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  1. 1. Chapter 8 Personal and Interdisciplinary Communication
  2. 2. Objectives <ul><li>Upon completion of this chapter, the reader should be able to: </li></ul><ul><ul><li>Analyze how current trends in society impact communication </li></ul></ul><ul><ul><li>Focus on the elements of the communication process </li></ul></ul><ul><ul><li>Describe the Health Insurance Portability and Accountability Act </li></ul></ul><ul><ul><li>Increase effectiveness of communication by using various communication modes </li></ul></ul>
  3. 3. Objectives <ul><ul><li>Identify the levels of communication </li></ul></ul><ul><ul><li>Describe organizational communication and skills in the workplace </li></ul></ul><ul><ul><li>Identify barriers to communication and strategies to overcome them </li></ul></ul>
  4. 4. Trends in Society that Impact Communication <ul><li>Increasing social diversity </li></ul><ul><li>Changing/differing beliefs </li></ul><ul><li>Aging population </li></ul><ul><li>Shift to computerized communication </li></ul>
  5. 5. Elements of the Communication Process <ul><li>Communication is an interactive process that occurs when a person (the sender) sends a verbal or nonverbal message to another person (the receiver) and receives feedback </li></ul><ul><li>Influenced by emotions, needs, perceptions, values, education, culture, goals, literacy, cognitive ability, and the communication mode </li></ul>
  6. 6. Health Insurance Portability and Accountability Act <ul><li>Became law 1996  </li></ul><ul><li>Privacy Rule enacted 2003 </li></ul><ul><li>Protects all individually identifiable health information held or transmitted by a covered entity or business associate, in any form or media, whether electronic, paper, or oral </li></ul><ul><li>Law lists 18 personal health identifiers </li></ul>
  7. 7. Modes of Communication <ul><li>Verbal </li></ul><ul><ul><li>Spoken </li></ul></ul><ul><li>Nonverbal </li></ul><ul><ul><li>Facial expressions, posture, gait, body movements, position, gestures, and touch </li></ul></ul><ul><li>Electronic </li></ul><ul><ul><li>Uses electronic media that do not have characteristics of the other modes </li></ul></ul>
  8. 8. Electronic Communication <ul><li>Plays an increasing dominant role in health care </li></ul><ul><li>Accurate spelling, correct grammar, and organization of thought assume greater importance in the absence of verbal and nonverbal cues that are given in face-to-face encounters </li></ul><ul><li>Always proofread correspondence prior to sending it </li></ul><ul><li>Keep the message brief and use standard font </li></ul>
  9. 9. Levels of Communication <ul><li>Public </li></ul><ul><ul><li>Communication with a group of people with a common interest </li></ul></ul><ul><li>Intrapersonal </li></ul><ul><ul><li>Internal communication within an individual </li></ul></ul><ul><li>Interpersonal </li></ul><ul><ul><li>Communication between individuals, person to person, or in small groups </li></ul></ul>
  10. 10. Organizational Communication <ul><li>Avenues of communication are often defined by an organization’s formal structure </li></ul><ul><ul><li>Downward: communication originates at top or upper levels of organization and works downward </li></ul></ul><ul><ul><li>Upward: communication originates at some level below the top of the structure and moves upward </li></ul></ul>
  11. 11. Organizational Communication <ul><ul><ul><li>Lateral: communication occurs among people at similar levels within the organization </li></ul></ul></ul><ul><ul><ul><li>Diagonal: communication occurs when people who may be on different levels of the organizational chart communicate with each other </li></ul></ul></ul><ul><ul><ul><li>Grapevine: an informal and unstructured avenue of communication; major benefit is speed, but its major drawback is its unreliability </li></ul></ul></ul>
  12. 12. Communication Skills <ul><li>Attending: active listening </li></ul><ul><li>Responding: verbal and nonverbal acknowledgment of the sender’s message  </li></ul><ul><li>Clarifying: communicating as specifically as possible to help the message become clear </li></ul><ul><li>Confronting: working jointly with others to resolve a problem or conflict </li></ul>
  13. 13. Barriers to Communication <ul><li>Gender </li></ul><ul><ul><li>Men and women may process information differently </li></ul></ul><ul><li>Culture </li></ul><ul><ul><li>Different cultures may have different beliefs, practices, and assumptions </li></ul></ul><ul><li>Anger </li></ul><ul><ul><li>An irrational response that arises from irrational ideas: awfulizing, can’t-stand-it-itis , shoulding and musting, and undeservingness and damnation  </li></ul></ul>
  14. 14. Barriers to Communication <ul><li>Incongruent responses </li></ul><ul><ul><li>When words and actions in a communication do not match the inner experience of self and/or are inappropriate to the context </li></ul></ul><ul><li>Conflict </li></ul><ul><ul><li>Arises when ideas or beliefs are opposed </li></ul></ul><ul><li>Offering false reassurance </li></ul><ul><ul><li>Promising something that cannot be delivered </li></ul></ul>
  15. 15. Barriers to Communication <ul><li>Being defensive </li></ul><ul><ul><li>Acting as though someone has been attacked </li></ul></ul><ul><li>Stereotyping </li></ul><ul><ul><li>Unfairly categorizing someone based on his or her traits </li></ul></ul><ul><li>Interrupting </li></ul><ul><ul><li>Speaking before other has completed his or her message </li></ul></ul>
  16. 16. Barriers to Communication <ul><li>Inattention </li></ul><ul><ul><li>Not paying attention </li></ul></ul><ul><li>Stress </li></ul><ul><ul><li>A state of tension that gets in the way of reasoning </li></ul></ul><ul><li>Unclear expectations </li></ul><ul><ul><li>Ill-defined tasks or duties that make successful completion of the communication unlikely </li></ul></ul>
  17. 17. Overcoming Communication Barriers <ul><li>Understand the receiver </li></ul><ul><li>Communicate assertively </li></ul><ul><li>Use two-way communication </li></ul><ul><li>Unite with a common vocabulary </li></ul><ul><li>Elicit verbal and nonverbal feedback </li></ul>
  18. 18. Overcoming Communication Barriers <ul><li>Enhance listening skills </li></ul><ul><li>Be sensitive to cultural differences </li></ul><ul><li>Be sensitive to gender differences </li></ul><ul><li>Engage in meta-communication </li></ul>
  19. 19. Use of Language in the Workplace <ul><li>Oral language is used to verbally communicate with patients and other health care professionals </li></ul><ul><li>Great diversity in spoken languages </li></ul><ul><li>Title VI of the Civil Rights Act of 1964 entitles an individual seeking health care who has limited English proficiency to have an interpreter available to facilitate communication </li></ul><ul><li>Language assistance needs to be comprehensive </li></ul>
  20. 20. Generational Differences in Communication <ul><li>Can create tensions among workers because of the divergent outlooks on life </li></ul><ul><li>Generations working together </li></ul><ul><ul><li>Matures, veterans </li></ul></ul><ul><ul><li>Baby boomers </li></ul></ul><ul><ul><li>Generation X </li></ul></ul><ul><ul><li>Generation Y </li></ul></ul>
  21. 21. Literacy <ul><li>Health literacy represents the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health </li></ul><ul><li>It is an outcome of health promotion and health education efforts </li></ul><ul><li>Most health care materials are written at the 10 th grade level; most adults read between an 8 th and 9 th grade level </li></ul>
  22. 22. Workplace Communication <ul><li>Superiors  </li></ul><ul><ul><li>Observe professional courtesies </li></ul></ul><ul><ul><li>Dress professionally </li></ul></ul><ul><ul><li>Arrive for the appointment on time </li></ul></ul><ul><ul><li>Be prepared to state the concern clearly and accurately </li></ul></ul><ul><ul><li>Provide supporting evidence and anticipate resistance to any requests </li></ul></ul><ul><ul><li>Separate your need from your desires </li></ul></ul><ul><ul><li>State a willingness to cooperate in finding a solution and then match behaviors to words and persist in the pursuit of a solution </li></ul></ul>
  23. 23. Workplace Communication <ul><li>Coworkers </li></ul><ul><ul><li>Report patient information accurately, informatively, and succinctly </li></ul></ul><ul><ul><li>Remember professional courtesies </li></ul></ul><ul><ul><li>Be mindful of an appropriate time and place to share your concerns </li></ul></ul><ul><ul><li>Do unto others as you would have them do unto you </li></ul></ul><ul><ul><li>Delegate clearly and effectively </li></ul></ul><ul><ul><li>Offer positive feedback </li></ul></ul>
  24. 24. Workplace Communication <ul><li>Physicians, nurse practitioners, and other health care professionals  </li></ul><ul><ul><li>Strive for collaboration, keeping the patient goal central to the discussion </li></ul></ul><ul><ul><li>Present information in a straightforward manner </li></ul></ul><ul><ul><li>Remain calm and objective even if the physician does not cooperate </li></ul></ul><ul><ul><li>Follow the institution’s procedure for getting the patient treated and then document the actions taken </li></ul></ul>
  25. 25. Workplace Communication <ul><li>Patients and families </li></ul><ul><ul><li>Use touch as a way to communicate caring and concern </li></ul></ul><ul><ul><li>Occasionally, language barriers will limit communication to the nonverbal mode </li></ul></ul><ul><ul><li>Be open and honest while respecting patients and families </li></ul></ul><ul><ul><li>Honor and protect patients’ privacy with both actions and words </li></ul></ul>
  26. 26. Workplace Communication <ul><li>Between mentor and prodigy </li></ul><ul><ul><li>Mentor’s wisdom shared through counseling, encouraging and seeking the novice out </li></ul></ul><ul><ul><li>Mentor can anticipate challenges for novice and make suggestions for how to manage them </li></ul></ul><ul><ul><li>Use role-playing, where the mentor describes a theoretical situation and allows the novice to practice her response </li></ul></ul>