The document discusses communication skills for pharmacists, categorizing patients into passive, aggressive, and assertive types. It emphasizes the importance of assertive behavior, effective feedback, and appropriate questioning techniques to foster trust and improve patient relationships. Additionally, it highlights strategies for responding to criticism and the value of listening and open-ended questions in healthcare communication.

1. COMMUNICATION
SKILLS FOR THE
PHARMACIST

2. Types of patients in
communication

3.  Patients divided into three types in their communication with the pharmacist:
1. PASSIVE
2. AGGRESSIVE
3. ASSERTIVE

4. ASSERTIVE BEHAVIOR
• Assertive behavior is the direct expression of ideas, opinions, and desires.
• The intent of assertive behavior is to communicate in an atmosphere of trust.
• Conflicts that arise are faced and solutions of mutual accord are sought.
• Assertive individuals initiate communication in a way that conveys their
concern and respect for others.

5. • Letting others know how you respond to their behavior can help to avoid
misunderstandings and also help to resolve the conflicts.
• However, providing honest feedback when you have a negative reaction to another person’s
behavior is difficult to accomplish without hurt feelings.
• When you choose to convey negative feedback to others, use techniques to make the
communication less threatening.
Assertiveness strategies
1) PROVIDING FEEDBACK

6. • Feedback focuses on a person’s behavior rather than personality. By focusing on behavior,
you are directing the feedback to something the individual can change.
• Feedback is descriptive rather than evaluative (No blame). Describing what was said or
done is less threatening than judging why you assume it was done.
•Many of the messages, patients send to you involve the way they feel about their illnesses or
life situations. If you are able to communicate back in a caring, accepting, nonjudgmental
way to a patient reflecting that you understand the client’s thoughts and feelings from the
client’s point of view, then a caring, trusting relationship can be established.
•Motivational feedback is very important in many cases which focuses on techniques to help
patients to move through the stages of change.
Criteria for useful feedback include:

7. • In any case, avoid arguing with your patient. You want to stay on the patient’s side and
arguing can make patients feel defensive. Rather than moving them toward changing
their behaviors, they may instead stop telling you the truth about the problems they have
in adhering to medical recommendations.
• Case
• Diabetic patient: I wish people would quit nagging me about my diet.
• Pharmacist: You’re right. It really is up to you whether or not you change your eating
habits.
• Patient: I know my kids mean well.
• Pharmacist: So, you think your kids nag because they are worried about your health?
Patient: Everyone in my family is overweight. It is in my genes.
• Pharmacist: There is some evidence of a genetic tendency to be overweight. Diabetics
who have been heavy all their lives but do lose weight often try many different strategies
until they find something that works for them.

8. • We need to invite feedback from others in order to improve our interpersonal
communication skills.
• For example, as a pharmacist, you should routinely assess patient satisfaction
and invite feedback on your services.
• Your ability to hear criticism or suggestions without defensiveness or anger,
to admit when you have made a mistake, and to encourage feedback from
others (even when it is negative) encourage people to be honest in their
communications with you.
2) Asking feedback from patients

9. • We have difficulty saying “no” to any request. Being assertive in setting limits
means that you take responsibility for the decisions you make on when & how
to say No without any hesitations toward others for making requests.
• Being assertive in setting limits does not mean that you stop saying “yes” to
requests. You will no doubt continue to help others.
3) SETTING LIMITS

10. • For example, patients who are angry or feeling helpless may lash out with
personal attacks.
• Pharmacists who feel unfairly criticized may respond in an aggressive or
sarcastic manner.
• Ignoring the critical comments of others and focusing exclusively on solving
underlying problems can do much to keep conflict away from the point that
relationships are damaged.
4) IGNORING PROVOCATIONS

11. Criticism is particularly destructive because we typically hold two common
beliefs:
1. We must be loved or approved of by virtually everyone we know.
2. We must be completely perfect in everything we do and never make mistakes.
• Since such perfectionist standards are impossible to achieve, we are constantly
faced with feelings of failure or unworthiness.
• In some cases, we may even have a desire to “get even” by launching into a
counterattack on the person levying the criticism.
• The only way to counteract such feelings and to begin to cope reasonably with
criticism is to begin to challenge the underlying wrong beliefs that lead us to
fear the disapproval of others.
5) RESPONDING TO CRITICISM

12. • Fogging involves acknowledging the truth or possible truths in what people tell you
about yourself while ignoring completely any judgments they might have implied by
what they said
• Often criticism is not justified or is not appropriate because it is too broad; it is a
personal attack rather than a criticism of specific behavior, or it is based on value
judgments that you do not agree with. If you consider criticism unfair or unreasonable,
it is important to state your disagreement.
FOGGING (Dealing with criticism)
• Supervisor: You spent a lot of time talking with that patient about
a simple OTC choice.
• Pharmacist: You’re right. I did.
• Supervisor: The other pharmacists let clerks do a lot of that sort of
stuff.
• Pharmacist: You’re probably right. They may not spend as much time as I do on OTC
consultations.
CASE

13. • The response makes it clear that your own standards guide your behavior without
provoking an argument with the person levying the criticism.
• A fogging response differs from agreeing with the criticism. Agreeing with criticism
includes acknowledging that you were wrong or behaved irresponsibly; you admit that
your behavior failed to meet your own goals for yourself.
• Supervisor: You spent a lot of time talking with that patient about
a simple OTC choice.
• Pharmacist: You’re right. I did.
• Supervisor: The other pharmacists let clerks do a lot of that sort of
stuff.
• Pharmacist: You’re probably right. They may not spend as much
time as I do on OTC consultations.

14. Components of an Effective Interview or communication
1. Listening skill
2. Questioning skill (Probing)
3. Non-verbal communication
4. Explaining skill
5. Building relationship

15. 2) PROBING
• Probing is the use of questions to get needed information from patients or to
help clarify their problems or concerns.
• For instance, “why” type questions can make people feel that they have to
justify their reason for doing a certain thing. It is usually better to use “what”
or “how” type of questions.
• The patient should be allowed to finish answering the current question before
proceeding to the next one.

16. • A closed-ended question can be answered with either a “yes” or “no” response or with a
few words at most. On the other hand, an open-ended question neither limits the patient’s
response nor induces defensiveness.
• Proper open-ended questions are harder to formulate than closed-ended questions, but
they are more crucial in obtaining complete information and in decreasing the patient’s
defensiveness.
• Open-ended question you are allowing patients to present information in their own words.
Closed-ended questions reduce the patient’s degree of openness and cause the patient to
become more passive.
• Open-ended questions permit open expression and for this reason are sometimes referred
to as “patient-centered questions.”

17. • A combination of open-ended and closed-ended questions most efficient in
your practice.
• Patient encounters may be initiated with an open-ended question, followed by
more directed, closed-ended questions.
• For new prescriptions, the questions “What did your doctor tell you the
medication is for?,” “How did your doctor tell you to take the medication?,”
and “What did your doctor tell you to expect?” are suggested as a way to
structure the assessment of patient understanding of new prescriptions

18. • Open-ended questions provide an opportunity for you to assess whether or not the patient
understands the key elements of drug therapy:
1. Purpose of medication
2. How the medication works
3. Dose/interval
4. Duration of therapy
5. Goals of therapy
6. How effectiveness will be monitored
7. Adverse effects and strategies to deal with these events
8. Drug-specific issue

19. Thank you …..