AET-COM Module for 1st M.B.B.S students

2. COMMUNICATION SKILLS IN
MEDICAL PRACTICE
• DEVELOPING STRONG
COMMUNICATION SKILLS IS INTEGRAL
TO BECOMING AN EFFECTIVE HEALTH
PROVIDER.
• IN RECENT YEARS GOOD DOCTOR–
PATIENT COMMUNICATION HAS BEEN
LINKED TO IMPROVED PATIENT
SATISFACTION, BETTER PATIENT CARE
AND A DECREASE IN MALPRACTICE
LAWSUITS.

3. WHY COMMUNICATION SKILLS
•Eliciting proper history from a patient is of paramount importance to establish an
•Accurate diagnosis and management in medical practice.
•Good communication skill is a Prerequisite for an effective physician patient
relationship.
• A systematic search of Medical literature has been made to formulate a guideline
for better communication
•During history taking, the guideline emphasizes on both physical environment and
Emotional encounter and the key points are expressed as tips on relevant issues.

4. TYPES OF DOCTOR PATIENT
RELATIONSHIP
• CONSUMERIST
• DOCTOR PASSIVE, SECOND OPINION, REFERRAL TO HOSPITAL, SICK NOTE
• PATERNALISTIC
• DOCTOR TAKES ON ROLE OF “PARENT”, PATIENT SUBMISSIVE
• MUTUALITY
• EQUAL PARTNERS, JOINT VENTURE, EXCHANGE OF IDEAS

5. COMPETENCY
• BUILD A RELATIONSHIP
• OPEN THE DISCUSSION
• GATHERS INFORMATION
• UNDERSTANDS THE PATIENT’S PERSPECTIVE
• SHARES INFORMATION
• REACHES AGREEMENT
• PROVIDES CLOSURE

6. BUILD A RELATIONSHIP
• GREET AND SHOWS INTEREST IN THE PATIENT AS A PERSON
Make sure that your beginning is
smooth. All you need to do is – greet
the patient, check the identity of the
patient, introduce yourself, offer some
personal but interesting and relevant
chit chat.

7. BUILD A RELATIONSHIP
• INTRODUCE YOURSELF TO THE PATIENT.
• EXPLAIN YOUR ROLE.
• SHAKE HANDS, BUT DON’T FORCE PHYSICAL CONTACT IF PATIENT IS
UNCOMFORTABLE.
• CALL THE ADULT PATIENT MR., MRS., OR MS. (DO NOT USE FIRST NAME )
• MAINTAIN PRIVACY.
• KEEP DOORS AND CURTAINS CLOSED.
• ACKNOWLEDGE AND GREET OTHERS IN THE ROOM.
GREET AND SHOWS INTEREST IN THE PATIENT AS A PERSON

8. BUILD A RELATIONSHIP
• USES WORDS THAT SHOW CARE AND CONCERN THROUGHOUT THE INTERVIEW

9. BUILD A RELATIONSHIP
• USE TONE, PACE, EYE CONTACT, AND POSTURE THAT SHOW CARE AND
CONCERN
• SITS SQUARE ON FACING THE
PATIENT
• MAINTAINS OPEN BODY POSITION
• LEANS SLIGHTLY FORWARD
• EYE CONTACT IS MAINTAINED
• RELAXED (IN AN APPROPRIATE
POSTURE) (KAUFMAN 2008)

10. BUILD A RELATIONSHIP
• RESPONDS EXPLICITLY TO PATIENT STATEMENTS ABOUT IDEAS, FEELINGS, AND
VALUES

11. OPEN THE DISCUSSION
• ALLOWS PATIENT TO COMPLETE OPENING STATEMENT WITHOUT INTERRUPTION
“Silence is golden”- so tolerate short silences. The patient may be doing important ‘work’.

12. OPENS THE DISCUSSION
• ASKS ‘IS THERE ANYTHING ELSE’ TO ELICIT FULL SET OF CONCERNS
• EXPLAIN AN AGENDA FOR THE VISIT
• IDENTIFYING THE REASON FOR THE CONSULTATION

13. GATHERS INFORMATION
• BEGINS WITH PATIENT NARRATIVE USING OPEN-ENDED QUESTIONS (‘TELL ME ABOUT
. . .’)
• OPEN QUESTIONS:– ALWAYS START WITH AN OPEN
ENDED QUESTION AND TAKE
• THE TIME TO LISTEN TO THE PATIENT’S ‘STORY’.
• CLOSED QUESTIONS: – ONCE THE PATIENT HAS
COMPLETED THEIR NARRATIVE TO CLOSED
QUESTIONS WHICH CLARIFY AND FOCUS ON
ASPECTS CAN BE USED.
• LEADING QUESTIONS:– QUESTIONS BASED ON YOUR
OWN ASSUMPTIONS THAT LEAD THE PATIENT TO THE
ANSWER YOU WANT TO HEAR. THESE SHOULD NOT
BE USED AT ALL.

14. GATHERS INFORMATION
• CLARIFIES DETAILS AS NECESSARY WITH MORE SPECIFIC OR ‘YES/NO’
QUESTIONS
• SUMMARIZES AND GIVES PATIENT OPPORTUNITY TO CORRECT OR ADD
INFORMATION
• TRANSITIONS EFFECTIVELY TO ADDITIONAL QUESTIONS

15. UNDERSTANDS THE
PATIENT’S PERSPECTIVE
• ASKS ABOUT LIFE EVENTS, CIRCUMSTANCES, OTHER PEOPLE THAT MIGHT AFFECT
HEALTH

16. UNDERSTANDS THE
PATIENT’S PERSPECTIVE
• ELICITS PATIENT’S BELIEFS, CONCERNS AND EXPECTATIONS ABOUT ILLNESS
AND TREATMENT
• MUTUALITY
• EQUAL PARTNERS
• EXCHANGE OF IDEAS
• JOINT VENTURE

17. SHARE INFORMATION
• ASSESSES PATIENT’S UNDERSTANDING OF PROBLEM AND DESIRE FOR MORE
INFORMATION

18. SHARES INFORMATION
• EXPLAINS USING WORDS THAT ARE EASY FOR PATIENT TO UNDERSTAND
• ASKS IF PATIENT HAS ANY QUESTIONS

19. REACHES AGREEMENT
• INCLUDES PATIENT IN CHOICES AND DECISIONS TO THE EXTENT SHE/HE DESIRES

20. REACHES AGREEMENT
• CHECKS FOR MUTUAL UNDERSTANDING OF DIAGNOSTIC AND/OR TREATMENT
PLANS
• ASKS ABOUT PATIENT’S ABILITY TO FOLLOW DIAGNOSTIC AND/OR TREATMENT
PLANS
• IDENTIFIES ADDITIONAL RESOURCES AS APPROPRIATE

21. PROVIDES CLOSURE
• ASKS IF THE PATIENT HAS QUESTIONS, CONCERNS, OR OTHER ISSUES
• ADVICE, REASSURANCE AND
SUPPORT FROM THE DOCTOR CAN
HAVE A SIGNIFICANT EFFECT ON
RECOVERY
• THE PLACEBO EFFECT

22. PROVIDES CLOSURE
• SUMMARISE
• CLARIFIES FOLLOW-UP OR CONTACT ARRANGEMENTS
• ACKNOWLEDGES PATIENT AND CLOSES INTERVIEW

23. THANKYOU
“WE HAVE NOT LOST FAITH, BUT WE HAVE TRANSFERRED IT FROM GOD TO THE MEDICAL
PROFESSION.”
GEORGE BERNARD SHAW