3. The aims
By the end of this session our future physicians
will be able to:
Know the basic of Management skills .
Know the basic of communication skills .
Know the different types of communications .
Recognize the barriers of effective communications.
Communications in special situation.
4. Communication Skills
Communication skills, which are fundamental
to consulting skills, are the key to the
effectiveness of the doctor as a professional &
expertise with these skills is fundamental to the
doctor-patient relationship.
Communication skill is essential in obtaining a
good history & constitutes 1 of the cornerstones
of therapy.
5. DEFINITION
Communication can be defined as “the successful
passing of a message from 1 person to another”.
Basic elements in the communication process:
The communicator
The message
The method of communicating
The recipient
The response
6.
7. COMMUNICATION IN THE
CONSULTATION
The doctor requires appropriate
communication skills for complete
diagnosis (physical, emotional & social) &
competent management).
The majority of interactions between
doctor & patient occurs in the traditional
consultation.
8. DIFFICULTIES IN
COMMUNICATION
Poor communication is the most important factor
causing complaints from patients & relatives
against doctors.
Effective communication depends on 4
interrelated factors:
1. The message
2. The doctor (the sender)
3. The patient (the recipient)
4. The environment in which the message is sent
9.
10. The Message
The nature & content of the message may
be uncomfortable for the doctor or the
patient or both. This applies to emotionally
charged, complex or subtle content such as
sexual problems, malignant disease, drug
abuse, bereavement, malingering &
psychiatric disorders.
12. The Patient
Do we recognize, with significant emotion,
these patients in our practice?
Smith speaking: “I insist on speaking to you
directly & not to the “iron curtain” out front.
“Doctor, I’ve lost my script again – be a good fellow
and …”
“Those pills you prescribed for me yesterday are
doing nothing for me.”
“Doctor, you’re the only one who can help me.”
13. Patient Characteristics That Can
Influence Communication:
Age
Adolescent
Elderly
Sex
Opposite
Senses
Deaf
Blind
Speech Impairment
Handicapped
Speech disorders
Visual impairment
Illness
Acutely ill
Injured
Psychological
Attitudes:
Aggressive, hostile, demanding
Aggrieved (fees, mistakes)
Perception of doctor’s authority
14. Environment
The physical environment is important. The
appearance, size & layout of consulting rooms,
waiting rooms & patients’ rooms will affect
communication, sometimes adversely,
especially if privacy is threatened by, say,
leaving the consulting room door open.
The doctor can create an obstacle simply by a
physical “barrier”, eg a large desk distancing
the doctor from the patient.
15. Summary of Environmental Factors That
Can Adversely Influence Communication
Waiting Room:
Poor physical layout
Length of waiting time
Time Pressure:
“Traffic” level
? Busy
? Noisy
? Sense of urgency
Physical Factors:
Desk – barriers
Layout inappropriate
Poor record system
Substandard exam
couch
Privacy:
Dressing/undressing
Sound
Interruptions - phone
16. NON-VERBAL
COMMUNICATION
Non-verbal communication or body language is
a most important feature of the communication
process. Birdwhistle has shown that more
human communication takes place by the use
of gestures, postures, position & distances (non-
verbal communication or body language) than
by any other method. Albert Mehrabian
showed that non-verbal cues comprise the
majority of the impact of any communicated
message.
17. Impact of the Message
Words alone 7%
Tone of voice 38%
Non-verbal communication 55%
18. Interpreting Body Language
The interpretation of body language,
which differs between cultures, is a
special study in its own right but there are
certain cues & gestures that can be
readily interpreted.
The depressed patient and other patients