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1. A report of the presentation on
“COMMUNICATION"
SUBMITTED BY
Ganesh Subedi (70011)
M.Pharm (Pharmaceutical Care)
Batch 2007-2009
SUBMITTED TO
Ass. Professor Ms. Nilima Shrestha
Department of Pharmacy
School of Science
Kathmandu University
Date of Submission: March 1 2008

2. Definition
Communication is the sharing of information, ideas, thoughts and feelings. It involves not only
the spoken words but also information, which are conveyed through inflection, vocal quality,
facial expression, body posture and other behavioral responses.
Pharmacists are the triage between the patients and the medical practitioners and after all helps in
taking medicines safely and appropriately by the patients. Hence, pharmacists should have good
communication skills. An act of poor communication can be associated with various sarcastic
problems as:
 Incomplete drug information may be provided to health care professional
 Incomplete advising for medication use to patients
 Inappropriate advising on dispensing
So pharmacists should possess good communication skills to correct weakness and strengthen
confidentiality in disseminating information.
Modes of Communication
Modes of communication can be categorized into following basic categories:
1. Verbal Communication
2. Non-Verbal Communication
1. Verbal Communication: Verbal communication includes the use of actual
words for communication. They denote the literary meanings of the actual words and accounts for
only about 10 percent of the message/theme of the communication.
2. Non-Verbal Communication: Non-verbal communication includes the tone of voice
used, the speed and volume of speech, the intonation and the whole range of body postures and
movements. It accounts for 90 percent of total communication.
Types of Non-Verbal Communication
a. Vocal communication: It includes quality and fluency of the voice. Quality refers to the
tone, pitch, volume and speed. Tone can be harsh and soft. A soft tone is more preferable
than a harsh tone, which has meaningful variations. The volume of the tone should focus
on a emphasized part of the sentence and should be adjusted accordingly. Similarly, the
speed should be considerable such that the listeners should perfectly be able to
understand things what speaker aims to say. In gist, a preferable vocal communication
should have soft tone, emphasized and adjustable volume and maintained speed. A
communication becomes effective when spoken with warm confident tone of voice at an
appropriate speed and volume and without interruption.
b. Body language: Body language refers to the overall impression that is perceived
with whom who is talking. It is often said, "You never get a second chance to make first
impression". Hence, many neglect an unfriendly and unhelpful person. Various
components of the body language play an important role to make understand what you
ought to. These includes:
i. Gestures: Gesture defines as the expressive movement of a part of the
body, especially, the hand or head. Appropriate use of gestures aids in explaining
things what you want. Hence, it is important not to overuse them. Pharmacists
can emphasize a point or procedures to describe y the use of gestures,

3. ii. Facial expressions: A confident facial expression urges listeners to
concentrate what one says. Facial expression expresses the mood and emotion
with the eyes and mouth giving the dominant signs. It encourages patients to
motive to listen perfectly and satisfy with the information provided by the
pharmacists.
iii. Eye contact: Eye contact expresses the ongoing process of communication. It
tells about whose turn to speak and when. Avoiding eye contact during
communication clearly states avoidance for the will to communicate.
iv. Physical contact: Physical contact is highly cultural variation. It is one of
the means of pleading to what is spoken for and often represent much number of
words spoken. However, cultural variation should be accounted.
v. Body posture: It explains the position of different body parts. Normally, the
words spoken during communication can be controlled. But body language is
quite difficult to control. A posture of a body can also influence the process. The
intention and concentration of a speaker/listener can be disclosed by body
posture. There are several classic body postures, which have been identified as
having significant meanings.
 Closed position (arms folded): This is seen as rather negative posture
and not one likely to encourage initiation of communication.
 Feet position: Feet position can be another checkpoint. It is assumed
that person's feet will be painting in the direction he wants to go. This can be
used to check for the listener's intention of hearing the information provided.
 Positive body posture: Leaning towards the person who is talking, or
sitting in a relaxed fashion, are both examples of non-verbal language, which
can encourage good communication.
vi. Personal space:It is the space around which one becomes comfortable to talk
with anyone. The space during the communication should be enough such that
maximum comfort is achievable during conversation. Adequate distance should
be attained to develop a good rapport and a meaningful dialogue to occur. The
personal space is generally divided into four major areas:
 General Area: This is approximately 3 m or more. This is the space we
would normally prefer to have around us if we are addressing a group of
people or are working alone.
 Sociable Area: This is approximately 1-3 m and is the type of distance
used when communicating with people we do not know very well.
 Personal Area: This is approximately 0.5-1 m. This is the space we
would normally feel comfortable with, when at a business or social meeting
with people we know reasonably well. It is sufficiently close to allow
friendly and meaningful communication without any individuals feeling
threatened by having their intentions zone invaded.
Patterns of behaviour in communication
Every individual have his or her own behavior. There is infact an individualistic variation and
people behave differently. However, the behaviour during communication can be categorized as
follows:
a. Assertiveness: It is a positive attitude. It is defined as standing up for personal
rights and expressing thoughts, feelings and beliefs in direct, honest and appropriate
ways, which do not violate another person's rights. Being assertive means listening to
others and understanding their feelings. Assertive people will deal with other people as
equal.

4. b. Aggressiveness: Aggressiveness means violation. An aggressive people
aim to achieve their goals in the expense of others. Aggressive behaviour is often
frightening, threatening and unpredictable. It will bring out negative feelings in the
receiver and communication will be difficult.
c. Passive-aggressive behaviour: These are back talking people. They may agree for what
you are saying but may criticize at your back.
d. Submissive behaviour: These people have very little confidence in themselves
and are self-esteemed. They often allow others to violate their personal rights and take
advantage of them.
Hence, communicating as effectively as possible assertive behaviour is advantageous. It helps in
resolving the issues of conflict, in negotiation, leadership and motivation, when giving and
receiving feedback, in cooperative working and in meetings. Assertive communication can give
the user confidence, a clear self-image and leads to a feeling of more control over situations.
Assertive behaviour shows recognition of personal rights and rights of others. Personal rights
include:
 To state one's own needs and priorities
 To be respected as an intelligent and capable equally
 To express one's feelings
 To express one's opinions and values
 To be able to say 'yes' and 'no'
 To make mistakes
 To change one's mind
 To say 'I don't understand'
Techniques in assertive communication
a. Use of I and You statements: When I is used in a statement it shows that the speaker
bears the responsibility rather than imposing the responsibility to the listener by using the you
statements. It also approaches to minimize negative reactions such as anger.
b. Repeating the message: It is firmly important to repeat the message provided or to be
taken, unless achieved. This should be acquainted without squeezing the outbreak for
achieving the result.
c. Clear communication: Both verbal and non-verbal communication should be matched
to avoid misunderstanding/confusion to make the communication clear.
d. Extract the truth: Impressive and affirmative communication avoids the
conversation being lousy. Anger and upset may cloud the message and one may exaggerate
during conversation. Hence, it is important to make the communication worthful without
distracting the attention of the communicator and extracting as much as information as
required to be true.
Empathy
Literally it is an ability to imagine and share another person's feelings, experiences, etc. It is the
ability to enter into the life of other people and to accurately understand both their meanings and
feelings. It involves an accurate perception and identification of both the actual words and
underlying feeling contained in what a person is saying.

5. Pharmacists need the skill to respond in a way that communicates this understanding
convincingly. Empathy is one of the cornerstones in communication skills and is an essential part
of assertiveness. It is needed in information gathering, when interviewing patients and when
educating and counseling.
Elements of Empathy
a. Facilitating empathy: During communication a safe and confident atmosphere must be
created to fully express the views. Pharmacist must be able to create this environment much
of which is attained by some non-verbal communications as eye contact, tone of voice and
body posture. There is also a good need to express respect and assurance. Pharmacists should
encourage people to describe their feeling at the utmost possibility.
b. Perceiving feelings and meanings: Pharmacists should be able to make correct
identification of feelings and their meanings. Expressing information by patients depends on
their swing of mood. It is ultimately the result for how they are being treated. Examination of
both expression of feeling and its correlation with the non-verbal communication should be
matched to clearly and accurately understand what one tries to speak. Pharmacists should also
prevent the biasness of perceiving what one tries to say by avoiding their own assumptions,
as all drug addicts are the same.
c. Responding: One should try communicating by simplifying the feelings generated by
the speaker. This response shows that pharmacists could intensely understand the feelings and
is trying to help out with patient's condition. Pharmacists must be able to understand and
focus and than be able to interpret the assessing with positive responses.
Questioning skills
It is one of the important assets for pharmacist. An honorary and respectful questioning aids in
discloser of some hesitating reasons in a briefing manner. Normally questions are asked to
encourage for finding essential information.
Types of questions
a. Closed questions: A closed question is one, which is direct and close-ended. It requires the
respondent to give a single word reply such as yes or no. Such questions do not include a
feeling component, but do provide specific information on a subject area. Examples
 Are you taking any medicines at present?
 Have you ever taken this medicine before?
 Do you understand how to take it?
 Do you have any questions about the medicine?
 Did the medicine work for you?
b. Open Questions: Open questions are open-ended and often allow people to respond in
their own way. They do not set any limits and generally allow the person to provide more
detailed information. Open questions encourage elaboration and help people expand on what
they have started to say. Examples:
 Describe your symptoms to me.
 What do you do when that sensation occurs?

6. The funneling technique
It is a method of first finding out the basic information i.e. background information by putting
open questions and then asking specific closed questions to provide specific details and clarity. In
a pharmacy setting where time can be a limiting factor, using the funneling technique can be
useful for directing and focusing a conversation to enable an end point to be achieved more
quickly.
Listening skills
For an effective communication, listening is an important component. True listening involves
eyes as well as ear. Perception of the actual description involves perfect listening by focusing on
what the speaker speaks for. Distraction by external circumstances should be prevented and in
depth meaning of the words should be understood.
Barriers of communication
Common barriers, which can be of prime consideration in a pharmacy setting, can be identified as
follows:
a. Environment
b. Patient factors
c. The pharmacists
d. Time
a) Environment: Community pharmacies, hospital outpatient pharmacies and hospital
wards pharmacies are all areas where pharmacists use their communication skills in a
professional capacity. None of these areas are ideal and problems may arise. Some areas
of potential problem areas are illustrated as follows:
 A busy pharmacy: This may create the impression that there appears to be little time
to discuss personal matters with patients. The pharmacist is supervising a number of
different activities at the same time and is unable to devote his full attention to an
individual matter. It is important that pharmacists organize their work patterns in
such a way as to minimize this impression.
 Lack of privacy: Some pharmacies, both in community and hospital outpatient
departments, have counseling rooms or areas, but many may not have. For good
communication to occur and rapport to be developed ideally the consultation should
take place in a quiet environment, free of interruption. Lack of these facilities
requires additional facilities.
 Noise: Noise levels within the working environment are an obvious
barrier to good communication. People strain to hear what is said, comprehension is
made more difficult and particular problems exist for the hearing impaired. The
opposite may also be true.
 Physical Barriers: Pharmacy counters and outpatient dispensing hatches are
physical barriers and also may dictate the distance between the pharmacists and
patient. This in turn can create problems in developing effective communication.
b) Patient Factors: Different people coming to pharmacy have different
expectations. Most of the people try to sort out the things as quickly as possible. Their
zeal of communication gets eloped because of their hectic business. Hence they may not
entertain longer communication. However, if he can be convinced stating and explaining
the necessity of communication, they may show their willingness to communicate.
 Physical Disability: Surrogate approach of communication with additional
skills may be required in dealing with the patient with differently capable abilities.

7.  Comprehensive difficulties: It is important to identify the level of
understanding of different people coming to the pharmacy. Accordingly
comprehensive adjustment should be made to make them understand what is intended
to.
 Illiteracy: To deal with these people different pictograms and verbal
communications should be adopted.
c) Pharmacists: Pharmacist must be confident and self determined to communicate in a
prefect and impressive manner. Pharmacists to develop the strength of communication
should easily overcome the following weakness:
 Lack of confidence
 Lack of interest
 Laziness
 Delegation of responsibilities to untrained staff
 A feeling of being under pressure, especially time pressure
 Being pre-occupied with other matter.
Time
Lack of time can be a major constraint on good communication. A meaningful communication
should be developed to provide or obtain concrete information.
Confidentiality
Matters related to health and illness is highly private affairs. Therefore it is important that privacy
and confidentiality are assured in the practice of pharmacy..
Private communication facilities (environment), psychological privacy, use of proper voice, eye
contact, leaning forward and concentrating on the person and their problem helps in generating
confidentiality. Ethical guidelines and privacy laws should be followed. Without the consent of
the person only information to prevent serious injury or damage to the health of the person can be
shared.
Summary
Good communication is a practice-based approach and gets developed slowly. Different people
have different personalities and skills. One should try to maximize the strengths and minimize the
weaknesses. Explaining things appropriately, listening with understanding is essential. Good
communication, however is not only needed for pharmacists but also to others and is a life skill
attitudes to be used at all times.