Piccolo et al, 2006 </li></ul>
  11. 11. Importance of cues <ul><li>Open questions linked to a cue are 4.5 times more likely to lead to further significant disclosure than unlinked open questions </li></ul>
  12. 12. Types of cues <ul><li>Words/phrases suggesting vague or undefined emotions </li></ul><ul><li>Verbal hints to hidden concerns </li></ul><ul><li>Non-verbal cues </li></ul><ul><li>Mention of a life threatening illness </li></ul>
  13. 13. Outcomes <ul><li>Reflect upon and appraise one’s own and others’ communication skills </li></ul><ul><li>Demonstrate skill in facilitating patients’ expression of their concerns within a structured assessment </li></ul><ul><li>Address the patient agenda through use of facilitative communication skills </li></ul>

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