Module 2.1: The Foundations of communication - 2

1. Module 2.1: The
Foundations of
communication - 2

3. National Medical Commission
Communication:part II

4. Introduction
Communication is a fundamental
prerequisite of the medical profession and
beside skills is crucial in ensuring professional
success for doctors. This module continues to
provide an emphasis on effective
communication skills.
During professional year II, the emphasis is on
active listening and data gathering.
AETCOM modules are based on Graduate
Medical Education Regulations, 2017.

5. Communication is an integral part of medicine
• Good communication skills are a must for
medical and other healthcare practice
• Not only for Doctor & patient interaction
but also within the healthcare team.

6. Definition of communication in AETCOM
module
• Communication is the purposeful activity of
information exchange between two or more
participants in order to convey or receive the
intended meanings.

7. 8 Why communication is needed
1. Helps patients feel at ease
2. Reduce their anxiety and build
their confidence
3. Makes patients feel valued
4. Provide for the best health care
5. Reduce chances of medical errors

9. 7 Principles of a good communication

10. Types of Communication in a
Healthcare Set-up
Communication
based on the
number of people
involved in the
process
Communication
based on the
medium used for
the process
Communication
based on the
feedback obtained
during the process
Communication
directed by the
authorities of an
institute
1. Intrapersonal 1. Verbal 1. Two-way 1. Formal
communication communication communication communication
2. Group 2. Non-verbal 2. One-way 2. Informal
communication communication communication communication
3.. Mass
communication
Dr. Sanjay Andrew R, Professor & Head of Physiology - C H R
I.

11. Communication
based on the
number of
people involved
in the process

12. Intrapersonal Communication
•Communication with oneself
•Involves thoughts, reflections, and internal
dialogue
Group Communication
•Interaction among a small group (3 or more
people)
•Focused on discussion, collaboration, or
decision-making
Mass Communication
•Reaches a large audience
•Uses media like TV, radio, newspapers, and the
internet

13. Communication
based on the
medium used
for the process

14. 15
Verbal communication
We need to ensure that what we say is:
 clear
 accurate
 honest
 appropriate (to the person’s age,
language/culture and level of

15. 16
But just as important is how we
say it. At all times we must be:

16. 17
NONVERBAL COMMUNICATION
Vocal cues of paralinguistic cues
Action cues
Object cues
Spaces
Touch

17. 18 Vocal cues of paralinguistic cues
 Pitch
 Tone of voice
 Loudness
 Rate and rhythm of talking
 Unrelated nonverbal sounds such as laughing ,
groaning, nervous coughing and sounds of
hesitation

18. 19
Action cues
 Facial expression
 Eye contact
 Appearance
 Gesture
 Automatic reflexes
 Movements and Posture

19. 20
Objects cues
 Signal for someone to do something
 An object or part of object used to refer to a
person, place, object, or activity
 Requires a simple motor response, such as
pointing, touching, picking up, showing, or
looking at it to make the message clear
 Especially for children and people with deaf
and poor speech

20. 21 Touch
 Can be a key to unlock a patient’s feeling
 A tentative touch may be perceived as distaste
or reluctance to care for individual
 A positive touch is firm but gentle
 To provide reassurance, anger , or frustration
 Should have professional purpose

21. Communication
based on the
feedback obtained
during the
process

22. 23
Ways to communicated
Area One-way Two-way
Types One direction Two direction
Easy/fast Difficult/slow
control Sender Sender/receiver
feedback None Maximum
Flexibility None Sender need to change
according to receiver’s
feedback
Role of nurse Teacher ,
evaluator
Therapeutic , corrective
Way of
determining
understandin
g
Cannot know Can know how much he is
understand
Examples of
use
instruction discussion

23. Communication
directed by the
authorities of an
institute

24. 25
🧭 Formal Communication
•Follows official channels or hierarchy
•Structured and documented
•Used in meetings, reports, memos, and emails
•Example: A manager sending a report to the CEO
💬 Informal Communication
•Unofficial, casual, and spontaneous
•Flows freely in all directions
•Helps build relationships and trust
•Example: Colleagues chatting during a break

25. Therapeutic communication:
• It takes place between a health care
personnel & a patient, with the purpose of
modifying the patient behavior.
• This is accomplished with repeated
interaction using certain essential attributes
such as trust, empathy, tenderness, concern
& nonjudgemental attitude.
Types of Communication:
Based on the purpose of communication

26. Benefits of Effective Communication
Doctor's Role
Good Working
Relationships
Treatment
Understanding
Patient
Satisfaction
Doctor
Satisfaction

27. Emotional states
influencing
communication
Physical conditions
affecting attention
and focus
Traditions and
beliefs influencing
communication
Barriers to Effective Communication
7.Semantic
Factors
Feedback
mechanisms in
communication
8.Process Factors
3.Environmental
Factors
Language and
interpretation
barriers
External conditions
affecting
communication
2.Psychological
Factors
6.Organizational
Factors
4.Social Factors
Roles and
responsibilities
within an
organization
Social strata and
hierarchies impacting
communication
5.Cultural Factors
1.Physiological
Factors

28. Emotional states
influencing
communication
Physical conditions
affecting attention
and focus
Traditions and
beliefs influencing
communication
Barriers to Effective Communication
7.Semantic
Factors
Feedback
mechanisms in
communication
8.Process Factors
3.Environmental
Factors
Language and
interpretation
barriers
External conditions like
temperature affecting
communication
2.Psychological
Factors
6.Organizational
Factors
4.Social Factors
Roles and
responsibilities
within an
organization
Social strata and
hierarchies impacting
communication
5.Cultural Factors
1.Physiological
Factors

29. Seven essential sets of
communication tasks:
(1) Build the doctor—patient relationship;
(2) Open the discussion;
(3) Gather information;
(4) Understand the patient's perspective;
(5) Share information;
(6) Reach agreement on problems and
plans; and
(7) Provide closure.

30. 1.Build a Relationship: The Fundamental
Communication Task
 The patient-centered, or relationship-centered, approach to
care, emphasizes both the patient's disease and his or her
illness experience.
 This requires eliciting the patient's story of illness while guiding
the interview through a process of diagnostic reasoning.
 It also requires an awareness that the ideas, feelings, and
values of both the patient and the physician influence the
relationship. Further, this approach regards the physician—
patient relationship as a partnership, and respects patients'
active participation in decision making.
 The task of building a relationship is also relevant for work with
patients' families and support networks. In essence, building a
relationship is an ongoing task within and across encounters

31. 2.Open the Discussion
Allow the patient to complete his
or her opening statement
Elicit the patient's full set of
concerns
Establish/maintain a personal
connection

32. 3.Gather Information
 Use open-ended and closed-ended
questions appropriately
 Structure, clarify, and summarize
information
 Actively listen using nonverbal (e.g., eye
contact) and verbal (e.g., words of
encouragement) techniques

33. 4.Understand the Patient's Perspective
 Explore contextual factors (e.g., family, culture,
gender, age, socioeconomic status, spirituality)
 Explore beliefs, concerns, and expectations about
health and illness
 Acknowledge and respond to the patient's ideas,
feelings, and values

34. 5.Share Information
 Use language the patient can
understand
 Check for understanding
 Encourage questions

35. 6.Reach Agreement on Problems and Plans
 Encourage the patient to participate in
decisions to the extent he or she desires
 Check the patient's willingness and
ability to follow the plan
 Identify and enlist resources and
supports

36. 7.Provide Closure
Ask whether the patient has other
issues or concerns
Summarize and affirm agreement
with the plan of action
Discuss follow-up (e.g., next visit,
plan for unexpected outcomes)

37. 38 Communication under stress
 Effective communication under stress is a critical
leadership component
 Communicating under stress is a skill that
everyone should have, regardless of their status
in a workplace
 Being able to think clearly, maintain composure,
and make the right decision is key

38. 39
 Take a deep breath
 Take a Minute and Assess the Situation
 Communicate in Person
 Listen
 Practice positive body language
Points to do ;

39. Kalamazoo communication skill
rating scale
criteria score
Builds doctor-patient relationship
Opens the discussion
Gathers information
Understands the patient’s
perspective
Shares information
Reach Agreement on Problems
and Plans
Provide Closure
Rating--Poor 1-3 , satisfactory 4-6 , superior 7-10

40. University theory questions
AETCOM 2.1
 Q. State few essential elements of communication in
medical encounters in accordance to the Kalamazoo
consensus statement
 Q. What is communication? What are the types of
communication? Discuss the importance of efficient
communication in healthcare settings.

41. Each student will practice the following communication scenario as per
their roll number allocation and will present a role play on 29-10-
2025.
1. Introduction to Patient (First Meeting) :Roll No. 1 – 26
2. General Communication with Patient: Roll No. 27 – 52
3. Explaining a Simple Procedure: Roll No. 53 – 78
4. Explaining Need for Investigation: Roll No. 79 – 104
5. Dealing with an Anxious Patient: Roll No. 105 – 130
6. Explaining Discharge Instructions: Roll No. 131 – 156
7. Handling a Patient’s Relative: Roll No. 157 – 166, R1 – R10
8. Breaking Bad News (Mild Scenario):R11 – R39
Note:
•First show what is wrong – demonstrate incorrect or poor communication.
•Then show what is right – demonstrate the correct, empathetic, and professional way.
•Total duration: 5–7 minutes per student/group.
•End with a closing sentence summarizing what you learned.
 For any queries, please contact the above-mentioned faculty members.
Dr Neha
Dr Mayur
Dr Savan

42. Instructions for Students
 Faculty Allocation for Case History Taking:
 Roll No. 1 – 68: Report to Dr. Neha
 Roll No. 69 – 136: Report to Dr. Mayur
 Roll No. 137 onwards: Report to Dr. Savan
 Activity: Patient History Taking
 Each student will accompany their allotted faculty member and take the
case history of different patients.
Note: Greet the patient politely, introduce yourself as a student doctor, explain
your purpose, take permission to ask questions, listen carefully, speak clearly
and kindly using simple words, show empathy, respect privacy, and thank the
patient at the end.

43. 44
A good relationship start
with a good
communication skill