2. Lecture’s main objectives:
To describe the importance of good
communication with patients
To describe the factors that may influence the
outcome of communication between the
doctor and patient
To explain the technique of conducting
effective communication with patients that
involves questioning, listening and facilitating
4. Several methods of communication:
Two friends talking
Radio/ TV
Newspaper/book
Wrting a letter
Telephoning/fax
Teaching/lecturing
Doctor or nurse with patient
5. Purposes of Communication
are to:
form & maintain relationship
give information
convey feelings
persuade
solve problems
alleviate distress
make decisions
give reassurance
6. Aim of a physician
(since ancient time):
“To cure sometimes,
relieve often,
comfort always……”
8. Main areas covered in Block MC
1. A.Taking medical history and review of body
systems
B. Giving information to patient
C. Special approach to specific patient/situation
2. Paper presentation and discussion
3. Writing medical letters & notes, and CV
4. Scientific writing
(5. Health education & health promotion for
community at large)
9. Good communication skills can be learned.
Prerequisites:
Written instructions (references)
Opportunities to practice
Feedbacks (SGD)
Discussion on performance (SGD)
13. Guidelines for conducting
interview with patient
A. Beginning
1. Greet patient by name, shake hand (?)
2. Ask patient to sit down
3. Introduce yourself
4. Explain purpose of interview
5. Say how much time available
6. Explain need to take notes
14. B. Main part of interview
1. Maintain +ve atmosphere, warm manner,
eye contact
2. Use open questions, esp at beginning
3. Listen carefully
4. Be alert and responsive to verbal & non
verbal cues
5. Facilitate patient verbally & non-verbally
6. Use closed questions when appropriate
15. 7. Clarify what patient has told you
8. Encourage patient to be relevant
C. Ending
1. Summarize what patient has told you
2. Ask if patient wants to add anything
3. Thank patient
16. • Key skills for communicating effectively with
patient
Questioning
Listening
Facilitating
17. 1. Questioning
Main purpose of interviewing patient:
to obtain information about patient’s
condition accurate, complete and relevant
Good communication with patient alone
contributes to correct diagnosis in 80% of
cases
18. • Open questions
– should be used as much as possible
– to obtain great deal of information from patient
“Would you please tell me how you have been
feeling in the past few days?”
“I understand that you have had pain. Would you
please tell me more about it?”
“Can you tell me what brings it on?”…etc
19. • Closed questions
– Give patient little choice in the way to answer
– Usually elicits little information, only “yes” or
“no”.
“Have you been feeling unwell today?”
“I see from your GP’s notes that you have had chest
pain. Do you still have the pain?”
“Was it tight or dull pain?”
“Did it go down your arm?”
“Did it get worse when you exercised?”
20. Advantages of open questions
More relevant information in given time
Patient feels more involved
Patient can express all concerns and anxieties
about problems
When to use close questions?
To obtain specific information not yet given by
patient
In emergency cases
21. 2. Listening
Features of active and effective listening:
Gathering and retaining information
accurately
Understanding implications for patient of
what is being said
Responding verbal & non-verbal signals or
cues
Demonstrating you are paying attention and
trying to understand
23. 3. Facilitating
Related with effective listening. Aim to help patient
to talk fully about problems.
Verbal way
“Please go on and tell me more about your pain”.
“Yes, I understand—please continue”.
Non verbal ways:
Leaning slightly forward toward patient
Making eye contact
Nodding head at appropriate time
24. Communication
with Family
How family can help?
Provide emotional & social support
Provide practical support
Provide understanding of beliefs about illness
& treatment
25. Provide information about family history
Help avoid/overcome bad patient compliance
Overcome difficulties arising from secrets
Anticipate/address problems that may affect
other family members
26. NO’S
Too many or complicated questions
Not allowing patients to tell story in their own
words
Unnecessary interruption
Failing to pick up verbal & non-verbal cues
27. Patients respect doctors who
are warm and sympathetic
are easy to talk to
introduced themselves
appear self-confident
listen to the patients and respond to their
verbal cues
ask easy-to-understand questions
28. Summary
The ability to communicate effectively and
sensitively is essential in medicine
Communicating effectively with patients involves the
core skills of questioning, listening and facilitating
Good communication leads to: accurate history
taking and diagnosis, patients’ compliance with
treatment plan, patients’ satisfaction with the care
given
The skills of good communication can be learnt and
retained