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Skills in medicine

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Skills in medicine

Skills in medicine

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  • 1. SKILLS IN MEDICINE TO BE A BETTER TEACHER / DOCTOR Dr.T.V.Rao MDDR.T.V.RAO MD 1
  • 2. COMMUNICATION SKILLS PROBABLY THE MOST IMPORTANT SKILL IN MEDICINE FOLLOW HIPPOCRATIC OATH• I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.• All that come to my knowledge in the exercise of my profession or in the daily commerce with men, which ought I not to be spread abroad, I will keep secret and will never reveal. DR.T.V.RAO MD 2
  • 3. MEDICAL SKILLS THE MOST IMPORTANT SKILL IN MEDICINE DUTIES OF ANY DOCTOR• Support patients in caring for • Support patients to self care themselves to improve and maintain their health • Treat patients politely and considerately• Work in partnership with patients• Listen to patients and respond to • You must make sure, wherever their concerns and preferences. practical, that arrangements are made to meet patient’s language• Give patients information in way and communication needs. they can understand • Respect patients rights to• Taking patient’s views into consideration when assessing their confidentiality condition • You must be considerate to• Respond to patients questions and relatives, carers and partners be keep them informed about how sensitive and provide information information is shared within teams. and support. DR.T.V.RAO MD 3
  • 4. COMMUNICATING WITH COLLEAGUES I THE MOST IMPORTANT SKILL IN MEDICINE DUTIES OF ANY DOCTOR• Communicate effectively with • BOLAM PRINCIPLE colleagues within and outside the team • Always do what a reasonable doctor skilled in their art will do and can• Make sure your patients and justify why they have done it. colleagues understand your role and responsibilities in the team and who is responsible for each aspect of patient care• You must treat your colleagues fairly and with respect• When referring a patient you must provide all relevant information about the patient. DR.T.V.RAO MD 4
  • 5. WE HAVE TO COORDINATE WITH.. MANY - CHALLENGES• Physician teams • Hospital Teams • Fellows • Physicians • Senior residents • Nursing staff • Junior residents • Ward staff • Students • Ancillary providers• Clinic teams • Operating Room Teams • Physicians • Surgeons • Front desk staff • Anesthesia • Nursing staff • Nursing • Ancillary staff • Scrub TechsDR.T.V.RAO MD 5
  • 6. COMMUNICATION THEORY Communication is a learned skill or a series of learned skills which is based on 3 pillars: Accuracy Efficiency Supportiveness all combine to contribute to effectiveness of communicationDR.T.V.RAO MD 6
  • 7. WE SHOULD COMMUNICATE BETTER: WHY? Communication is essential for all aspects of life. Effective communication is the basis of mutual understanding & trust. Poor communication causes a lot of misunderstanding & hinders work & productivity.DR.T.V.RAO MD 7
  • 8. DO DOCTORS NEED TO BE BETTER COMMUNICATORS ? Doctors need to learn essentials of good communication more than other professionals because patients are humans with sensitive needs. Doctors can not practice medicine without effective communication skills. Poor communication causes a lot of medico-legal and ethical problems.DR.T.V.RAO MD 8
  • 9. COMMUNICATION SKILLS THE MOST IMPORTANT SKILL IN MEDICINE CONSULTATION MODELS-WHY?• To get the most out of the consultation for the patient foremost and for the doctor.• To plan the consultation using a framework• To adapt your style of consulting to meet the needs of the patient• To handle difficult situations• To have “rescue” plans when things go wrong• To use time efficiently in the consultation• To be able to assess and improve the consultation DR.T.V.RAO MD 9
  • 10. CONSULTATION SKILLS THE MOST IMPORTANT SKILL IN MEDICINE CONSULTATION MODELS- THE DOCTOR PERSPECTIVE• Doctor centred I• Patient centred I• Task orientated I• Behavioural orientated I• Plan your skillsDR.T.V.RAO MD 10
  • 11. Task OrientatedDoctor centred Patient centred Behaviour Orientated DR.T.V.RAO MD 11
  • 12. YOU ARE SKILLED PERSON IF YOU HAVE ABILITIES..The ability to integrate - knowledge base- communication skills- examination skills- problem-solving abilityDR.T.V.RAO MD 12
  • 13. CAN COMMUNICATION SKILLS BE TAUGHT?l communication is a clinical skilll It is a series of learnt skillsl Experience is a poor teacherl There is conclusive evidence that communication skills can be taughtand that in communication skills teaching is retained DR.T.V.RAO MD 13
  • 14. COMMUNICATION SKILLS SOME TECHNIQUES• Developed fluent dialogue with patient• Used silence effectively, allowing patient enough time to express thoughts or feelings• Actively encouraged patient through use of supportive words or comments• Dialogue with patient was enhanced by effective use of non-verbal behaviour• Used open, exploratory questions – inviting patient to become actively involved• Adjusted language as appropriate, to suit particular needs of the situation DR.T.V.RAO MD 14
  • 15. COMMUNICATION SKILLS SOME TECHNIQUES• Developed fluent dialogue with patient• Used silence effectively, allowing patient enough time to express thoughts or feelings• Actively encouraged patient through use of supportive words or comments• Dialogue with patient was enhanced by effective use of non-verbal behaviour• Used open, exploratory questions – inviting patient to become actively involved• Adjusted language as appropriate, to suit particular needs of the situation DR.T.V.RAO MD 15
  • 16. MEDICAL LEADERSHIP SKILLS• All physicians function as a leader on a daily basis• Most physicians have some baseline skills• Some are naturally better at it than others• Leadership skills can learned, developed and honedDR.T.V.RAO MD 16
  • 17. LEADERSHIP SKILLS ARE NOT TAUGHT BUT TO BE LEARNT ???• Endless amount of literature, books, courses, seminars, and institutes dedicated to leadership• Inadequate time to study leadership skills• Medical curricula do not include an emphasis on leadershipDR.T.V.RAO MD 17
  • 18. GOOD DOCTORS-PATIENTS RELATIONSHIP MINIMIZES CONFLICTS Developing rapport to enable the patient to feel understood, valued and supported. Encouraging an environment that maximizes accurate and efficient information gathering, planning & and explanation. Enabling supportive counseling as an end in itself.•DR.T.V.RAO MD 18
  • 19. ARE THERE PROBLEMS IN COMMUNICATION BETWEEN DOCTORS AND PATIENTS?L Reasons for the patients attendanceL Gathering informationl Explanation and planningl Adherence to plansl Medico-legall Lack of empathy and understanding DR.T.V.RAO MD 19
  • 20. LEARNING SUCCESSFUL LEADERSHIP SKILLS• Find a mentor • Someone you respect • Someone you can approach repeatedly and in a crisis • Ask if they will consent to being your mentor • Recognize your mentors efforts • Expect to do the same for others (be a mentor)DR.T.V.RAO MD 20
  • 21. TRAITS OF SUCCESSFUL LEADERS• Seek input• Spread authority• Treat people with respect• Don’t dictate• Challenge your team membersDR.T.V.RAO MD 21
  • 22. TRAITS OF SUCCESSFUL LEADERS• Patience • Not everyone has your agenda, goals or motivation • That doesn’t mean they aren’t an important part of the team • Doesn’t mean they are wrongDR.T.V.RAO MD 22
  • 23. TRAITS OF SUCCESSFUL LEADERS• Sense of humor • Don’t take yourself or the world too seriously • A smiling cheerful leader wins more cooperation than a grim or gloomy one.DR.T.V.RAO MD 23
  • 24. TRAITS OF SUCCESSFUL LEADERS• Know yourself• Have/demonstrate a sense of direction and mission• Make the hard decision • Part of leadership is making the decision no one else will or wants to make • Take responsibility for the decisionDR.T.V.RAO MD 24
  • 25. THE PARTICULAR PROBLEMS OF TEACHING ESTABLISHED DOCTORSMany established doctors havereceived little previous instruction incommunicationTheir only "training" has been gainedfrom their experience in medicineExperience alone is a poor teacher:need observation, well-intentionedfeedback and rehearsal DR.T.V.RAO MD 25
  • 26. THE PARTICULAR PROBLEMS OF TEACHING BY ESTABLISHED DOCTORS further to fallL more unlearning more ingrained habitsl more threateningl less aware of needDR.T.V.RAO MD 26
  • 27. WISH TO CONTINUE IN TEACHING PROFESSION..You need a methodology that:l is based on experiential learning -observation, feedback and rehearsall tackles the participants own problemsBUT ALSOL extends their understanding of underlyingcommunication skills and principles DR.T.V.RAO MD 27
  • 28. SEVEN FIVE DEADLY SINS “OF A LEADER”• Truth, if it becomes a weapon against persons.• Beauty, if it becomes a vanity.• Love, if it becomes possessive.• Loyalty, if it becomes blind, careless trust.• Tolerance, if it becomes indifference.• Self-confidence, if it becomes arrogance.• Faith, if it becomes self-righteous. Ashley Cooper, WriterDR.T.V.RAO MD 28
  • 29. WISH TO CONTINUE AS DOCTOR/TEACHER• You must become a leader to practice medicine successfully.• Mid Career requires more complex and sophisticated leadership skills• Make leadership development a part of your daily routine.• Learn from those around you.• Seek out opportunities for skill development• Practice at every opportunity.DR.T.V.RAO MD 29
  • 30. LEARNING SUCCESSFUL LEADERSHIP SKILLS FROM GOOD BOOKSLeadership texts • Good to Great by Jim Collins • Dealing with Difficult People by Harvard Press • Bargaining for Advantage By G Richard Shell DR.T.V.RAO MD 30
  • 31. WISH TO BE A HAPPY LEADER FOLLOW… • The happiest people don’t necessarily have the best of everything. They just make the best of everything.”DR.T.V.RAO MD 31
  • 32. TO SURVIVE AS A TEACHER / LEADER • With the increasing life expectancy and growing demands in the Medical Profession with explosion of Knowledge, the question remains can we survive with progressing age. It is certainly YES if you take positive attitude, and learn effective communion skills. Our Indian Medical Education do not orient much of the importance of Skills of Communication. We certainly need enlightenment with training on Communication skills including Electronic communication skills • Dr.T.V.Rao MD • Professor of Microbiology • doctortvrao@gmail.com •DR.T.V.RAO MD 32

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