How effective communication is important in making a clinical diagnosis

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SCHOOL OF NURSING
DEPARTMENT: BEHAVIORAL SCIENCES
COURSE CODE: NSC 200
COURSE TITLE: COMMUNICATION SKILLS
PRESENTED TO: PROF AYUKU
DATE OF PRESENTATION: 15TH
, JULY, 2013
NAME: MUNYAO STEPHEN KING’ESI
ADMISSION NUMBER: NUR/15/12
SIGNATURE: ……..………………………

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MSC 200: COMMUNICATION SKILLS
Question: Effective communication is an integral part of diagnosis. Discuss.
Diagnosis (diagnostic procedure) in medicine refers to the process of
attempting to determine or identify a possible disease or disorder that may have
caused complaints in the patient. It can be performed by various members of health
care team including the nurses, doctors, physiotherapists, dentists. This mainly
involves gathering information from the patient/client that would enable the
healthcare provider identify the underlying disorder or abnormality in the
patient/client.
In order to reduce diagnostic errors, a proper history taking, a process that
involves keen listening of the patient complains (problems), whether it has a
medical diagnosis attached or not, so as to identify the client’s needs. The doctor/
healthcare provider needs to employ effective communication skills, which
includes expressing interest in the patient, concentration, body language as well as
the ability to interpret non-verbal communication skills since communication may
be both verbal and non-verbal (posture, use of gestures and facial cues).
Effective communication especially during the introductory phase with the
client helps create a rapport with the client. Warm reception of the patient helps
create confidence in the patient as well as reducing the client’s anxiety and hence

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promoting cooperation. The history is a sharing of between the patient and the
healthcare provider. A consultation allows patients unburden themselves from the
upset of their condition or with frustrations of life and it is important to give vent
to these feelings. The introduction also helps the clinician know different
developmental stages and levels and the ways in which clear communication can
be achieved at any level. It also helps know the patent’s mental status as well as his
or her past medical history.
After establishing a close relationship with the client, the healthcare provider
can now evaluate the level of understanding of the patient’s current problem
considering his/her personal religious or cultural background. If the client needs to
be enlightened, then the clinician can do so and hence increase the patient’s
understanding of their current status.
The choice of questions is important when making a diagnosis. Types of
questions employed include open questions, questions with options and leading
questions. Open questions are is the gold standard of history inquiry. This gives the
patient or client a chance to express what is in their mind. It is always good to
allow the patient tell the story freely as the consultant keeps the questions as open
as possible.

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After data collection, the healthcare provider needs to give the client a
summary of their condition or problems. This further increases confidence and
trust in the client-healthcare provider relationship. After data collection, it is
important to validate data collected. When analyzing data, the healthcare needs to
keep an open mind and ask oneself if is making assumptions. A discussion with a
fellow member of healthcare team for any mistake made. There is also need to be
prepared to re-consider the causes of symptoms that one or a colleague has decided
upon.
A feed back to the patient is important so that the patient can be aware of
their condition and their role in promotion of their quick recovery. Punctuality of
feedback from the laboratory, radiology department or any other department that
would assist in arriving at differential diagnosis of the client’s problem is
important and hence assisting in quick plan of patient’s care.
Consent seeking from the patient when a procedure or an investigation is to
be done is an important part of making a diagnosis. The client is allowed to
participate in the choice s about his/her care. It originates from the legal and ethical
right that the patient has to direct what happens to his or her body and from the
ethical duty of the physician to involve the patient in the care. The patient is given
information in a sensitive and understandable way. The person should be given
enough to consider the information and an opportunity to ask questions if they

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wish to. Informed consent is meant to establish that trust you must respect patients’
autonomy their right to decide whether or not to undergo any medical
intervention/investigation. This involves effective communication skills between
the client and the healthcare provider for clarity and provision of adequate
information.
Conclusion
Most diagnoses (about 80%) are made on history alone. Further 5-10% made from
examination and remainder on investigations. Hence communication contributes
the biggest percentage in making diagnosis.