Communication Skills Text-English.pdf

Dr. Bassam Banat, Dr. Ola Hussein & Dr. Rabee Owais
1

Table of Contents
Page
Content
4
Course outline
8
Chapter 1
9
Communication
12
Principles of communication
19
Communication as information transmission
26
Chapter 2
27
Communication process
38
Communication barriers
54
Chapter 3
55
How to avoid communication barriers
75
Chapter 4
76
Types of communication
76
Verbal communication
79
Non-Verbal communication
104
Chapter 5
105
Body Language
126
Chapter 6
127
Speaking too quickly
137
Speaking hints
145
Chapter 7
146
How to detect lies
159
Workshop
163
Communication strategies
167
Presentation planning
177
Chapter 8
2

178
Counselling
206
Chapter 9
207
Communication and culture
227
Chapter 10
228
Breaking bad news
247
Chapter 11
248
Therapeutic communication
275
Appendices
276
Example of a communication curriculum
285
The two-guide format of the Calgary–Cambridge Process Guide
292
A protocol for writing simulated patient cases
299
Sample OSCE marking sheets
(Objective Structure Clinical Examination
«OSCE»)
308
Self-assessment communication survey
310
Interpersonal skills self-assessment
314
Presentation model
3

Faculty of Medicine
Department of Behavioral and Social Sciences
Intended Learning Outcomes (ILOs)
Curriculum & Programme Evaluation Committee
Internal Quality Committee
4

Communication Skills
Sequence
Credit Hours
Course Number
2020/2021
2
6106141
Dr. Bassam Banat, Dr. Ola Hussein, Dr. Rabee Owais
Course Teachers
bbanat@staff.alquds.edu, ohussein@staff.alquds.edu,
rowais@staff.alquds.edu
E. mail
Course Description:
This is an introductory course in interpersonal communication. It covers basic communication
theories and explores different types of communication techniques and skills including effective
critical thinking and problem solving. The focus of this course is applying communication
techniques of individuals or groups. Both verbal and non-verbal communication skills, structure
of communication, communication of emotions and feelings, the effects of culture and gender
differences will be demonstrated in relation to theories and models of communication, in addition
to ethics, skills and basic principles of communication.
Goals & Objectives:
1. To understand interpersonal communication and its principles and types.
2. To acknowledge communication process in relation to social relationship, gender,
culture, and situational context.
3. To understand the main techniques of communication.
4. To demonstrate basic skills of communication.
5. To be able to communicate diagnosis, death and dying to the patients and their relatives.
6. To be able to communicate therapeutically with clients and their relatives.
7. To demonstrate the skills of communication in crisis and breaking bad news.
8. To understand interpersonal communication with peers in workplace.
Course Schedule
Week # Topic Additional
Information
1 Introduction
Principles of communication and relationships
Chapter 1+4
handout
2 Types and models of communication
Levels of communication
Factors that influence communication
Chapter 1+4
handout
3 Perception and communication Chapter 2
5

4 Language and communication Chapter 3
5 Cultural and communication Chapter 7
6 Interpersonal communication Chapter 6
7 Midterm exam
8 Listening skills Chapter 5
9 Workplace communication Chapter 8
10 Therapeutic communication handouts
11 Therapeutic communication- continued handouts
12 Communicating diagnosis and breaking bad news handouts
13 Student's presentations
14 Students presentations
15 Students presentations
16 Final exam
What approaches to use in teaching the module:
 Stories and case studies
 Role plays
 Simulating situations
 Brain storming
 Exercises
 Lecture
 Presentations of students and group work
 Teaching films
Evaluation:
Assignments: 20%
Midterm Exam: 30%
Final Exam: 50%
Total: 100%
Assignments:
Groups of students will be required to present a paper about using different models of
communication or a case study in which critical thinking and problem-solving techniques are
required. This paper describes using different communication skills in relation to specific problems
such as informing patients about their diagnosis, communication misunderstanding in workplace,
and dealing with patients with critical illnesses.
6

Text Book & other reading materials:
1. Human communication. 3rd
edition. (2008). By: Judy Pearson, Paul Nelson, Scott
Titsworth, and Lynn Harter. McGraw Hills: Boston.
2. Banat, B., Hussein, O. & Owais, R. (2021). Communication skills for Medicine students.
Al-Quds University: Faculty of Medicine.
References:
3. Intercultural Communication in Contexts. (2010). By: Judith, N.. Mrtin and Thomas, K.
Nakayama. McGraw Hill: Boston.
4. Nursing ethics. 3rd
ed. (1994). By: Ian E. Thompson, Kath M. Melia, and Kenneth M.
Boyd. Churchill Livingstone: Edinburgh.
5. Law and Ethics for Medical Careers. (2010). 5th
edit. By: Karen Judson and Carlene
Harrison. McGraw Hill: Boston.
6. Exploring Human society. (1989). By: William Williams and Norman Sheffe. McGraw
Hill: Toronto.
7. Social Psychology in the 90s.(1993) . 6th
edit. By: Kay Deaux, Francis C. Dane, and
Lawrence S. Wrightsman. Brooks/Cole Publishing Company: Pacific Grove, California.
8. Fundamentals of Nursing: Caring and Clinical Judgment. (2010). 2nd
edit. By: Helen
Hark reader and Mary Ann Hogan. Saunders
9. ‫الصوت‬ ‫ونبرات‬ ‫الجسم‬ ‫وحركات‬ ‫الوجه‬ ‫تعبيرات‬ ‫قراءة‬ ‫فن‬ :‫الجسد‬ ‫لغة‬
( .
0202
‫للنشر‬ ‫فاروس‬ . ‫حافظ‬ ‫احمد‬ . )
‫والتوزيع‬
10. ( ‫محمود‬ ،‫سعدات‬
0202
‫األلوكة‬ :‫القاهرة‬ .‫الفعال‬ ‫االتصال‬ ‫مهارات‬ .) .
7

“We are born to see, but have to train
ourselves to observe”
9

What
(Definition )
Why
(Importance )
How
(Elements +
Principles)
By what
(Forms)
Why not
(Barriers )
10

WHAT IS COMMUNICATION?
 Communication is sending or receiving ideas,
thoughts or feelings from one person to one or more
persons in such a way that, the person receiving it
understands it in the same way the sender wants
him/her to understand.
 The term ‘communication’, derived from a Latin term
‘communicare’.
• Also known as “people skills” or “soft skills”.
• Ranked in a global survey as the most important
requirement for successful job performance. 11

Continuous Dynamic
Transactional Irreversible
Communication
12

WHY WE STUDY COMMUNICATION SKILLS?
1-History taking: 60% to 80% of diagnosis.
2-Good communication provides information to the
patient:
-more than 50% of patients deviate from the doctors’ advice
or do not follow it at all.
3-Poor quality of communication leads to patient’s
dissatisfaction:
- Doctors interrupt patients very early.
- Patients do not understand what the doctor is saying.
- Advice is too difficult to follow. 13

Communication
Communication
 The purpose of communication is to get your message
The purpose of communication is to get your message
(
(thoughts and ideas )
thoughts and ideas ) across to others.
across to others.
 This is a process that involves both the sender of the
This is a process that involves both the sender of the
message and the receiver.
message and the receiver.
 This process leaves room for error, with messages often
This process leaves room for error, with messages often
misinterpreted by one or more of the parties involved.
misinterpreted by one or more of the parties involved.
 This causes unnecessary confusion and counter
This causes unnecessary confusion and counter
productivity, both personally and professionally.
productivity, both personally and professionally.
 A message is successful only when both the sender and the
A message is successful only when both the sender and the
receiver perceive it in the same way
receiver perceive it in the same way
 For successful communication - Getting your message
For successful communication - Getting your message
across is of paramount importance.
across is of paramount importance.
14

Communication Guidelines
Communication Guidelines
 Understand what your message is
Understand what your message is
 What audience you are sending it to
What audience you are sending it to
 How it will be perceived
How it will be perceived
 The circumstances surrounding your communications,
The circumstances surrounding your communications,
such as situational and cultural context.
such as situational and cultural context.
15

Types of Communication
Types of Communication
1.
1. Verbal
Verbal
 Communication through talking and listening
Communication through talking and listening
2.
2. Non-Verbal
Non-Verbal
 When one communicate to make other understand their
When one communicate to make other understand their
felling without talking to them is called non verbal
felling without talking to them is called non verbal
communication
communication
 Non verbal communication may be in the form of written
Non verbal communication may be in the form of written,
,
posture , attitude , eye contact etc.
posture , attitude , eye contact etc.
16

Elements of Communication
 There are three major parts in human face to face
There are three major parts in human face to face
communication which are
communication which are
1.
1. Body Language
Body Language
2.
2. Voice Tonality
Voice Tonality
3.
3. Words.
Words.
17

 93% (55% + 38%) of
93% (55% + 38%) of
communication is
communication is
nonverbal
nonverbal
55% body language-
55% body language-
postures, gestures,
postures, gestures,
through facial
through facial
expression and eye
expression and eye
contact
contact
38% through tone of
38% through tone of
voice
voice
 7% Content or the words
7% Content or the words
used in the
used in the
communication process.
18

Communication as
Communication as
information
information
transmission
transmission
19

Communication modeling
 Communication can be seen as processes of information
Communication can be seen as processes of information
transmission governed by three levels of semiotic rules:
transmission governed by three levels of semiotic rules:
1.
1. Syntactic (formal properties of signs and symbols)
Syntactic (formal properties of signs and symbols)
2.
2. Pragmatic (concerned with the relations between
Pragmatic (concerned with the relations between
signs/expressions and their users)
signs/expressions and their users)
3.
3. Semantic (study of relationships between signs and
Semantic (study of relationships between signs and
symbols and what they represent).
symbols and what they represent).
20

Communication modeling contd
contd .
.
 Therefore, communication is a kind of social interaction
Therefore, communication is a kind of social interaction
where at least two interacting agents share a common set
where at least two interacting agents share a common set
of signs and a common set of semiotic rules.
of signs and a common set of semiotic rules.
(This rule essentially ignores auto communication,
(This rule essentially ignores auto communication,
including intrapersonal communication via diaries or
including intrapersonal communication via diaries or
self-talk).
self-talk).
21

Simple model of Information Transmission
Simple model of Information Transmission
 In a simple model,
In a simple model,
information or content (e.g. a message in natural
information or content (e.g. a message in natural
language) is sent in some form (as spoken language)
language) is sent in some form (as spoken language)
from a emisor / sender / encoder to a destination /
from a emisor / sender / encoder to a destination /
receiver / decoder.
receiver / decoder.
In a slightly more complex form a sender and a receiver
In a slightly more complex form a sender and a receiver
are linked reciprocally.
are linked reciprocally.
22

The model- Communication major
The model- Communication major
dimensions scheme
dimensions scheme
23

The Model - Communication code scheme
The Model - Communication code scheme
24

V I D E O
Communication Skills
https://www.youtube.com/watch?v=8L2wl1UEDhQ 25

Communication
Communication
Process
Process
27

Communication processes
 Communication processes are;
Communication processes are;
1.
1. Sender
Sender
2.
2. Message
Message
3.
3. Channel
Channel
4.
4. Receiver
Receiver
5.
5. Feedback
Feedback
6.
6. Context
Context
28

Communication processes contd.
contd.
29

 Thought:
Thought: First, information exists in the mind of the
First, information exists in the mind of the
sender. This can be a concept, idea, information, or
sender. This can be a concept, idea, information, or
feelings.
feelings.
 Encoding:
Encoding: Next, a message is sent to a receiver in words or
Next, a message is sent to a receiver in words or
other symbols.
other symbols.
 Decoding:
Decoding: lastly, the receiver translates the words or
lastly, the receiver translates the words or
symbols into a concept or information that he or she can
symbols into a concept or information that he or she can
understand.
understand.
30

Sender
Sender
 To establish yourself as an effective communicator –
To establish yourself as an effective communicator –
first establish credibility - by displaying knowledge of the
first establish credibility - by displaying knowledge of the
subject, the audience and the context in which the message
subject, the audience and the context in which the message
is delivered.
is delivered.
 Know your audience (individuals or groups to which you
Know your audience (individuals or groups to which you
are delivering your message).
are delivering your message).
 Failure to understand who you are communicating to will
Failure to understand who you are communicating to will
result in misunderstanding.
result in misunderstanding.
31

Message
Message
 Written, oral and nonverbal communications are effected
Written, oral and nonverbal communications are effected
by the sender’s tone, method of organization, validity of
by the sender’s tone, method of organization, validity of
the argument, what is communicated and what is left out,
the argument, what is communicated and what is left out,
as well as individual style of communicating.
as well as individual style of communicating.
 Messages also have intellectual and emotional
Messages also have intellectual and emotional
components.
components.
 Intellectual component is the ability to reason
Intellectual component is the ability to reason
 Emotional components present motivational appeals,
Emotional components present motivational appeals,
ultimately changing minds and actions.
ultimately changing minds and actions.
32

Channel
Channel
Messages are conveyed through channels
Messages are conveyed through channels
 Verbal Channels - face-to-face meetings, telephone and
Verbal Channels - face-to-face meetings, telephone and
video conferencing;
video conferencing;
 Written Channels - letters, emails, memos and reports.
Written Channels - letters, emails, memos and reports.
 Nonverbal Channels- Body Language
Nonverbal Channels- Body Language
33

Receiver
Receiver
 Messages are delivered and received by the audience.
Messages are delivered and received by the audience.
 The audience also enters into the communication process
The audience also enters into the communication process
with ideas and feelings that will undoubtedly influence
with ideas and feelings that will undoubtedly influence
their understanding of your message and their response.
their understanding of your message and their response.
 To be a successful communicator, you should consider
To be a successful communicator, you should consider
these before delivering your message, acting
these before delivering your message, acting
appropriately.
appropriately.
34

Feedback
Feedback
Feedback
Feedback
 Audience will give feedback, verbal and nonverbal reactions
Audience will give feedback, verbal and nonverbal reactions
to your communicated message.
to your communicated message.
 Pay close attention to this feedback as it is crucial to
Pay close attention to this feedback as it is crucial to
ensuring the audience understood your message.
ensuring the audience understood your message.
35

Context
Context
 Context is the situation in which your message is
Context is the situation in which your message is
delivered
delivered
 This may include the surrounding environment or
This may include the surrounding environment or
broader culture (i.e. corporate culture, international
broader culture (i.e. corporate culture, international
cultures, etc.).
cultures, etc.).
36

Content
Content
 Content is the actual words or symbols of the message
Content is the actual words or symbols of the message
which is known as
which is known as language
language - the spoken and written
- the spoken and written
words combined into phrases that make grammatical and
words combined into phrases that make grammatical and
semantic sense.
semantic sense.
 We all use and interpret the meanings of words differently,
We all use and interpret the meanings of words differently,
so even simple messages can be misunderstood.
so even simple messages can be misunderstood.
 And many words have different meanings to confuse the
And many words have different meanings to confuse the
issue even more.
issue even more.
37

Barriers to
Barriers to
Communication
Communication
38

Barriers to Communication
Nothing is so simple that it cannot be
Nothing is so simple that it cannot be
misunderstood.
misunderstood.
Freeman Teague, Jr.
Freeman Teague, Jr.
39

Barriers to Communication contd
contd .
.
Removing Barriers At All These Stages:
Removing Barriers At All These Stages:
To deliver your messages effectively, you
To deliver your messages effectively, you
must commit to breaking down the barriers
must commit to breaking down the barriers
that exist in each of these stages of the
that exist in each of these stages of the
40

The Importance of Removing
The Importance of Removing
Communication Barriers
Communication Barriers
 Communication barriers can pop-up at every stage of the
Communication barriers can pop-up at every stage of the
communication process
communication process
 Communication barriers can create misunderstanding and
Communication barriers can create misunderstanding and
confusion.
confusion.
42

Types of Communication Barriers
Types of Communication Barriers
 Anything that prevents understanding of the message is a
Anything that prevents understanding of the message is a
barrier to communication.
barrier to communication.
 Many physical and psychological barriers exist:
Many physical and psychological barriers exist:
1. Senders
2. Culture, background, and
bias
3. Noise
4. Ourselves
5. Perception
6. Message
7. Environmental
8. Smothering
9. Stress
43

Barriers in senders
Barriers in senders

Offering too much information too fast.
Offering too much information too fast.
 Take care of other people’s time, especially in today’s ultra-
Take care of other people’s time, especially in today’s ultra-
busy society.
busy society.
 Work on to understand your audience’s culture, making sure
Work on to understand your audience’s culture, making sure
you can converse and deliver your message to people of
you can converse and deliver your message to people of
different backgrounds and cultures
different backgrounds and cultures.
.
44

Culture, background, and bias
Culture, background, and bias
 We allow our past experiences to change the meaning of the
We allow our past experiences to change the meaning of the
message.
message.
 Culture, background, and bias they allow us to use our past
Culture, background, and bias they allow us to use our past
experiences to understand something new
experiences to understand something new
 But when they change the meaning of the message they
But when they change the meaning of the message they
interfere with the communication process.
interfere with the communication process.
45

Noise
Noise
 Equipment or environmental noise impedes clear
Equipment or environmental noise impedes clear
communication.
communication.
 The sender and the receiver must both be able to
The sender and the receiver must both be able to
concentrate on the messages being sent to each other.
concentrate on the messages being sent to each other.
46

Ourselves
Ourselves
 Focusing on ourselves, rather than the other person can
Focusing on ourselves, rather than the other person can
lead to confusion and conflict.
lead to confusion and conflict.
 The "Me Generation" is out when it comes to effective
The "Me Generation" is out when it comes to effective
communication.
communication.
 Some of the factors that cause this are
Some of the factors that cause this are
Defensiveness (we feel someone is attacking us),
Defensiveness (we feel someone is attacking us),
Superiority (we feel we know more that the other)
Superiority (we feel we know more that the other)
Ego (we feel we are the center of the activity).
Ego (we feel we are the center of the activity).
47

Perception
Perception
 If we feel the person is talking too fast, not fluently, does
If we feel the person is talking too fast, not fluently, does
not articulate clearly, etc., we may dismiss the person.
not articulate clearly, etc., we may dismiss the person.
 Also our preconceived attitudes affect our ability to listen.
Also our preconceived attitudes affect our ability to listen.
 We listen uncritically to persons of high status and dismiss
We listen uncritically to persons of high status and dismiss
those of low status.
those of low status.
48

Message
Message
 If your message is too lengthy, disorganized, or contains
If your message is too lengthy, disorganized, or contains
errors, you can expect the message to be misunderstood
errors, you can expect the message to be misunderstood
and misinterpreted.
and misinterpreted.
 Use of poor verbal and body language can also confuse the
Use of poor verbal and body language can also confuse the
message.
message.
 Distractions happen when we focus on the facts rather than
Distractions happen when we focus on the facts rather than
the idea.
the idea.
 Semantic (change of meaning) distractions occur when a
Semantic (change of meaning) distractions occur when a
word is used differently than you prefer.
word is used differently than you prefer.
 For example, the word chairman instead of chairperson, may
For example, the word chairman instead of chairperson, may
cause you to focus on the word and not the message.
cause you to focus on the word and not the message.
49

Environmental and Stress
Environmental and Stress
Environmental
Environmental
 Bright lights, an attractive person, unusual sights, or any
Bright lights, an attractive person, unusual sights, or any
other stimulus provides a potential distraction.
other stimulus provides a potential distraction.
Stress
Stress
 People do not see things the same way when under stress.
People do not see things the same way when under stress.
 What we see and believe at a given moment is influenced by
What we see and believe at a given moment is influenced by
our psychological frames of references - our beliefs, values,
our psychological frames of references - our beliefs, values,
knowledge, experiences, and goals.
knowledge, experiences, and goals. 50

Smothering (conceal)
Smothering (conceal)
 We take it for granted that the impulse to send useful
We take it for granted that the impulse to send useful
information is automatic.
information is automatic.
Not true!
Not true!
 Too often we believe that certain information has no value
Too often we believe that certain information has no value
to others or they are already aware of the facts.
to others or they are already aware of the facts.
51

Barriers
Barriers
 These barriers can be thought of as filters, that is, the
These barriers can be thought of as filters, that is, the
message leaves the sender, goes through the above filters,
message leaves the sender, goes through the above filters,
and is then heard by the receiver.
and is then heard by the receiver.
 These filters muffle the message.
These filters muffle the message.
 To overcome these filters is through active listening and
To overcome these filters is through active listening and
feedback.
feedback.
52

V I D E O
Barriers
to communication
https://www.youtube.com/watch?v=e9U-r9D6oVw 53

How to avoid Barriers?
How to avoid Barriers?
To overcome these filters – barriers is through
To overcome these filters – barriers is through
1.
1. Active listening
Active listening
2.
2. Feedback.
Feedback.
55

Active Listening
Active Listening
56

Hearing V/S Listening
Hearing V/S Listening
Is Hearing and listening are the same thing?
Is Hearing and listening are the same thing?
Answer
Answer
A Big
A Big
“
“NO”
NO”
57

Active Listening
Active Listening
 Hearing and listening are not the same thing.
Hearing and listening are not the same thing.
Hearing
Hearing
 It is the act of perceiving sound.
It is the act of perceiving sound.
 It is involuntary and simply refers to the reception of aural
It is involuntary and simply refers to the reception of aural
stimuli.
stimuli.
Listening
Listening
 It is a selective activity which involves the reception and
It is a selective activity which involves the reception and
the interpretation of aural stimuli.
the interpretation of aural stimuli.
 It involves decoding the sound into meaning.
It involves decoding the sound into meaning.
59

Listening
Listening
 Listening is divided into two main categories:
Listening is divided into two main categories:
1.
1. Passive
Passive
2.
2. Active.
Active.
Passive listening
Passive listening
 It is little more that hearing.
It is little more that hearing.
 It occurs when the receiver of the message has little
It occurs when the receiver of the message has little
motivation to listen carefully, such as when listening to
motivation to listen carefully, such as when listening to
music, story telling, television, or when being polite.
music, story telling, television, or when being polite.
60

Listening
Listening
 People speak at 100 to 175 words per minute (WPM), but
People speak at 100 to 175 words per minute (WPM), but
they can listen intelligently at 600 to 800 WPM.
they can listen intelligently at 600 to 800 WPM.
 Since only a part of our mind is paying attention, it is easy
Since only a part of our mind is paying attention, it is easy
to go into
to go into mind drift
mind drift - thinking about other things while
- thinking about other things while
listening to someone.
listening to someone.
61

Active listening
Active listening
 The cure for this is
The cure for this is active listening
active listening - which involves listening
- which involves listening
with a purpose.
with a purpose.
 It may be to gain information, obtain directions, understand
It may be to gain information, obtain directions, understand
others, solve problems, share interest, see how another
others, solve problems, share interest, see how another
person feels, show support, etc.
person feels, show support, etc.
 It requires that the listener attends to the words and the
It requires that the listener attends to the words and the
feelings of the sender for understanding.
feelings of the sender for understanding.
 It takes the same amount or more energy than speaking.
It takes the same amount or more energy than speaking.
 It requires the receiver to hear the various messages,
It requires the receiver to hear the various messages,
understand the meaning, and then verify the meaning by
understand the meaning, and then verify the meaning by
offering feedback.
offering feedback.
62

Traits of active listeners
1.
1. Spend more time listening than talking.
Spend more time listening than talking.
2.
2. Do not finish the sentences of others.
Do not finish the sentences of others.
3.
3. Do not answer questions with questions.
Do not answer questions with questions.
4.
4. Control biases.
Control biases.
5.
5. Never daydreams or become preoccupied with their own
Never daydreams or become preoccupied with their own
thoughts when others talk.
thoughts when others talk.
6.
6. Let the other speakers talk. Do not dominate the
Let the other speakers talk. Do not dominate the
conversations.
conversations.
63

is being said.
7.
7. Plan responses after the others have finished speaking,
Plan responses after the others have finished speaking,
NOT while they are speaking.
NOT while they are speaking.
8.
8. Provide feedback, but do not interrupt constantly.
Provide feedback, but do not interrupt constantly.
9.
9. Analyze by looking at all the relevant factors and asking
Analyze by looking at all the relevant factors and asking
open-ended questions. Walk others through by
open-ended questions. Walk others through by
summarizing.
summarizing.
10.
10. Keep conversations on what others say, NOT on what
Keep conversations on what others say, NOT on what
interests them.
interests them.
11.
11. Take brief notes. This forces them to concentrate on what
Take brief notes. This forces them to concentrate on what
64

Feedback
Feedback
When you know something, say what you know.
When you know something, say what you know.
When you don't know something, say that you
When you don't know something, say that you
don't know.
don't know.
That is knowledge.
That is knowledge.
Kung Fu Tzu (Confucius)
Kung Fu Tzu (Confucius)
66

Purpose of feedback
Purpose of feedback
 The purpose of feedback is to alter messages so the
The purpose of feedback is to alter messages so the
intention of the original communicator is understood by the
intention of the original communicator is understood by the
second communicator.
second communicator.
 It includes verbal and nonverbal responses to another
It includes verbal and nonverbal responses to another
person's message.
person's message.
67

Ones.
How to give Feedback?
 Providing feedback is accomplished by paraphrasing the
Providing feedback is accomplished by paraphrasing the
words of the sender.
words of the sender.
 Restate the sender's feelings or ideas in your own words,
Restate the sender's feelings or ideas in your own words,
rather than repeating their words.
rather than repeating their words.
 Your words should be saying, "This is what I understand your
Your words should be saying, "This is what I understand your
feelings to be, am I correct?"
feelings to be, am I correct?"
 It not only includes verbal responses, but also nonverbal
It not only includes verbal responses, but also nonverbal
68

How to give Feedback? Contd
Contd .
.
 Nonverbal responses like.
Nonverbal responses like.
Nodding your head or squeezing their hand to show
Nodding your head or squeezing their hand to show
agreement
agreement
Dipping your eyebrows shows you don't quite
Dipping your eyebrows shows you don't quite
understand the meaning of their last phrase
understand the meaning of their last phrase
Sucking air in deeply and blowing it hard shows that
Sucking air in deeply and blowing it hard shows that
you are also exasperated (frustrated) with the situation.
you are also exasperated (frustrated) with the situation.
69

Carl Rogers categories of feedback
 Carl Rogers listed five main categories of feedback
Carl Rogers listed five main categories of feedback
 They are listed in the order in which they occur most
They are listed in the order in which they occur most
frequently in daily conversations.
frequently in daily conversations.
 We make judgments more often than we try to understand:
We make judgments more often than we try to understand:
1.
1. Evaluative:
Evaluative:
 Making a judgment about the worth, goodness, or
Making a judgment about the worth, goodness, or
appropriateness of the other person's statement.
appropriateness of the other person's statement.
2.
2. Interpretive:
Interpretive:
 Paraphrasing - attempting to explain what the other person's
Paraphrasing - attempting to explain what the other person's
statement means.
statement means. 70

contd.
contd.
3.
3. Supportive:
Supportive:
 Attempting to assist or bolster the other communicator.
Attempting to assist or bolster the other communicator.
4.
4. Probing:
Probing:
 Attempting to gain additional information, continue the
Attempting to gain additional information, continue the
discussion, or clarify a point.
discussion, or clarify a point.
5.
5. Understanding:
Understanding:
 Attempting to discover completely what the other
Attempting to discover completely what the other
communicator means by her statements.
communicator means by her statements.
71

Imagine how much better daily communications
Imagine how much better daily communications
would be if listeners tried to understand first,
would be if listeners tried to understand first,
before they tried to evaluate what someone is
before they tried to evaluate what someone is
saying.
saying.
72

V I D E O
Active Listening
https://www.youtube.com/watch?v=nogoxMP0SNE 73

V I D E O
Active Listening
https://www.youtube.com/watch?v=CXOV7xZHY6I 74

VERBAL COMMUNICATION
 Organize Thoughts
 Paint Word Pictures
 Watch Grammar
77

VERBAL COMMUNICATION
clear
 Clarify
 Listen
 Encourage
 Appreciate
 reassure
Don’t
Give orders
Attack
Be aggressive
Be ridiculous.
78

Nonverbal
Nonverbal
Behaviors of
Behaviors of
Communication
Communication
79

Non-verbal communication can
Reinforces, Complements,
Contradicts, Regulates, or Replaces a
verbal message.
81

Non verbal communication
Non verbal communication
 It is the information that is communicated without using
It is the information that is communicated without using
words.
words.
 To deliver the full impact of a message, use nonverbal
To deliver the full impact of a message, use nonverbal
behaviors to raise the channel of interpersonal
behaviors to raise the channel of interpersonal
communication:
communication:
1. Written
2. Posture, body orientation,
appearance, hairstyle, clothes,
color choice
3. Gestures
4. Eye contact , Shaking hands,
your breathing
5. Expression - in your eyes , Facial
Expressions and smile
6. Vocal, Voice, tone and
confidence
7. Proximity - How close you stand
to others- personal space
8. How you listen
9. The way you move, the way you
stand, the way you touch
10.Attitude
11.Silence.
82

The Importance of NVC
The Importance of NVC
 It’s not always just what you say matters but also how you
It’s not always just what you say matters but also how you
“say” it
“say” it
 Always take care of Nonverbal cues , they are very powerful
Always take care of Nonverbal cues , they are very powerful
 E.g.. of Non
E.g.. of Non-verbal cues are gestures, eye contact, facial
-verbal cues are gestures, eye contact, facial
expressions, posture, gestures space even clothing and
expressions, posture, gestures space even clothing and
personal space.
personal space.
 Be mindful of your own nonverbal cues, as well as the
Be mindful of your own nonverbal cues, as well as the
nonverbal cues of those around you.
nonverbal cues of those around you.
 Keep your messages short and concise. This means
Keep your messages short and concise. This means
preparing in advance whenever possible.
preparing in advance whenever possible. 84

Types Of NVC
Types Of NVC
1.
1. Paralanguage
Paralanguage - The vocal cues that accompany spoken
- The vocal cues that accompany spoken
language The way we say words
language The way we say words
2.
2. Kinesics
Kinesics - Body Movements
- Body Movements
3.
3. Occulesics
Occulesics - Eye behavior
- Eye behavior
4.
4. Appearance /Artifacts
Appearance /Artifacts.- Attractiveness
.- Attractiveness
85

Types Of NVC
Types Of NVC contd
contd .
.
5.
5. Proxemics-
Proxemics- The
The NVC
NVC of space and distance
of space and distance
6.
6. Haptics-
Haptics- The
The NVC
NVC study of touch
study of touch
7.
7. Olfactics-
Olfactics- The
The NVC
NVC study of smell.
study of smell.
8.
8. Chronomics-
Chronomics- The
The NVC
NVC study of time
study of time
9.
9. Facial Expressions-
Facial Expressions- We have 80 muscles in our face
We have 80 muscles in our face
that can create more than 7,000 facial expressions
that can create more than 7,000 facial expressions
86

G. W. PORTER CATEGORIES AND
G. W. PORTER CATEGORIES AND
FEATURES OF COMMUNICATION
FEATURES OF COMMUNICATION
87

G. W. Porter Categories of
G. W. Porter Categories of
Communications
Communications
 Categories and Features G. W. Porter divides non-verbal
Categories and Features G. W. Porter divides non-verbal
communication into four broad categories:
communication into four broad categories:
1.
1. Physical.
Physical.
 This is the personal type of communication.
This is the personal type of communication.
 It includes facial expressions, tone of voice, sense of touch,
It includes facial expressions, tone of voice, sense of touch,
sense of smell, and body motions.
sense of smell, and body motions.
2.
2. Aesthetic.
Aesthetic.
 This is the type of communication that takes place through
This is the type of communication that takes place through
creative expressions: playing instrumental music, dancing,
creative expressions: playing instrumental music, dancing,
painting and sculpturing.
painting and sculpturing. 88

G. W. Porter Categories of Communications
G. W. Porter Categories of Communications
contd
contd .
.
3.
3. Signs.
Signs.
 This is the mechanical type of communication, which
This is the mechanical type of communication, which
includes the use of signal flags, the 21-gun salute, horns,
includes the use of signal flags, the 21-gun salute, horns,
and sirens.
and sirens.
4.
4. Symbolic.
Symbolic.
 This is the type of communication that makes use of
This is the type of communication that makes use of
religious, status, or ego-building symbols.
religious, status, or ego-building symbols.
89

G. W. Porter Features of
G. W. Porter Features of
Communications
Communications
A) Static Features
1. Distance
2. Orientation
3. Posture
4. Physical Contact
B) Dynamic Features
1. Facial Expressions
2. Gestures
3. Looking
90

Eye contact / Looking
Eye contact / Looking
 A major feature of social communication is eye contact.
A major feature of social communication is eye contact.
 This helps to regulate the flow of communication.
This helps to regulate the flow of communication.
 It can convey emotion, signal when to talk or finish, or
It can convey emotion, signal when to talk or finish, or
aversion.
aversion.
 It signals interest in others and increases the speaker's
It signals interest in others and increases the speaker's
credibility.
credibility.
 People who make eye contact open the flow of
People who make eye contact open the flow of
communication and convey interest, concern, warmth, and
communication and convey interest, concern, warmth, and
credibility.
credibility.
 The frequency of contact suggest either interest or boredom.
The frequency of contact suggest either interest or boredom.
91

Facial Expressions
Facial Expressions
 A smile, frown, raised eyebrow, yawn, and sneer all convey
A smile, frown, raised eyebrow, yawn, and sneer all convey
information.
information.
 Smiling is a powerful cue that transmits happiness,
Smiling is a powerful cue that transmits happiness,
friendliness, warmth, and liking.
friendliness, warmth, and liking.
 So, if you smile frequently you will be perceived as more
So, if you smile frequently you will be perceived as more
likable, friendly, warm and approachable.
likable, friendly, warm and approachable.
 Smiling is often contagious and people will react favorably.
Smiling is often contagious and people will react favorably.
 They will be more comfortable around you and will want to
They will be more comfortable around you and will want to
listen more.
listen more.
 Facial expressions continually change during interaction
Facial expressions continually change during interaction
and are monitored constantly by the recipient.
and are monitored constantly by the recipient.
 There is evidence that the meaning of these expressions
There is evidence that the meaning of these expressions
may be similar across cultures.
may be similar across cultures.
92

Gestures
Gestures
 If you fail to gesture while speaking you may be perceived as
If you fail to gesture while speaking you may be perceived as
boring and stiff.
boring and stiff.
 One of the most frequently observed, but least understood,
One of the most frequently observed, but least understood,
cues is a hand movement.
cues is a hand movement.
 While some gestures (e.g., a clenched fist) have universal
While some gestures (e.g., a clenched fist) have universal
meanings, most of the others are individually learned and
meanings, most of the others are individually learned and
idiosyncratic.
idiosyncratic.
 A lively speaking style captures the listener's attention,
A lively speaking style captures the listener's attention,
makes the conversation more interesting, and facilitates
makes the conversation more interesting, and facilitates
understanding.
understanding. 93

Posture
Posture
 Obviously one can be lying down, seated, or standing.
Obviously one can be lying down, seated, or standing.
 These are not the elements of posture that convey
These are not the elements of posture that convey
messages.
messages.
 You communicate numerous messages by the way you talk
You communicate numerous messages by the way you talk
and move.
and move.
Are we slouched or erect ?
Are we slouched or erect ?
Are our legs crossed or our arms folded ?
Are our legs crossed or our arms folded ?
 Such postures convey a degree of formality and the degree
Such postures convey a degree of formality and the degree
of relaxation in the communication exchange.
of relaxation in the communication exchange.
94

Posture
Posture contd
contd .
.
 Standing erect and leaning forward communicates you are
Standing erect and leaning forward communicates you are
approachable, receptive and friendly.
approachable, receptive and friendly.
 Interpersonal closeness results when you and the listener
Interpersonal closeness results when you and the listener
face each other.
face each other.
95

Body Orientation
Body Orientation
 People may present themselves in various ways:
People may present themselves in various ways:
Face-to-face
Face-to-face
Side-to-side
Side-to-side
Or Even back-to-back.
Or Even back-to-back.
 For example, cooperating people are likely to sit side-by-
For example, cooperating people are likely to sit side-by-
side while competitors frequently face one another.
side while competitors frequently face one another.
 Speaking with your back turned or looking at the floor or
Speaking with your back turned or looking at the floor or
ceiling should be avoided as it communicates disinterest.
ceiling should be avoided as it communicates disinterest.
96

Proximity / Distance
Proximity / Distance
 The distance one stands from another frequently conveys a
The distance one stands from another frequently conveys a
non-verbal message.
non-verbal message.
 Cultural norms dictate a comfortable distance for interaction
Cultural norms dictate a comfortable distance for interaction
with others.
with others.
 In some cultures it is a sign of attraction, while in others it
In some cultures it is a sign of attraction, while in others it
may reflect status or the intensity of the exchange.
may reflect status or the intensity of the exchange.
 You should look for signals of discomfort caused by
You should look for signals of discomfort caused by
invading the other person's space.
invading the other person's space.
 Some of these are: rocking, leg swinging, tapping, and gaze
Some of these are: rocking, leg swinging, tapping, and gaze
aversion (dislike).
aversion (dislike). 97

Physical Contact
Physical Contact
 Shaking hands, touching, holding, embracing, pushing, or
Shaking hands, touching, holding, embracing, pushing, or
patting on the back all convey messages.
patting on the back all convey messages.
 They reflect an element of intimacy or a feeling of (or lack
They reflect an element of intimacy or a feeling of (or lack
of) attraction.
of) attraction.
98

Vocal
Vocal
 Speaking can signal nonverbal communication when you
Speaking can signal nonverbal communication when you
include such vocal elements as:
include such vocal elements as:
1.
1. Tone
Tone
2.
2. Pitch
Pitch
3.
3. Rhythm
Rhythm
4.
4. Timbre (resonance , Quality)
Timbre (resonance , Quality)
5.
5. Loudness
Loudness
6.
6. Inflection (modulation).
Inflection (modulation).
 For maximum teaching effectiveness, learn to vary these six
For maximum teaching effectiveness, learn to vary these six
elements of your voice.
elements of your voice.
 One of the major criticisms of many speakers is that they
One of the major criticisms of many speakers is that they
speak in a monotone voice.
speak in a monotone voice.
Listeners perceive this type of speaker as boring and
Listeners perceive this type of speaker as boring and
dull.
dull.
99

The Power of Pitch
People will pick up on the
pitch of your voice and react
to it.
A high pitch is often
interpreted as anxious or
upset.
A low pitch sounds more
serious and authoritative.
The variation in the pitch of your voice is important
to keep the other party interested.
100

V I D E O
Verbal
communication
https://www.youtube.com/watch?v=Cgut_WRNywo 102

V I D E O
Non-verbal
communication
https://www.youtube.com/watch?v=-JSxDoNzy0g 103

Body Language
Body Language
105

Body language
Body language
 It is a term for communication using body movements or
It is a term for communication using body movements or
gestures instead of, or in addition to, sounds, verbal
gestures instead of, or in addition to, sounds, verbal
language or other communication.
language or other communication.
 It accounts for over 90% of a conversation!
It accounts for over 90% of a conversation!
 It can be used to help conduct an interview, give a
It can be used to help conduct an interview, give a
presentation or make that important sale: a conversation
presentation or make that important sale: a conversation
stretches so much further than speech.
stretches so much further than speech.
 Body language is the reason why selling face-to-face has a
Body language is the reason why selling face-to-face has a
huge advantage over selling by phone.
huge advantage over selling by phone.
106

Body language
Body language
 It forms part of the category of paralanguage, which
It forms part of the category of paralanguage, which
describes all forms of human communication that are not
describes all forms of human communication that are not
verbal language.
verbal language.
 This includes the most subtle of movements that many
This includes the most subtle of movements that many
people are not aware of, including winking and slight
people are not aware of, including winking and slight
movement of the eyebrows.
movement of the eyebrows.
 In addition body language can also incorporate the use of
In addition body language can also incorporate the use of
facial expressions.
facial expressions.
107

Body Language
Body Language
108

Examples Of Body Language
Sr. No. Nonverbal Behaviour Interpretation
1 Brisk, erect walk Confidence
2 Standing with hands on hips Readiness, aggression
3
Sitting with legs crossed, foot
kicking slightly
Boredom
4 Sitting, legs apart Open, relaxed
5 Arms crossed on chest
Defensiveness
Person is putting barrier between
themselves and others
6
Walking with hands in
pockets, shoulders hunched
Dejection
7 Hand to cheek Evaluation, thinking
8
Touching, slightly rubbing
nose
Rejection, doubt, lying
9 Rubbing the eye Doubt, disbelief
10 Hands clasped behind back Anger, frustration, apprehension 110

Examples Of Body Language contd
contd .
.
11 Locked ankles Apprehension
12
Head resting in hand, tilting
at one side, eyes downcast
Boredom
13 Rubbing hands Anticipation
14
Sitting with hands clasped
behind head, legs crossed
Confidence, superiority
15 Open palm Sincerity, openness, innocence
16
Pinching bridge of nose,
eyes closed
Negative evaluation
17 Tapping or drumming fingersImpatience
18 Steepling fingers Authoritative
19 Patting/fondling hair Lack of self-confidence; insecurity
20 Tilted head Interest
21 Stroking chin Trying to make a decision
112

Examples Of Body Language contd
contd .
.
22
Looking down, face turned
away
Disbelief
23 Biting nails Insecurity, nervousness
24 Pulling or tugging at ear Indecision
25 Leaning forward Intrested
26 Leaning away from the speaker. Expressing opposition
27 Consistent eye contact Thinking positively
28 Lack of eye contact indicate negativity.
29
Looking at you but is making
the arms-across-chest signal
The eye contact indicates
something is bothering, and he
wants to talk about it.
30
averted gaze, touching the ear
or scratching the chin.
Disbelief
31
Female crosses her legs
towards a male she is
interested in.
Sexual desire
113

Using Body Language Effectively
Body
Language, 54%
Voice, 39%
Words, 7% , 0
Power of Body Language in Communication
Source: www.voiceworks.co.za/
115

Smiles
Frowns
Raised eyebrow
– Inquisitiveness
– Curiosity
– Disbelief
Chewing lips
– Thinking
– Boredom
– Anxiety or nervousness
Body Language
Facial Expressions
116

Crossed arms and legs
often
– Closed mind
Body Language
Hands, Arms, Feet, Legs
Fidgeting
– Boredom
– Nervousness
117

Body Language
Standing - Sitting
Sitting hunched over typically
– Stress
– Discomfort
Leaning back when standing or
sitting
– Casual
– Relaxed demeanor
Standing ramrod straight typically
– Stiffness
– Anxiety
118

Expressing Messages by
Body Language
 Eyes
 Face
 Body
 Posture
 Hair
 Clothing
 Cosmetics
 Accessories and jewelry
 Gesture
 Touch
 Space
119

V I D E O
Body
Language
https://www.youtube.com/watch?v=eJMaPZTGJ-o 124

V I D E O
Body
Language
https://www.youtube.com/watch?v=PCSVLcmg7Kk 125

Speaking Too
Speaking Too
Quickly
Quickly
127

A lot of us speak quickly when we are on the
A lot of us speak quickly when we are on the
Phone or with our customers / clients.
Phone or with our customers / clients.
Sometimes it
Sometimes it
is a habit or we are in a hurry
is a habit or we are in a hurry
Whatever
Whatever
the case, it is a habit that can cost us business.
the case, it is a habit that can cost us business.
128

Problems with speaking quickly .
 When you speak quickly, it affects other vocal issues.
When you speak quickly, it affects other vocal issues.
 Speed affects the clarity of words.
Speed affects the clarity of words.
The lips, teeth and tongue can’t get into the right position
The lips, teeth and tongue can’t get into the right position
in your mouth.
in your mouth.
 Customers expect to hear the words as they learned them.
Customers expect to hear the words as they learned them.
If you are slipping over syllables or eliminating them all
If you are slipping over syllables or eliminating them all
together, customers start focusing on what you just said,
together, customers start focusing on what you just said,
versus what you are currently saying.
versus what you are currently saying.
They feel like they are translating a foreign language.
They feel like they are translating a foreign language.
 It affects comprehension.
It affects comprehension.
Especially a person whose mother tongue is not English,
Especially a person whose mother tongue is not English,
it may be difficult for them to make any sense out of what
it may be difficult for them to make any sense out of what
you are saying.
you are saying.
129

Contd
Contd .
.
 Affects the tone of your voice.
Affects the tone of your voice.
It is impossible to sound friendly, sincere or empathetic
It is impossible to sound friendly, sincere or empathetic
without pausing.
without pausing.
Voice became monotone.
Voice became monotone.
If the voice is a monotone, the customer concludes you
If the voice is a monotone, the customer concludes you
are disinterested.
are disinterested.
• Who wants to do business with someone who is
Who wants to do business with someone who is
disinterested?
disinterested?
130

Ways to slow down
Ways to slow down
1.
1. First, get into the mind set that when you are at work; put
First, get into the mind set that when you are at work; put
cash on voice, the voice that earns you a living.
cash on voice, the voice that earns you a living.
 Actors, Show host, Radio jokey they all speak a lot slower
Actors, Show host, Radio jokey they all speak a lot slower
on television than they do when they are with friends and
on television than they do when they are with friends and
family.
family.
 They know that if they speak quickly, viewers will be
They know that if they speak quickly, viewers will be
complaining, and they will lose their jobs.
complaining, and they will lose their jobs.
131

Ways to slow down
Ways to slow down contd
contd .
.
2.
2. Secondly - Artist learn is the value of pausing.
Secondly - Artist learn is the value of pausing.
 In fact, they pause a lot.
In fact, they pause a lot.
 They pause not only at the end of sentences and clauses,
They pause not only at the end of sentences and clauses,
but whenever they want to emphasize a point or idea.
but whenever they want to emphasize a point or idea.
 More you pause, the more the listeners understand.
More you pause, the more the listeners understand.
132

Ways to slow down
contd .
.
 To get comfortable pausing, use your voice mail system to
To get comfortable pausing, use your voice mail system to
give you feedback.
give you feedback.
When you send internal voice mail messages, press
When you send internal voice mail messages, press
“review” before you press “send.” If you hear yourself
“review” before you press “send.” If you hear yourself
speaking quickly, redo the message until you are
speaking quickly, redo the message until you are
satisfied.
satisfied.
 Get feedback from family members and friends .
Get feedback from family members and friends .
Ask them to tell you to pause more or to remind you that
Ask them to tell you to pause more or to remind you that
you are mumbling.
you are mumbling.
133

Ways to slow down
contd .
.
3.
3. Thirdly slow down yourself
Thirdly slow down yourself
 Fast talkers also mumble (murmur / speak unclearly).
Fast talkers also mumble (murmur / speak unclearly).
 Read out loud to your child (if you have one or ..).
Read out loud to your child (if you have one or ..).
 Children demand that you really get into the story.
Children demand that you really get into the story.
 They will tell you to slow down because they want to enjoy
They will tell you to slow down because they want to enjoy
the story.
the story.
 As you drive down the street, use your car as a laboratory.
As you drive down the street, use your car as a laboratory.
Say out loud what you are seeing and over - enunciate
Say out loud what you are seeing and over - enunciate
(Pronounce) each word.
(Pronounce) each word.
No one will hear you.
No one will hear you.
Over - enunciating will get you used to saying every
Over - enunciating will get you used to saying every
syllable in the word.
syllable in the word.
134

Ways to slow down
contd .
.
 While speaking quickly is a habit, it is not a habit that helps
While speaking quickly is a habit, it is not a habit that helps
you to develop relationships with your customers.
you to develop relationships with your customers.
 The more you pause, the more they feel you care. The less
The more you pause, the more they feel you care. The less
likely they are to become upset.
likely they are to become upset.
 A one or two second pause can make a huge difference.
A one or two second pause can make a huge difference.
 Put on your “cash” voice and see what a difference it will
Put on your “cash” voice and see what a difference it will
make.
make.
135

It is not what you know
It is not what you know
but how you communicate it
but how you communicate it
that makes a difference.
that makes a difference.
136

Speaking Hints
Speaking Hints
137

Speak comfortable words!
Speak comfortable words!
William Shakespeare
William Shakespeare
138

Speaking Hints
Speaking Hints
1.
1. When speaking or trying to explain something, ask the
When speaking or trying to explain something, ask the
listeners if they are following you.
listeners if they are following you.
2.
2. Ensure the receiver has a chance to comment or ask
Ensure the receiver has a chance to comment or ask
questions.
questions.
3.
3. Try to put yourself in the other person's shoes - consider
Try to put yourself in the other person's shoes - consider
the feelings of the receiver.
the feelings of the receiver.
4.
4. Be clear about what you say.
Be clear about what you say.
139

Speaking Hints
Speaking Hints
5.
5. Look at the receiver.
Look at the receiver.
6.
6. Make sure your words match your tone and body language
Make sure your words match your tone and body language
(Nonverbal Behaviors).
(Nonverbal Behaviors).
7.
7. Vary your tone and pace.
Vary your tone and pace.
8.
8. Do not be vague, but on the other hand, do not complicate
Do not be vague, but on the other hand, do not complicate
what you are saying with too much detail.
what you are saying with too much detail.
9.
9. Do not ignore signs of confusion.
Do not ignore signs of confusion.
140

Enhancing your communications
 Eye contact is an important step in sending and receiving
Eye contact is an important step in sending and receiving
messages.
messages.
 Eye contact can be a signal of interest, a signal of
Eye contact can be a signal of interest, a signal of
recognition, even a sign of honesty and credibility.
recognition, even a sign of honesty and credibility.
 Closely linked to eye contact are facial expressions, which
Closely linked to eye contact are facial expressions, which
can reflect attitudes and emotions.
can reflect attitudes and emotions.
 Posture can also be used to more effectively communicate
Posture can also be used to more effectively communicate
your message.
your message.
 Clothing is important. By dressing for your job, you show
Clothing is important. By dressing for your job, you show
respect for the values and conventions of your organization.
respect for the values and conventions of your organization.
141

Enhancing your communications contd
contd .
.
 Do not invade personal space by
Do not invade personal space by
getting too close and do not confuse
getting too close and do not confuse
communications by trying to exchange
communications by trying to exchange
messages from too far away.
messages from too far away.
 Be aware of your gestures, tone of
Be aware of your gestures, tone of
voice, movement and facial
voice, movement and facial
expressions.
expressions.
142

V I D E O
Talking to
the Doctor
https://www.youtube.com/watch?v=8bAccWMfyHo 143

V I D E O
Poor
Communication
https://www.youtube.com/watch?v=W1RY_72O_LQ 144

How to Detect Lies
How to Detect Lies
146

How to Detect Lies
How to Detect Lies
 The techniques of How to Detect Lies is often used by
The techniques of How to Detect Lies is often used by
police, and security experts.
police, and security experts.
 This knowledge is also useful for managers, employers,
This knowledge is also useful for managers, employers,
and for anyone to use in everyday situations where telling
and for anyone to use in everyday situations where telling
the truth from a lie can help prevent you from being a
the truth from a lie can help prevent you from being a
victim of fraud/scams and other deceptions.
victim of fraud/scams and other deceptions.
147

Warning
Warning
Sometimes Ignorance is bliss;
Sometimes Ignorance is bliss;
after gaining this knowledge,
after gaining this knowledge,
you may be hurt
you may be hurt
when it is obvious that someone is lying to you.
when it is obvious that someone is lying to you.
148

Signs of Deception (Dishonesty)
Signs of Deception (Dishonesty)
1.
1. Body Language of Lies
Body Language of Lies
2.
2. Emotional Gestures & Contradiction
Emotional Gestures & Contradiction
3.
3. Interactions and Reactions
Interactions and Reactions
4.
4. Verbal Context and Content
Verbal Context and Content
5.
5. Other signs of a lie
Other signs of a lie
149

1) Body Language of Lies
1) Body Language of Lies
1.
1. Physical expression
Physical expression
 Physical expression will be limited and stiff, with few arm
Physical expression will be limited and stiff, with few arm
and hand movements.
and hand movements.
 Hand, arm and leg movement are toward their own body the
Hand, arm and leg movement are toward their own body the
liar takes up less space.
liar takes up less space.
2.
2. Eye contact.
Eye contact.
 A person who is lying to you will avoid making eye contact.
A person who is lying to you will avoid making eye contact.
3.
3. Movement of Hands
Movement of Hands
 Hands touching their face, throat & mouth.
Hands touching their face, throat & mouth.
 Touching or scratching the nose or behind their ear.
Touching or scratching the nose or behind their ear.
 Not likely to touch his chest/heart with an open hand.
Not likely to touch his chest/heart with an open hand.
150

2) Emotional Gestures & Contradiction
1.
1. Timing and duration of emotional gestures and emotions
Timing and duration of emotional gestures and emotions
are off a normal pace.
are off a normal pace.
 The display of emotion is delayed, stays longer it would
The display of emotion is delayed, stays longer it would
naturally, then stops suddenly.
naturally, then stops suddenly.
2.
2. Timing is off between emotions gestures/expressions and
Timing is off between emotions gestures/expressions and
words.
words.
 Example: Someone says "I love it!" when receiving a gift,
Example: Someone says "I love it!" when receiving a gift,
and then smile after making that statement, rather then at
and then smile after making that statement, rather then at
the same time the statement is made.
the same time the statement is made.
153

2) Emotional Gestures & Contradiction contd
contd .
.
3.
3. Gestures/expressions
Gestures/expressions don’t match the verbal statement,
don’t match the verbal statement,
such as frowning when saying “I love you.”
such as frowning when saying “I love you.”
4.
4. Expressions
Expressions are limited to mouth movements when
are limited to mouth movements when
someone is faking emotions like happy, surprised, sad,
someone is faking emotions like happy, surprised, sad,
awe (fear) instead of the whole face.
awe (fear) instead of the whole face.
 For example; when someone smiles naturally their whole
For example; when someone smiles naturally their whole
face is involved: jaw/cheek movement, eyes and forehead
face is involved: jaw/cheek movement, eyes and forehead
push down, etc.
push down, etc.
154

3) Interactions and Reactions
3) Interactions and Reactions
 A guilty person gets defensive. An innocent person will
A guilty person gets defensive. An innocent person will
often go on the offensive.
often go on the offensive.
 A liar is uncomfortable facing his questioner/accuser and
A liar is uncomfortable facing his questioner/accuser and
may turn his head or body away.
may turn his head or body away.
 A liar might unconsciously place objects (book, coffee cup,
A liar might unconsciously place objects (book, coffee cup,
etc.) between themselves and you.
etc.) between themselves and you.
155

4) Verbal Context and Content
i.
i. A liar will use your words to make answer a question.
A liar will use your words to make answer a question.
 When asked, “Did you eat the last cookie?”
When asked, “Did you eat the last cookie?”
 The liar answers, “No, I did not eat the last cookie.”
The liar answers, “No, I did not eat the last cookie.”
ii.
ii. A statement with a contraction (short) is more likely to be
A statement with a contraction (short) is more likely to be
truthful: “ I didn't do it” instead of “I did not do it”
truthful: “ I didn't do it” instead of “I did not do it”
iii.
iii. Liars sometimes avoid "lying" by not making direct
Liars sometimes avoid "lying" by not making direct
statements.
statements.
 They imply answers instead of denying something
They imply answers instead of denying something
directly.
directly.
iv.
iv. The guilty person may speak more than natural, adding
The guilty person may speak more than natural, adding
unnecessary details to convince you... they are not
unnecessary details to convince you... they are not
comfortable with silence or pauses in the conversation.
comfortable with silence or pauses in the conversation.
156

v.
v. A liar may leave out pronouns and speak in a monotonous
A liar may leave out pronouns and speak in a monotonous
tone.
tone.
 When a truthful statement is made the pronoun is
When a truthful statement is made the pronoun is
emphasized as much or more than the rest of the words in
emphasized as much or more than the rest of the words in
a statement.
a statement.
vi.
vi. Words may be garbled and spoken softly, and syntax and
Words may be garbled and spoken softly, and syntax and
grammar may be off.
grammar may be off.
 In other words, his sentences will likely be muddled rather
In other words, his sentences will likely be muddled rather
than emphasized.
than emphasized.
157

5) Other signs of a lie
5) Other signs of a lie
 If you believe someone is lying, then change subject of a
If you believe someone is lying, then change subject of a
conversation quickly, a liar follows along willingly and
conversation quickly, a liar follows along willingly and
becomes more relaxed.
becomes more relaxed.
 The guilty wants the subject changed; an innocent person
The guilty wants the subject changed; an innocent person
may be confused by the sudden change in topics and will
may be confused by the sudden change in topics and will
want to back to the previous subject.
want to back to the previous subject.
158

Can you guess the nonverbal body language
Can you guess the nonverbal body language
the faces below are communicating?
the faces below are communicating?
160

Communication
Communication
Strategies
Strategies
163

Communication Strategies - Care
Communication Strategies - Care
 SOLER (Egan, 1986) is a technique used by care workers.
SOLER (Egan, 1986) is a technique used by care workers.
 It helps the clients or patients to trust the care-giver and to
It helps the clients or patients to trust the care-giver and to
feel safe and helps in effective communication.
feel safe and helps in effective communication.
 SOLER is:
SOLER is:
 S – Sit squarely in relation to the patient
S – Sit squarely in relation to the patient
 O – Open position
O – Open position
 L – Lean slightly towards the patient
L – Lean slightly towards the patient
 E – Eye contact
E – Eye contact
 R – Relax
R – Relax
164

Oral presentations
Oral presentations
Sr. No. Skills Criteria
1
Select and organise
information
• Relevance of information
• Amount appropriate to the time available
• Brief introduction
• Argument is well organised, using markers
• Short conclusion or link (if in group)
2
Project confidence and
enthusiasm
• Strong stance, calm appearance, eye contact
• Minimal reference to notes
3
Use audio-visuals
effectively
• Clear speech
• Steady pace
• Some modulation
• Appropriate emphasis
• Explain or define new terms
• Avoid jargon and long sentences
4
Use audio-visuals
effectively
• Over Head Transparencies (OHTs) not crowded
• Equipment used with ease
• Information selected that assists the audience
5
Respond to the
• Counter arguments explained
• Own argument summarised
• Active listening and focused response
audience 165

Short answers
Short answers
Sr.
No.
Skills Criteria
1 Analyse the question • The question is answered
2
Select relevant
information
• The content is all relevant to the question
3
Think critically and
analytically
• The answer shows understanding of how key
aspects relate
• Information is questioned
4
Begin with a
proposition
• The proposition shows understanding of the
question and indicates the points to be covered
• The final sentence summarises
5 Present an argument• The argument is logical and concise
166

Presentation
Presentation
Planning
Planning
167

2)
2) Delivery
Delivery
 Are you knowledgeable about the product covered in your
Are you knowledgeable about the product covered in your
presentation?
presentation?
 Do you have your promotional inputs in order?
Do you have your promotional inputs in order?
 Where and how will you present (indoors, outdoors,
Where and how will you present (indoors, outdoors,
standing, sitting, etc.)?
standing, sitting, etc.)?
 Have you checked and practice your visual aids,
Have you checked and practice your visual aids, brochure
brochure
and other promotional inputs?
and other promotional inputs?
169

3) Appearance
3) Appearance
 Make sure you are dressed and groomed appropriately and
Make sure you are dressed and groomed appropriately and
in keeping with the audience’s expectations.
in keeping with the audience’s expectations.
 Practice your speech standing (or sitting, if applicable),
Practice your speech standing (or sitting, if applicable),
paying close attention to your body language, even your
paying close attention to your body language, even your
posture, both of which will be assessed by the audience.
posture, both of which will be assessed by the audience.
170

4) Visual Aids
4) Visual Aids
 Are the visual aids easy to read and easy to understand?
Are the visual aids easy to read and easy to understand?
 Did you understand the Visual aid?
Did you understand the Visual aid?
 Are they are in proper condition?
Are they are in proper condition?
 Can doctor see them easily while you are detailing them?
Can doctor see them easily while you are detailing them?
171

Basic structure of a presentation
 Opening
Opening
 Get attention
Get attention
 Create interest and sustain it (Joke , Graph, Picture etc.)
Create interest and sustain it (Joke , Graph, Picture etc.)
 Present benefits
Present benefits
 Demonstrate
Demonstrate
 Feedback
Feedback
 Handle objection
Handle objection
 Close
Close
172

V I D E O
Lies
https://www.youtube.com/watch?v=0qw9VTspiKA 175

V I D E O
Presentation
https://www.youtube.com/watch?v=PrxpxtpbMt0 176

COUNSELLING
Counselling is a process that uses communication skills to help
client/patient to reach an informed decision/choice
Counselling will provide customized, client-oriented information
and negotiate available alternatives to help take a decision
based on clear information.
Helping a person or a group to develop
self-help and self-care abilities.
178

CONSULTATION & COUNSELING
Consultation:
Process of a dialogue that leads to a
decision
Counseling:
Helping a person or a group of people to
develop self help
179

CONSULTATION
After each consultation session 5 things
must be established:
1) Discover the reasons of patient attendance
2) Define clinical problem (HPT, DM)
3) Address the patient’s problem (details)
4) Explain the problem to the patient
5) Make effective use of the consultation
180

PRINCIPLES FOR GOOD COUNSELLING
 Treat each client well
 Interact actively
 Give the right amount of information
Tailor and personalize the information
 Use and provide memory aids
 Provide the services that satisfy the client’s
expectations. Help clients remember instructions.
 Confidentiality
181

COUNSELING
Preparing a counseling session
Physical setting
Timing
Interpersonal space
182

1. Physical setting
Privacy: in a quiet, calm & no
interruption
 Proper lightening & temperature.
2. Timing
45-60 minutes
183

3. Interpersonal space
 4-9 feet
D
 D
P D P P
(√) (√) (×)
184

COUNSELING,
CONSULTATION, COMMUNICATION PROCESS
 Initiating the session
 Gathering Information
 Building Relationship
 Explanation and Planning
 Closing the sessions
185

BUILDING RELATIONSHIP
 Using appropriate non verbal behavior: eye
contact, posture, demonstrate confidence
 Develop rapport: accept patient views, feeling,
provide support, deals sensitively with disturbing
topics
 Involve the patients: explain rationale, ask
permission and explain process during physical
examination
188

EXPLANATION & PLANNING
A- Providing the correct amount and type of
information:
-Assesses patient’s starting point
-Asks patients what other information does you
needs and would be helpful.
-Give explanation at appropriate time
189

EXPLANATION AND PLANNING
b) Aiding recall and understanding:
 -Organizes explanation.
 -Uses explicit categorization.
 -Uses easily understood language.
 -Uses visual methods of conveying information.
 -Checks patient’s understanding.
190

C-Achieving a shared understanding:
 -Provides opportunities to patients to contribute.
 -Picks up verbal and non-verbal cues.
 -Elicits patient’s beliefs, reactions and feelings.
191

D-Planning: shared decision making:
 -Encourage patient to contribute his thoughts.
 -Negotiate acceptable plan.
 -Offers choices.
 -Checks with patients if he accepts plans and if
his concerns have been addressed
192

CLOSING THE SESSIONS
A-Forward planning:
 -Contracts with patients next steps.
 -Explain possible unexpected outcomes.
B-Ensuring appropriate point of closure:
 -Summarizes session briefly and clarifies plan of
care.
 -Final check that patient is satisfied, comfortable
with plan.
193

THE ELEMENTS OF COUNSELLING
G A T H E R
Greet
Ask
Tell
Help
Explain
Return visit 194

GREET
 Give the clients your full attention as soon as you
meet them.
 Be polite, friendly and respectful.
 Introduce your self and offer them seats.
 Ask how you can help?
 Explain what will happen during the visit.
 Conduct counselling privately
195

ASK ABOUT
 Reasons for coming.
 Their experience with the health matter that
concerns them.
 Any information needed to complete client
records.
 Ask Clients about themselves and their families
as appropriate.
196

TELL CLIENT
-To decide what choices and decisions.
-To express their feelings, needs, wants, & any doubts,
concerns or questions.
 Keep questions open, simple and brief.
 Look at your client as you speak.
 Listen actively to what the client says.
 Show your interest and understanding all the time.
 Tell the clients about their condition or Choices
 Help clients understand their possible condition
 Information should be: Simple, correct and relevant
197

HELP CLIENT TO UNDERSTAND
 Help the clients think about the results of each
possible choice.
 Ask if the client wants anything made clearer,
repeat and rephrase information as needed.
 Check whether the client has made a clear
understanding .
 “What have You understood?”
 “What have you decided to do?”
 Wait for the client to answer.
198

EXPLAIN WHAT TO DO
 Give supplies, if appropriate.
 If the service cannot be given at once, tell the
client how, when & where it could be provided.
 Describe possible side effects and what to do
if they occur.
 Ask the client to repeat instructions. make
sure the client remembers & understands.
 If possible give the client printed materials to
take home.
 Explain when to come back and why
199

RETURN VISIT
 Check if the client is using the Treatment
correctly.
 Ask if the client has any Question or anything to
discuss. Consider all concerns seriously.
 Ask if the client is Satisfied, has there been any
problems since last visit???
 Help the client handle any Problems.
 Refer client who need specialized care.
200

CONCLUSION
Your communication skills can make a difference
between being
hired and fired.
*****
Practice makes a man perfect…
201

ROLE MODELING
IS THE “GOLD” STANDARD IN
TEACHING COMMUNICATION SKILLS
202

ROLE PLAY IS THE
“SILVER” STANDARD IN TEACHING
COMMUNICATION SKILLS
203

To Be a Good Doctor, You Have
to Be a
GOOD COMMUNICATOR
204

V I D E O
Counselling
https://www.youtube.com/watch?v=jP-4krHFS98 205

Communication
 Communication is the exchange of thoughts,
messages or information by signals, writing,
speech or behavior.
208

Communication
 There are two main types of communication …
 Verbal
 Non verbal (93% of most communication).
Communication
Non Verbal
Verbal 209

Culture
 Culture is the way of life of a group of people, usually passed
from one generation to the next through the socialization
process.
 It identifies the group through Language, Dressing, Behavior,
etc.
 Our culture (from nurture or adoption) may affect the way we
communicate.
210

Culture
 Different cultures may exist within a region or family!
 Reasons for multicultural communities …
 Jobs
 Marriages
 Education
 Tours
 Immigration
 Etc.
211

Culture
 Implying that many cultures or sub-cultures exist in the same
country or community.
 There will be frequent communication with individuals from
other cultures.
 Knowing that differences exist is very important to prevent
problems.
 The responsibility of understanding lies on everybody.
 Could there be instances where we misunderstood what
someone said or did?
212

Culture
 Ways cultures differ and affect communication
 1. Conversational styles
 2. Narrative styles
 3. Stance and attitudes
 4. Personal responsibility
213

Culture
 Understanding cultural differences
 1. Conversational styles
 Soft vs. loud tones
 Slow vs. fast pace
 Gestural vs. motionless
 Topic of conversation
 Acceptable conversational topics: Weather, News, Sports,
Health, Job
 Non-acceptable conversational topics: Religion, Politics, Salary,
Age, Weight, Physical appearance, Marital status 214

Culture
 2. Narrative styles
 Cultures may differ on the right way to tell a story:
 Which story
 Ideal channel
 Ideal medium
215

Culture
 3. Stance and Attitudes
 People’s frame of mind or beliefs affect behavior and thoughts
 More eye-contact
 Giving more smiles and nods
 These may be interpreted differently in another culture
 Eye-contact
 Some cultures, looking people in the eyes generally signifies that you are
interested in the person, or it is honesty and straight forwardness and in
others it is seen as challenging and rude
216

Culture
 Gestures
 A movement of part of the body, especially a hand or the head, to express an
idea or meaning.
217

Culture
 Clothing
 Traditional clothing is an important part of a region’s history and identity.
218

Culture
 Greeting
 There is a huge different in greeting from a culture to another which affect the
communication.
219

Culture
 4. Personal responsibility
 Is the perception of doing the right thing
 Differences exist in:
 Limits to express one’s view
 Limits to acceptable actions
220

Culture
 Failure to understand these cultural differences may lead to
miscommunication or misunderstanding.
221

Culture
 How we can fit well in a new community:
 Research the new environment’s basic communication and cultural
norms
 Learn some basic words and sentences if the language is different
 Be tolerant and patient
 Understand the people’s likes and dislikes
 Observe…and identify more differences
222

Culture
 To sum up:
 The world can only get more diverse… not less
 This will occur primarily through migration
 Cultures are different in many ways
 Most communications reflect culture
 We should take steps to understand the people from
other cultures
223

V I D E O
Consultation
https://www.youtube.com/watch?v=rUDA3isummM 224

V I D E O
Cross cultural
communication
https://www.youtube.com/watch?v=rQrfQM3FAto 225

BREAKING BAD NEWS
A N E S S E N T I A L C O M M U N I C A T I O N S S K I L L 226

BAD NEWS
Any news that drastically and
negatively alters the patient’s view
of his or her future
The common denominator is that bad news is a message, which has the potential
to shatter hopes leading to very different lifestyles
228

EXAMPLES OF BAD NEWS
•Cancer diagnosis
•Intra uterine foetal death
•Life long illness e.g. Diabetes, epilepsy
•Poor prognosis related to chronic diseases e.g.
heart failure
•Informing parents about their child’s serious
mental/physical handicap
•Non clinical situations like giving feedback to
poorly performing trainees or colleagues
229

PATIENT’S AND FAMILY
EXPECTATIONS
Privacy
Empathy
Dignity
Clarity of message
Competency
Time for questions
230

PATIENTS HAVE A RIGHT TO:
• Accurate and true information
• Receive or not receive bad news!
• Decide how much information they want or do not
want
• Decide who should be present during the
consultation, e.g. Family members
• Decide who should be informed about their diagnosis
and what information that person(s) should receive
231

RESPONSES TO BAD NEWS
• Denial
• Shock
• Anger
• Guilt
• Blame
• Agitation
• Helplessness
• Sense of unreality
• Misinterpreting
information
• Regret/anxiety
232

DO…
• Ensure privacy and
confidentiality
• Respect
• Honest
• Simple language
• Listen
• Sensitive to the non-
verbal language
• Allow for silence, tears
and other patient
reactions
• Document and liaise
with the
multidisciplinary team
233

DO NOT…
•Overload with
information
•Distort the truth
•Give false
reassurance
•Feel obliged to keep
talking all the time
•Withhold information
•Assume that you
know what is
concerning the
patient
•Criticize
•Make judgements
234

AVOID
1. Meeting in public
2. Being alone
3. Hurrying!
4. Not being prepared!
5. Interrupted by your mobile phone!
6. Patronizing e.g. It is all your fault you smoked!
7. Give prognosis e.g. You have 6 months to live!
235

1. S: SETTING
Arrange for some privacy
Sit down
Make connection and establish rapport with
the patient
Manage time constraints and interruptions
237

2. P: PERCEPTION
Determine what the patient knows?
Listen to the patient!
Accept denial but do not confront at this
stage.
238

3. I: INVITATION
Ask patient if they wish to know?
Accept patient’s right not to know!
Offer to answer questions later if they wish
239

4. K: KNOWLEDGE
Use language appropriate to patient
Give information in small chunks
Give diagnosis e.g. Cancer
Give any positive aspects e.g. Cancer has not
spread
Check whether the patient understood what
you said!
240

5. E: EXPLORE
Prepare to give an empathetic response
Give the patient time to express their
feelings then respond
241

6. S: STRATEGY (SUMMARY)
Ask whether they want to clarify
something else?
Offer agenda for the next meeting e.g. I
will speak to you again when we have the
opinion of cancer specialist.
Close the interview
242

V I D E O
H O W T O
B R E A K B A D N E W S
https://www.youtube.com/watch?v=HWAZnhCuAeE 243

V I D E O
H O W T O
https://www.youtube.com/watch?v=qHGvjv_7PLU 244

V I D E O
H O W T O
https://www.youtube.com/watch?v=QvW_g6w8uY0 245

BREAKING BAD NEWS
SUMMARY
•A Difficult But Fundamentally Important Task
for All Health Care Professionals.
•Focused Training in Communication Skills &
Techniques Improves Performance.
•Enhances Patients’ Satisfaction & Physicians’
Comfort.
•An Essential Skill of Good Medical Practice.
246

Communication
 Communication is a process by which information is
exchanged between individuals through a common system
of signs, symbols or behavior.
 We communicate when we talk and also when we don’t talk.
 We communicate within ourselves and with others.
 Communicate in, is very significant in nursing.
 Nursing process itself is a communication process. 249

Therapeutic Communication
 In therapeutic communication, the nurse directs the
communications towards the patient to identify his current
health problem, plan, implement & evaluation the action
taken.
 The therapeutic interaction between the nurse and the
client will be helpful to develop a mutual understanding
between two individuals.
 Interaction is a learning experience for both clients and
for the nurse and a corrective emotional experience for
the client to modify his behavior.
250

Goals of Therapeutic Communication
 Establish a therapeutic nurse-patient relationship.
 Identify the most important patient’s needs.
 Assess the patient’s perception of the problem.
 Facilitate the patient’s to express their thoughts, emotions truly,
openly.
 Implement interventions designed to address the patient’s needs.
 Motivates the client to utilize the new coping strategies.
 Improves the patient’s ego strengths.
 Implement the nursing process effectively. 251

Principles of Therapeutic Communication
 The patient should be the primary focus of the interaction.
 A professional attitude sets the tone of the therapeutic
relationship.
 Use self-disclosure cautiously & only when it has a
therapeutic purpose.
 Avoid social relationships with patients.
 Maintain patient confidentiality. 252

Principles of Therapeutic Communication
 Assess the patient’s intellectual competence to determine
the level of understanding.
 Implement interventions from a theoretical base.
 Maintain a non-judgmental attitude. Avoid making
judgments about the patient’s behavior.
 Avoid giving advice.
 Guide the patient to interpret his or her experiences
rationally.
253

Therapeutic Communication Techniques
 1. Listening 2. Broad opening
 3. Restating 4. Clarification
 5. Reflection 6. Humor
 7. Information 8. Focusing
 9. Sharing perceptions 10. Sharing Empathy
 11. Silence 12. Sharing Observation
 13. Suggesting
254

 1. Listening
 It is an active process of receiving information.
 Response on the part of the nurse such as maintaining
eye-to-eye contact, nodding, gesturing & other forms of
receptive nonverbal communication convey to the patient
that he is being listened to & understood.
 As the patient is talking, the nurse responds by nodding
her head, or by saying. Yes I follow what you told me.
The nurse is actively listening. 255

 2. Broad Opening
 Encouraging the patient to select topics for discussion.
 Example, “What are you thinking about?
256

 3. Restating
 Repeating the main thought expressed by the patient.
 Example,
 Patient: My children are going through a financial
problem because am sick.
 Nurse: Your children are going through a financial
problem because you are sick.
 The nurse is restating the statement to increase the
patient’s awareness of his children’s suffering due to his
sickness. 257

 4. Clarification
 Attempting to put vague ideas or nuclear thoughts of the
patient into words to enhance the nurse’s understanding
or asking the patient to explain what he means.
 Example,
 Patient: I am very sad today.
 Nurse: You say you are feeling very sad today. Would
you elaborate what is happening?
 Explanation given by the patient will clarify further what is
making him feel sad. 258

 5. Reflection
 Directing back the patient’s ideas, feelings, questions &
content.
 Example,
 Patient: I am very angry with my wife.
 Nurse: It sounds that you are really angry with your wife.
 The nurse use of reflection helps the patient to make
further or additional clarification about the statement.
259

 6. Humor
 The discharge of energy through comic enjoyment of the
imperfect.
 Example, “That gives a whole new meaning to the word nervous,
said with shared kidding between the nurse & the patient”.
260

 7. Information
 The skill of information giving.
 Example, “I think you need to know more about your
medications”.
261

 8. Focusing
 Questions or statements that help the patient expand on a topic of
importance.
 Example, “I think that we should talk more about your relationship
with your father”.
262

 9. Sharing perceptions
 Asking the patient to verify the nurse’s understanding of
what the patient is thinking or feeling.
 Example, “You are smiling, but I sense that you are really
very angry with me”.
263

 10.Sharing Empathy
 The ability to understand and accept another
person’s reality, to accurately perceive feelings,
and to communicate understanding.
 Example, “It must be very frustrating to know
what you want and not be able to do it”.
264

 11.Silence
 Lack of verbal communication for a therapeutic reason.
 Example, Sitting with a patient & nonverbally
communicating interest & involvement.
265

 12.Sharing Observation
 Making observations by commenting on how the
other person looks, sounds, or acts.
 Example, “You look tired” or “I haven’t seen you
eating anything today”.
266

 13.Suggesting
 This is the presentation of alternative ideas related to
problem-solving.
 It is the most useful communication technique when
the patient has analyzed his problem area, and is
ready to explore alternative coping mechanisms.
 At that time suggesting technique increase the
patient‘s choices. 267

Non-Therapeutic Techniques
 Reassuring
 Rejecting
 Giving approval
 Advising
 Defending
 Requesting
 Belittling the feeling of the patient.
 These non-therapeutic techniques should be
avoided.
268

V I D E O
Nontherapeutic
Vs Therapeutic
Communication
https://www.youtube.com/watch?v=Ik_hwMHVHM4 271

V I D E O
How to deal
with an Angry
Patient
https://www.youtube.com/watch?v=BBN_Q-cMoDc 272

V I D E O
Medical
Communication
Skills Challenge
https://www.youtube.com/watch?v=GehHk-vDsUc 273

V I D E O
Effective
Interactions
with Patients
https://www.youtube.com/watch?v=I6TqSwlDtoY 274

‫المالحق‬
Appendices
275

Communication Skills Text-English.pdf

Communication Skills Text-English.pdf

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