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Communication Skills Slides B.ppt. for students doing communication skill
- 1.
- 2. A disappointedsalesman of Coca Cola returns from his Middle East assignment. A friend asked, "Why weren't you successful with the Arabs?" The salesman began to explain… "When I got posted in the Middle East , I was very confident that I would make a good sales pitch as Cola is virtually unknown there. But, I had a problem I didn't know how to speak Arabic. So, I planned to convey the message through three posters...
- 3. First poster: Aman lying in the hot desert sand...totally exhausted and fainting. Second poster: The man is drinking our Cola. Third poster: Our man is now totally refreshed and full of energy. And Then these posters were pasted all over the place "Then that should have worked!" said the friend. "The hell it should have!? said the salesman. I didn't realize that Arabs read from right to left"
- 4. Refer to factorsthat interfere with effective communication. Can be: External Semantic Barrier Interpersonal Barriers Intrapersonal Barriers
- 5. Such barriers canbe evidenced in the health sector in various forms such as: Being defensive or distant. Interrupting, not allowing patient to finish speaking. Giving false assurances. Providing opinion and advice - prejudice. Overpowering the case - speaking loudly, standing over the client, making condescending statements. Asking several questions at once. Being aggressive. Inappropriate interpreter/cultural and language barriers Research indicates that ineffective communication is one of the leading causes of medical errors and patient harm. Communication failures lead to increase in patient harm, length of stay and resource use and caregiver’s dissatisfaction
- 6. However, dealing witha variety of clients with varied personalities is tasking and demands adequate comm. skills. Communication in a health care setting involves- •Explaining diagnosis, investigation and treatment. •Involving the patient in the decision-making. •Communicating with relatives. •Communicating with other health care professionals and the academic world. •Breaking bad news. •Seeking informed consent/clarification for an invasive procedure or obtaining consent for a post-mortem. •Dealing with anxious patients or relatives. •Giving instructions on discharge. •Giving advice on lifestyle, health promotion or risk factors.
- 7. Health workers oftenexperience barriers from the organisations they are associated with. Such barriers could arise from: •Organisational policy •Organisational rules and regulations •Status relations •Complexities in organisation Such barriers exhibited interpersonally are in the forms of: Barriers in superiors •Attitude of superior •Fear of challenge of authority •Lack of time •Lack of awareness Subordinates •Unwillingness to communicate •Lack of proper incentives
- 8. Assertive: maintainsone’s rights without compromising the rights of others. E.g. “Although you may smoke outside in the courtyard, smoking is not permitted in the building because it is a health risk to others.” Passive: relinquishes one’s rights in deference to others. When essential: when an issue is minor, when conflict will cause greater problem; when emotions are running high and time is of great importance; when the other’s position is impossible to change (e.g. government policies) Aggressive: demands one’s rights at the expense of others. When important: when a decision has to be made quickly; during emergencies; when you know you are right and that fact is crucial
- 9. Almost every eventin the health sector is built on communication.
- 10. Communication, collaboration,and teamwork do not always occur in clinical settings – nurses cited issues with physicians-. Social, relational, and organisational structures contribute to communication failures and adverse clinical events and outcomes - intimidation -. Prioritisation of patient care differs between members of the healthcare team Faulty and incomplete exchange of information Inability to heed patient’s communication cues Professionals ignore potential red flags and clinical discrepancies thereby creating situations where medical errors can occur. These errors have the potential to cause severe injury or unexpected patient death
- 11. Refers toprofessionals assuming complementary roles and cooperatively working together, sharing responsibility for problem solving and making decisions to formulate and carry out plans for patient care. Characterized by Trust Respect Working together for the good of the goal – patient’s health
- 12. Among which are: Additionaltime Perceived loss of autonomy Lack of confidence or trust in decisions of others Clashing perceptions Territorialism Lack of awareness of the education, knowledge, and skills held by colleagues from other disciplines Open communication and respect for each other enhances collaboration among health workers.
- 13. Is an Interactiveprocess between health worker and client Helps client overcome stress Established with purpose of helping client Health worker responds to content Empathy is central. It is a process where- People feel with one another Embraces the attitude of the person who is speaking Grasps the idea that what the client has to say is important NOT synonymous with sympathy Interprets clients feelings without inserting own
- 14. Physical attending - Facethe person squarely Adopt an open posture Lean toward the person Maintain good eye contact Try to be relatively relaxed Using silence Encouraging the client to communicate Allowing client time to ponder what has been said Allow client time to collect thoughts Allow client time to consider alternatives Look interested Uncomfortable silence should be broken and analyzed
- 15. Reflection- while reflecting- Repeat the client’s message (verbal/nonverbal Reflecting feelings- verbalize implied feelings in client’s comment Encourage client to clarify Imparting information Supply additional data - do not withhold useful information Draw a line between information and advice Avoid personal, social information Involve client participation in decision making - yields positive mental health outcomes and educated empowered client -.
- 16. Clarifying - attemptto understand client’s statement Ask client to give an example Paraphrasing - assimilates or restates in own words Checking perceptions - share how one person perceives another Questioning - very direct way of speaking with clients Open-ended questions focus the topic Close question limits choice of responses Careful not to ask questions that steer answer Structuring - attempt to create order, establish guidelines Define parameters of doctor-client relationship
- 17. Pinpointing - callsattention to certain kinds of statements Identify the relationship Point to inconsistencies Linking – health worker responds to client Ties together two events, experiences, feelings Connect past experiences with current behaviours Providing feedback - shares reaction to what client said Given in a way that does not threaten client or make client feel rejected Health worker should be open and receptive to cues
- 18. Confronting- used whenclient deliberately invites an examination of some aspect of personal behaviour that indicates discrepancy between actions and words. Can be: Informational confrontation - describes visible behaviour Interpretive confrontation - draws inferences about the meaning of behaviour. Confrontational skills – use of Personal statements Relationship statements Behavior descriptions Description of personal feelings Responses aimed at understanding Constructive feedback skills
- 19. Avoid these commontherapeutic mistakes Giving advice Minimizing or discounting feelings Deflecting Interrogating Sparring Failure to listen Improperly decoding intended message Placing the health worker’s needs above client’s
- 20. Skills to enhancetherapeutic relationship Listen actively Help identify the client’s feelings Be empathetic, honest, genuine, and credible Use ingenuity Be aware of cultural differences Maintain confidentiality Know your role and your limitations
Editor's Notes
- #4 External factors: visible and tangible barriers such as noise or unpleasant weather. In work situations, barriers could arise from the layout of a room, or from interference or distractions. Any distraction that causes you to miss part of the message. Semantic Barrier: occurs when meaning is either present or absent from the language used and is not shared by both the sender and receiver. Different words have different meanings. These differences are referred to as denotation and connotation. Interpersonal barriers arise from interaction between people. The following list of barriers is not complete. The very length of it shows how involved communication is and how easily it can be disrupted. Inattention Poor Expression Premature Evaluation Emotions Distrust of Inconsistency Physical Barriers Insufficient warning of change Individual Differences Lack of Feedback Insecurity of Communicator Intrapersonal barriers are unique to individuals . Examples – perception, assumption, stereotypes, prejudice, expectations, emotions
- #8 Assertive style is not: Yelling or bullying Accusatory Being disrespectful of authority Is: Focused on patient Noting your perceptions Persistently raising concerns, intended to move toward desired action . When assertiveness does not work: Restate your concerns in another way Engage another healthcare worker Engage your supervisor Engage another physician on the team
- #9 Communication plays a central role in identifying patient’s symptoms correctly, expediting the delivery of medical treatment, monitoring effectiveness of treatment options, Increasing patient compliance with prescribed treatment, dealing with different types of patients, relating with the patient’s family and the community, increasing team work and collaborative practices, empowering patients to make better informed decisions, collecting data, surveys providing decision makers with timely, location-related information and various other roles.
- #12 In health care, desire to consistently retain hierarchy at times are cultural blocks to effective communication and constitute problems that endanger the client’s life.
- #13 Four phases of therapeutic empathizing Identification Incorporation Reverberation Detachment On guard against over-distancing or burnout
- #17 Feedback should be focused on: behavior, observations, description On more-or-less, rather than either/or On here-and-now: what is said, not why Sharing of information, ideas Exploration of alternatives Value to client Amount of information client is able to use Appropriate time and place
- #20 During a patient’s visit: Use plain language and listen carefully Use simple language and define technical terms – avoid medical jargon Use the active voice Break down complex information into understandable pieces Organize information so the most important points come first Use a medically trained interpreter if necessary Check for understanding using the “teach-back” method Ask open-ended questions Use hand signals or visual cues