Introduction to clinical communication skills.pptx 2011
INTRODUCTION TO CLINICALCOMMUNICATION SKILLSDr RM AbrahamClinical skillsNRMSM UKZN
CLINICAL COMMUNICATIONSKILLS(CCS)AIM: To promote the practice of effectivecommunication within the healthcare settingswith patients, carers, collegues and otherprofessionals.
EFFECTIVECOMMUNICATION/GOODCONSULTATIONinvolves: Understanding the patients problems fromhis/her perspective by allowing the patients tonarrate their story in their words and at thesame time demonstrating interest, empathy,respect and attending to their comfort at alltimes. Sharing information with the patients withregards to:a)Explaining procedures that would be necessaryto help make a diagnosis.b)Discussing the various treatment options andtheir effects.
GOOD DOCTOR Remember that the success of a good doctordepends not only on his/her medical knowledgebut also the way he/she communicates withhis/her patients e.g the way he explains theproblems, diagnosis and treatment to hispatients. Since Medicine is a subject that is learnt fromthe interaction with patients, it is thereforeessential that medical students develop theircommunicating capacity at the undergraduatelevel. We would therefore be teaching and providingyou with the building blocks that are necessaryto create a Good consultation.
CCS-OBJECTIVES To explore the basics of what makes a gooddoctor. Importance of a medical interview in clinicalpractice from the point of view of :a)The doctorb)The patient
A-WHAT MAKES A GOOD DOCTOR? Think of a previous medical encounter you had with adoctor-How did the consultation go?-How was the Doctor-patient relationship and what doyou perceive should be a good doctor-patientrelationship?-What do you really value and need in a good doctor?-Why does a good doctor-patient relationship matter?-What did the doctor do to make the interview go well?-What could the doctor do to make the interview gobetter?-What message about being a good doctor did you takeaway from the experience?
GOOD DOCTOR-PATIENTRELATIONSHIP Achieved by:1)Establishing a good rapport with the patient: Greet the patient Obtain patients name Intrd yourself, clarify your role and the nature of theinterview Obtain consent2)At all times demonstrating interest,empathy,respect andattending to the patients physical comfort.3)Good communication with patient: Gives the patient the chance to tell you what is wrong withthem in their words. They will tend to open up as they have the impression thatyou are honest with them and hence they trust you andfeel more confident to tell you what is exactly going on intheir mind
GOOD COMMUNICATIONSkills:-Encouraging the patient to tell his/her story of the problem from whenit started to the present in their words using a more open questioningtechnique.-Listening attentively without interrupting by: Wait time-give pt adequate time to respond Facilitative response-encourage pt to say more using phrases "uh-huh", "go-on","I see", "yes" Non-verbal skills-gives the pt a clue of your level of interestE.g. body posture, eye contact, gesture, facial expression, touch Picking up pts verbal and non-verbal cues and responding to them-often pts ideas, concern and expectations are provided in these cues.-Use of appropriate language (avoid using medical jargon or explain thejargon).-Clarifying statements that appear vague.-Summarizing periodically to verify your understanding and also givespt the feeling that you are listening to them attentively.
AIM: TO OBTAIN FACTUAL ACCOUNT OF PATIENTS ILLNESSAS WELL AS THE PATIENTS PERSPECTIVE OF THE ILLNESSB4 SUGGESTING AND AGREEING TO A PLAN OFMANAGEMENTDoctors agenda:a)Develop a goodrelationship with the pt.b)Make a diagnosis- by obtaining thesequence of events andanalyzing the symptomsetc(History taking) Examination of pt. Investigating pt.c)Manage the pt.- Pharmacological Non-pharmacologicalPatients agenda:To discussa)Ideas and thoughts ofthe illness.b)Concerns about theillness.c)Expectations from theconsultation.d)Feelings about theillness.e)Effects the illness ishaving on their life.
ANALYZING A CONSULTATION Watch the DVD clippings of medicalconsultations on the facebook page(www.facebook/clinicalskillsukzn) to help exploretheira) Purposeb) Difficultiesc) Strengths andd) WeaknessesFrom both the doctors and patients view point