Effective Communication Between Doctor and Patient

Table of Contents
Table of Contents .....................................................................................................................................................1

CHAPTER 1 : BRAINSTROMING AND COGNITIVE STRATEGY ..................................................................3
1.1
MAIN PROBLEMS ..................................................................................................................................3
1.2
KEYWORDS ............................................................................................................................................3
1.3
EARLY HYPOTHESIS ............................................................................................................................3
1.4
ADDITIONAL QUESTIONS OR INFORMATION ...............................................................................3
1.5
LEARNING ISSUES ................................................................................................................................3
CHAPTER 2 : PROBLEM ANALYSIS ..................................................................................................................4

2.1
THE ANSWER OF LEARNING ISSUES ...............................................................................................4
2.1.1
Definition of Communication skill ...................................................................................................4
2.1.2
Definition of effective communication between doctors and patients..............................................4
2.1.3
How communication between doctors and patients can be done effectively ...................................5
2.1.4
Methods to Improve Doctors Communication Skill .......................................................................7
2.1.5
How communication skill can affect effectiveness of the communication between doctors and
patients ................................................................................................................................................
..........................................................................................................................................................8
2.1.6
Definition of health outcomes .................................................................................................... 10
2.1.7
How communication skill can affect in health outcomes. ............................................................. 10
2.1.8
How patients openness can affect effectiveness of the communication between doctors and
patients. .......................................................................................................................................... 12
2.2
TWO STORIES REPRESENTING EFFECTIVE AND INEFFECTIVE PATIENT PHYSICIAN
INTERACTION/COMMUNICATION BASED ON THE EXPLORATION RESULT OF DOCTORPATIENT INTERACTION EXPERIENCE ..................................................................................................... 13
2.2.1
Effective Communication .............................................................................................................. 13
2.2.2
Ineffective Communication ........................................................................................................... 14
2.3
SUMMARY OF LITERATURE REVIEW .......................................................................................... 15
CHAPTER 3 : PROBLEM SOLVING ................................................................................................................. 17

3.1
CONCEPT MAPPING AND FINAL HYPOTHESIS .......................................................................... 17
3.1.1
Concept Mapping .......................................................................................................................... 17
3.1.2
Final Hypothesis ............................................................................................................................ 18

1
PBL Group 9B Medical Faculty of Airlangga University

Human Interaction Module
3.2
DESCRIPTION OF CONCEPT MAPPING ......................................................................................... 18
4.1
REFERENCE ........................................................................................................................................ 19
4.2
APPRAISAL ......................................................................................................................................... 21
4.4
APPENDIX ........................................................................................................................................... 26
2
CHAPTER 1 : BRAINSTROMING AND COGNITIVE STRATEGY
1.1 MAIN PROBLEMS

Lack of effective communication between doctors and patients in determining final decision of
the treatment(s).
1.2 KEYWORDS
Effective Communication, Communication skill of Doctors, Health outcomes, Patients
openness, Final Decision of Treatment(s)
1.3 EARLY HYPOTHESIS
Communication skill of doctors and patients activeness can affect the effectiveness of the
communication in final decision of treatment(s) taken.
1.4 ADDITIONAL QUESTIONS OR INFORMATION
There are no additional questions or informations that we need.
1.5 LEARNING ISSUES
1. What is communication skill?
2. What is effective communication between doctors and patients?
3. How can communication between doctors and patients done effectively?
4. What methods which can be used to improve doctors communication skill?
5. How can communication skill affect effectiveness of the communication between doctors and
patients?
6. What is health outcomes?
7. How can communication skill affect in health outcomes?
8. How can patients openness affect effectiveness of the communication between doctors and
patients?
3
CHAPTER 2 : PROBLEM ANALYSIS
2.1
THE ANSWER OF LEARNING ISSUES

2.1.1
Definition of Communication skill

Communication skill is our ability to exchange ideas, information, feelings,
attitudes, or beliefs and impressions with others, understand others' perspectives and
solve problems. Communication skills can involve verbal, nonverbal, and paraverbal
components. The verbal component refers to the content of our message the choice and
arrangement of our words. The nonverbal component refers to the message we send
through our body language. The Example for non verbal component included eye
contact, body language, muscle tension, posture, mannerism, and proxemics. The
paraverbal component refers to how we say what we say like the tone, pacing and
volume of our voices (Peer Centre, 2014).
We should improve our communication skills. The important one to improve our
communication skills is to develop our listening skills. Developing our listening skills
involves two specific steps i.e. dealing with barriers that prevent you listening and
developing and using listening behaviours. There are various barriers to listening,
including jumping to conclusions; hearing what we want to hear; rehearsing our
response and being inattentive (Dixon, Tara, Ohara, Martin, n.d.)
2.1.2
Definition of effective communication between doctors and patients

Effective communication is communication process between doctor and patient
which occurs well and is influenced by health messages. Good communication built by
doctor and patient can be the success key for doctor in giving medical service.
Otherwise, if doctor fail to give medical service, he can make good communication with
patient, thus conflict and miscommunication will not rise.
In process to reach a successful effective communication, doctor and patient
communication exchange is one of the key factors. Doctor must have communication
skill to communicate with his patient. There are three objectives why doctor must
4
communicate with his patient: (1) creating a good interpersonal relationship (2)
exchange of information (3) medical decision making. (Arianto, 2013)
2.1.3
How communication between doctors and patients can be done effectively

Effective doctor-patient communication is a central clinical function, and the
resultant communication is the heart and art of medicine and a central component in the
delivery of health care. The three main goals of current doctor-patient communication
are creating a good interpersonal relationship, facilitating exchange of information, and
including patients in decision making. Effective doctor-patient communication is
determined by the doctors bedside manner, which patients judge as a major
indicator of their doctors general competence. Good doctor-patient communication has
the potential to help regulate patients emotions, facilitate comprehension of medical
information, and allow for better identification of patients needs, perceptions, and
expectations (Ha and Longnecker, 2010).
There are several ways to improve the effectiveness of patient-doctor
communication.
1. ACTIVE LISTENING
Encourage the patient to tell his/her story of the illness, through the restatement of
information in the patient's own words, and the development of open ended
questions during the medical interview.
2. NONVERBAL COMMUNICATION
Effective use of nonverbal communication can help develop an environment of
support, comfort, trust, and security. Frequent eye contact and periods of welltimed
silence are examples of methods that can enhance the interview.
3. AGENDAS
Patients and physicians may approach the appointment with somewhat different
agendas. The physician's agenda may help patients accept the diagnosis of a
functional disorder and to consider symptom management. The patient, on the other
hand, might come to the appointment seeking a specific diagnosis, a cure, or the
reassurance that they do not have cancer. Therefore, it is important for both
physician and patient to communicate their agendas at the onset of the appointment.
To facilitate this, physicians can ask several questions such as: "What do you think
5

is going on, what are your concerns and fears, and how can I be of most help to you
at this time?"
4. EMPATHIZE
The physician should acknowledge the difficulty patients experience in trying to
manage their pain as they struggle to perform jobs, maintain their roles within the
family, and validate their disorders to themselves and others. Patients who have
experienced major psychosocial loss or trauma (e.g., abuse history) might find it
embarrassing to discuss these issues. For this reason, it is important for the
physician to validate the patients feelings without making a personal judgment or
offering a quick solution. Furthermore, mentioning how studies have shown a link
between traumatic events and GI disorders can increase patient's understanding of
the issue. Empathy means demonstrating an understanding of the patient's pain and
distress while maintaining an objective and observant stance.
5. EDUCATING PATIENTS
Education plays a crucial part in a good doctor patient relationship. Education
involves a dialogue where the physician elicits the patients thoughts, feelings and
beliefs, and then provides new information consistent with the patients needs and
interests. Providing written materials can be particularly helpful in supplementing
and enhancing the information obtained from the physician during the appointment.
6. REASSURANCE
Identifying and legitimizing a patients concerns and worries without offering false
reassurances can help comfort the patient. It puts them at ease by knowing that the
physician has a commitment to them and recognizes their emotions as important and
their disorder as real and not "in their head."
7. AGREEING ON A TREATMENT PLAN
After the medical interview and physical exam are completed, it is important for the
patient and physician to agree upon a treatment plan. The physician should take into
account the patient's personal experiences and life style, and provide choices that are
consistent with these factors.
6
8. TAKING RESPONSIBILITY
It is important to have the patient acknowledge their role in managing their pain,
symptoms and treatment. The physician should ask the question "how are you
managing your symptoms," rather than "how is your pain." This shifts the
responsibility for pain and symptoms management from the doctor to the patient
and helps patients acknowledge their role in their care.
9. AVOID OVERREACTING
Some patients may appear demanding, dependent or even adversarial. It is the
physician's responsibility to not overreact in these situations. This can be achieved
by establishing limitations (boundaries) on what can be provided and suggesting
appropriate ways for the patient to contact the physician. Physicians should address
unrealistic demands, frequent phone calls or inappropriate requests for narcotics in a
timely fashion before this type of behavior escalates into impulsive actions from the
patient. Feelings and emotions should be addressed honestly, thereby facilitating
communications between the doctor and patient on a positive level and helping to
avoid conflict.
10. ESTABLISHING BOUNDARIES
Frequent phone calls, unscheduled visits, and unrealistic expectations are ways in
which some patients lose perspective on the shared responsibility for their care.
Doctors need to establish boundaries for patients in a way that does not belittle
them. Scheduling brief return appointments can meet the needs of patients, while
helping the physician set boundaries as to when and how often he/she will be
accessible for out of the office contact (Drossman and Swantkowski, 2014).
2.1.4
Methods to Improve Doctors Communication Skill

Doctors are not born with excellent and perfect communication skills. They
have different innate talents. Communication skills involve both style and content.
Improved the communication skills between doctors and patient tends to increase patient
involvement and adherence to recommended therapy; influence patient satisfaction,
adherence, and health care utilization; and improve quality of care and health outcomes.
Besides that, sometimes in sample of cases, there is a miscommunication happen.
Miscommunication has serious implications, as it may hinder patients understanding,
7

expectations of treatment, or involvement in treatment planning. In addition,

miscommunication decreases patient satisfaction with medical care, level of
hopefulness,
and
subsequent
psychological
adjustment.
To
prevent
the
miscommunication cases like that, we need methods to improve the communication skill
between doctors and patient.
1. Communication Training.
Communication skills training has been found to improve doctor-patient
communication. However, improved behaviours may lapse over time. It is therefore
important to practice new skills, with regular feedback on the acquired behaviour.
Some have said that medical education should go beyond skills training to encourage
physicians responsiveness to the patients unique experience.
2. Collaborative Communication
The Collaborative communication is reciprocal and dynamic relationship, involving
the 2-way exchange of information. In an ideal world, doctors should collaborate
with their patients to provide the best care because doctors tend to make decisions
based on quick assessments, which may be biased. This requires the doctors to take
time or set up opportunities to offer and discuss treatment choices to patients and
share the responsibility and control with them. Successful information exchange
ensures that concerns are elicited and explored and that explanations of treatment
options are balanced and understood to allow for shared decision making. In this
approach, the doctor facilitates discussion and negotiation with patients and the
treatment options are evaluated and tailored to the context of the patients situation
and needs, rather than a standardized protocol. Care options need to be collaborative
between doctor and patient, taking into account patient expectations, outcome
prefer-Example of influences that a patient takes into account on the doctors advice.
(Ha and Longnecker, 2010)
2.1.5
How communication skill can affect effectiveness of the communication between
doctors and patients.

To establish an effective communication between doctor and patient, good
communication skill is essentially needed. Many studies had shown that communication
skill have a positive impact in effectiveness of the communication, thus furthermore
8
have a positive impact in the health outcomes. Doctors communication skill is

associated with patients' emotional distress and improving doctor's communication skill
is associated with a reduction in emotional distress in patients. (Wong and Lee, 2006)
Another study showed that communication and good doctor-patient relationship
are important in improving patients satisfaction with health service. Uses of more
statement of orientation, including educating patients about what to expect and the flaw
of visit, soliciting patients opinion, checking understanding, and encouraging patients
to talk, results in less patients complaints and claims. (Levinson et al. cited in Wong
and Lee, 2006)
Doctors good communication skill builds trust in patient-doctor relationship,
helps patient disclose information, enhances patient satisfaction, involves the patient
more fully in health decision making, and helps the patient make better health decisions.
Thus, leads to more realistic patient expectations, produces more effective practice, and
reduces the risk of errors and mishaps. (Communicating with Patients: Advice for
medical practitioners, 2014)
Effective doctor-patient communication is a central clinical function in building
a good doctor-patient relationship. This is important in the delivery of high-quality
health care. Much patient dissatisfaction and many complaints are due to breakdown in
the doctor-patient relationship. (Ha and Longnecker, 2014)
A doctors communication and interpersonal skills encompass the ability to
gather information in order to facilitate accurate diagnosis, counsel appropriately, give
therapeutic instructions, and establish caring relationships with patients. These are the
core clinical skills in the practice of medicine, with the ultimate goal of achieving the
best outcome and patient satisfaction, which are essential for the effective delivery of
health care. (Ha and Longnecker, 2010)
Good doctor-patient communication has the potential to help regulate patients
emotions, facilitate comprehension of medical information, and allow for better
identification of patients needs, perceptions, and expectations. Patients reporting good
communication with their doctor are more likely to be satisfied with their care, and
especially to share pertinent information for accurate diagnosis of their problems, follow
advice, and adhere to the prescribed treatment. Patients agreement with the doctor
9
about the nature of the treatment and need for follow up is strongly associated with their
recovery. (Ha and Longnecker, 2010)
Doctors with better communication and interpersonal skills are able to detect
problems earlier, can prevent medical crises and expensive intervention, and provide
better support to their patients. This may lead to higher-quality outcomes and better
satisfaction, lower costs of care, greater patient understanding of health issues, and
better adherence to the treatment process. There is currently a greater expectation of
collaborative decision making, with physicians and patients participating as partners to
achieve the agreed upon goals and the attainment of quality of life. (Ha and Longnecker,
2010)
2.1.6
Definition of health outcomes

Health outcomes is the result of the health status of the patient after undergoing
a selective method of medication from the inform consent between the doctor and the
patient. The health outcomes varies between a good health outcomes and a bad health
outcomes. A good one means that the health status of the patient is increased, thus the
patient will be healthy. A bad one means that the health status of the patient is worse,
thus the patient illness will be worse than before. So, the health outcomes will decide the
quality of life on a human. (Garratt, 2002)
2.1.7
How communication skill can affect in health outcomes.

Effective communication is an important component of patient care. Having a
good communication can help doctor to establish good conversation between patient and
doctor. So it can impact on better health outcome (Stewart, M. A., 1995). The studies
reviewed that effective communication between patient-doctor exerts a positive
influence not only on the emotional health of the patient but also ion symptom solution,
functional and physiologic statue and pain control. Beside that doctor attitude toward his
patient, his ability and his knowledge to elicit and respect the patients attention, the
provision of appropriate information and the demonstration of empathy and trust of
patient are the key aspect of better compliance with medical treatments in patient.
For example, doctor should ask some questions, not only about physical aspects
of the patients problem but also about the feelings and the concerns, understanding the
10

problem. After that the doctor may give a solution and give options on what should
patient do, may be do therapy or something like that. Because the patient need to feel
that they are active participants in care and feel satisfaction that their problem has been
discussed and fully solved.
Patient should share in decision making when a plan for management is
formulated. They should be encouraged to ask some questions and they need clear
verbal information. Agreement among patient, patients family, and doctor about the
nature of the problem and the course of action appears to bode well for a successfully
outcomes.
There are several factors that influence good communication. First is
communication skill of doctor. The effect of communication skill training on the process
and outcome of care associated with patients emotional distress. Beside that effective
communication can reduce in emotional distress in patient. So it can make a positive
impact on patient satisfaction in health care (Shukla, A.K., et al, 2010).
Effective communication is high correlated with patient satisfaction with healthcare services. When patient feel satisfaction automatically health outcomes will increase.
Good communication is one step to reduce medical malpractice claims. Because when
we wrong to say something and the patient miscommunication, so it can make patient
will be worry with the doctor. And the patient will think that the doctor do malpractice.
So it will increase the number of complaint of the patient for doctor and enquiries
received by the regulatory bodies, and a rise in consumerism in medicine. From here we
know how important of effective communication between patient-physician it is
(Shukla, A.K., et al, 2010).
Beside that, lack of explanation may cause patient misunderstanding. However as
a physician, we need to listen completely what the patient say. We need to listen with
both ears. This is a symbol that the doctor respect what patient says. One ear used to
receive biomedical and another one to receive psychosocial information. Therefore the
patient feels comfortable with the physician. Transcultural awareness also plays an
important role in effective doctor-patient communication. It includes appropriateness of
eyes contact, hand gestures, cultural beliefs surrounding the ill, and physical contact
between sexes (Shukla, A.K., et al, 2010).
11
Thus, effective patient-doctor communication can impact on several aspects of

health outcomes, higher compliance to therapeutic regimens in patient, higher
satisfaction of the patient include the service and the facility, and decreases malpractice
claims. Start from medical education to emphasis the importance of communication
between patient-doctor, start to know technique of communication skill in many
undergraduate and postgraduate learning program.
2.1.8
How patients openness can affect effectiveness of the communication between doctors
and patients.
Several studies have clearly shown that doctors and patients have different views
on what makes good and effective communication. Patients today are health consumers
and want to be active participants in medical decision making. Good doctor-patient
communication offers patients tangible benefits. Many studies have found significant
positive associations between doctors communication skills and patients satisfaction.
Several studies and reviews clearly show a correlation between effective communication
and improved health outcomes. The outcomes affected were emotional health, resolution
of symptoms, function, pain control, and physiological measures such as blood pressure
and blood sugar concentration.
Learning communication skills in times of change and uncertainty depends on an
emotional openness to self and others. Medical educators should use knowledge of
patients perceptions of care to focus teaching on areas that will help trainees to meet
patients expectations. Teaching communication skills should be included at all levels of
medical education and, even more importantly, should be a mandatory element of the
medical school curriculum and programmes of continuing medical education. This can
be achieved only with the support of all grades of doctors in all specialties. (Meryn,
1998)
12
2.2
TWO STORIES REPRESENTING EFFECTIVE AND INEFFECTIVE PATIENT

PHYSICIAN INTERACTION/COMMUNICATION BASED ON THE EXPLORATION
RESULT OF DOCTOR-PATIENT INTERACTION EXPERIENCE
2.2.1
Effective Communication
About 3 months ago, Rana was suffering from headache, high fever, and pain in
the stomach. Rana also went to a doctor to get checked for illness she suffered. Arrived
at the doctor's office, Rana was welcomed to come in and see the doctor to be checked.
With a warm greeting and a smile, the doctor allowed Rana to sit down and then the
doctor introduced himself as dr. Emil. With a polite tone, dr. Emil asked for her name
and age. After made a note about Ranas data, dr. Emil allowed her to explain the
symptomps she felt. Rana begun to tell the symptoms, "I feel a heavy dizzy, since a few
days ago I have had a fever and my temperature is quite high, I also feel pain in my
stomach. I've been taking medicine for fever and ulcer drugs because at first I thought I
was sick in the stomach because of usual ulcer. While Rana was telling what she felt,
dr. Emil never interrupted Rana slightest. Dr. Emil was listening patiently and carefully.
After hearing the grievances felt by Rana, dr.Emil asked some habits that usually
done by Rana, such as how many times she eats in a day and the types of food that she
likes to eat. Apparently Rana eat twice a day and likes to eat spicy foods. After that,
dr.Emil continued to the examination by asking Rana lying in bed then examining
carefully and cautiously. After dr.Emil checked the ptient, he asked her to back to her
seat.
Dr.Emil honestly said that he can not ensure what illness that she suffered only
from Ranas symptomps. Dr.Emil asked Rana to undergo further physical check in
laboratory to obtain more accurate result, and he also asked Rana to not eat spicy foods
until her condition get better and have an enough rest to recover her health. Then,
dr.Emil prescribed medications to relieve pain she felt. Dr.Emil also offered a powder
drug if Rana can not take tablets drugs. After giving the prescription to Rana, dr.Emil
ascertain if Rana has completely perceive and feel satisfied with his service or not. Rana
were satisfied upon checked by dr.Emil, because he provided good service and very
13
careful in making decisions. Although dr.Emil can not be sure the illness of Rana, but it
was a thoughtful gesture that the dr.Emil did, he has upheld the values of medical ethics.
2.2.2
Ineffective Communication
One day, there was a patient named Rana. She experienced abdominal pain after
undergone an event on his campus. Then, Rana paid a visit to a doctor in a private hospital.
There, Rana met a doctor named Lulu. The doctor did not answer Ranas greeting. The patient
asked some questions to the doctor. But the doctor didnt hear the patient well and always
directly interrupted and asked some information that was important in the anamnesis process.
Then the doctor was quickly prescribe and forcing patients to comply. All of it goes quickly,
less than 2 minutes. Eventually, the patient came out with a disgruntled face and taking
prescription medication.
Rana swapped prescription given by the doctor at a drugstore. There, he met a
pharmacist named Fildzah. Rana gives the recipe while telling about the pain she suffered.
When the pharmacist read the prescription, she was at odds with the prescription she read. She
was given a prescription which is not in accordance with the patient's pain suffered. However,
because the patient insisted on receiving the drug, the pharmacist accepted to make the drugs.
As the non-generic drug prices are very high, the patient would be forced to buy the drug. And
finally, the patient was going home and his daily medication.
A week later, Rana was still experiencing the same pain. Sore that did not healed made
she stirred back to the same doctor, dr. Lulu. There, Dr. Lulu was not surprised. He immediately
gave the new prescription to Rana, with him wondered Rana out just like last week.
Outside the office, Rana shocked. Because she had only few money left, while the price
of the drug would certainly be more expensive, because those are non-generic antibiotics.
Suddenly, the nurse who always worked in that hospital came to Rana. There, the nurse
introduced her self, and her name was Oretha. Nurse Oretha asked the patient about the pain she
suffered. Oretha did so, because she knew that Rana visited the same doctor twice. And just
now, she saw Rana was holding the prescription paper. From there she noticed something odd.
Nurse Oretha found out that the given drug was a drug with more expensive prices, and was
14
given in a dose that does not fit. Oretha also talked about dr. Lulu who turns out to be a private
doctor who had just graduated. Rana felt sad and disappointed, she also planned to go to another
doctor, which is more reliable for sure.
2.3
SUMMARY OF LITERATURE REVIEW

Communication skill is the ability to exchange ideas, information, feelings, attitudes, or
beliefs and impressions with others, understand others' perspectives and solve problems.
Improved communication skill between doctors and patients tends to increase patient
involvement and adherence to recommended therapy, influence patient satisfaction, adherence,
and health care utilization. To prevent miscommunication cases that have serious implications,
we need methods to improve the communication skill between doctors and patient i.e.
communication training, and collaborative communication.
Effective doctor-patient communication is a central clinical function. To establish an
effective communication between doctor and patient, good communication skill is essentially
needed. Many studies had shown that communication skill has a positive impact in
effectiveness of the communication. Doctors good communication skill builds trust in patientdoctor relationship, helps patient disclose information, enhances patient satisfaction, involves
the patient more fully in health decision making, and helps the patient make better health
decisions.. Effective doctor-patient communication is determined by the doctors bedside
manner, which patients judge as a major indicator of their doctors general competence.
There are several ways to improve the effectiveness of patient-doctor communication, like
active listening, communicate with nonverbal communication, emphatize, educating patients,
reassurance, agreeing on treatment plan, taking responsibility, avoid overreacting, and
establishing boundaries.
Effective communication is an important component of patient care. Doctors with better
communication and interpersonal skills are able to detect problems earlier, can prevent
medical crises and expensive intervention, and provide better support to their patients. Beside
that, having a good communication can help doctor to establish good conversation between
patient and doctor. This may lead to higher-quality outcomes and better satisfaction, lower
costs of care, greater patient understanding of health issues, and better adherence to the
15
treatment process. The studies reviewed that effective communication between patient-doctor
exerts a positive influence not only on the emotional health of the patient but also ion
symptom solution, functional and physiologic statue and pain control. So, effective
communication can impact on better health outcomes.
16
CHAPTER 3 : PROBLEM SOLVING
3.1 CONCEPT MAPPING AND FINAL HYPOTHESIS

3.1.1 Concept Mapping
Communicant
Verbal
Communication
Media
Para verbal
Communicator
Education and
training
Nonverbal
Doctor-patient
communication
Still need be
improved
In reality
Doesnt
care
Sullen
Non effective
Bad Speaking skill

Miscommunication
Bad Listening skill

Ignorance
Effective
Smile
Good doctor
communication skill
Good Listening skill
Full attention
Welcome
Good Speaking skill
Clarification
Patients
dissatisfaction
Complaint
Patient satisfaction
Claims
Video tutorial on how

to be a good doctor
Introduction
Bad doctor
communication skill
Malpractic
e
More practice
Low health
outcomes
Patient activeness
Active
ask to
doctor
Active give
information
No complaint
Efficient time
No claims
Health outcomes
Effective
treatment
PROBLEMS IS SOLVED
17
3.1.2 Final Hypothesis
Effective communication between doctors and patients can enhance the accuracy in
determining disease and treatment by the doctors. Effective communication are
affected by communication skill of the doctors, patients activeness to ask and
openness to tell ehat he feels.
Effective Communication that suggested are :

-
Acquantanceship
Hear the patient well
Explain in detail according to how far the patient wants to know with a language
that the patient can easily understand
Ascertain the patient can understand the doctors explanation well
3.2 DESCRIPTION OF CONCEPT MAPPING

Communication is an activity in which we can give and get some information.
Communicator, communicant, media are several roles included in communication.
Communication is divided on three kinds; there are verbal, paraverbal, and nonverbal.
Communication happens anywhere, for example communication between doctor and patient. In
reality doctors-patients communication effectiveness is still low. Doctors communication skill
need to be improved by education and training on communication, more practice, and video
tutorial on how to be a good doctor. Communication between doctor and patient can occurred as
a non effective communication or an effective communication. Non effective communication
caused by bad doctor communication skill such as bad listening skill, bad speaking skill, etc.
Therefore, sometimes misscomunication and ignorance happen in this communication. But not
rearly, communication between doctors and patients can be done effectively. There are several
factors that influence, such as good listening skill, good speaking skill, and patient activeness. If
all aspect can be practiced maximally, patient will feel satisfied and thus health income will
increase. In other side, if all aspect does not work well of course patient will feel dissatisfied
and health outcomes will decrease.
18
CHAPTER 4 : CRITICAL APPRAISAL
4.1 REFERENCE
Arianto, A. (2013). KOMUNIKASI KESEHATAN (Komunikasi Antara Dokter Dan Pasien).
[online]
Available
at:
http://jurnalilkom.uinsby.ac.id/index.php/jurnalilkom/article/view/42/36 [Accessed 8 Oct.

2014].
Communicating with Patients Advice for medical practitioners. (2014). 1st ed. [ebook]
Available
at:
http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/e58.pdf
[Accessed 26 Oct. 2014].

Dixon,
Tara,
Ohara,
Martin.
Communication
Skills.
[online]
Available
at:
http://cw.routledge.com/textbooks/9780415537902/data/learning/11_Communication%20S
kills.pdf [Accesed 22 Oct. 2014].
Drossman, D. and Swantkowski, D. (2014). Improving the Doctor - Patient Relationship.
[online]
Available
at:
http://www.med.unc.edu/ibs/files/educational-gi-
handouts/Improving%20the%20Patient-Doctor%20Relationship.pdf [Accessed 25 Oct.

2014].
Garratt, A. (2002). Quality of life measurement: bibliographic study of patient assessed health
outcome
measures.
BMJ,
[online]
324(7351),
pp.1417-1417.
Available
at:
http://dx.doi.org/10.1136/bmj.324.7351.1417 [Accessed 22 Oct. 2014].

Ha, J. and Longnecker, N. (2010). Doctor-patient communication: a review. The Ochsner
Journal,
[online]
10(1),
pp.38--43.
Available
at:
http://www.ochsnerjournal.org/doi/pdf/10.1043/TOJ-09-0040.1 [Accessed 25 Oct. 2014].

Meryn, S. (1998). Improving doctor-patient communication: Not an option, but a
necessity. BMJ : British Medical Journal, [online] 316(7149), p.1922. Available at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1113402/ [Accessed 25 Oct. 2014].
Peer Centre. (2012). Introduction to Communication Skills. [online] Available at:
http://peer.hdwg.org/sites/default/files/1%20IntroductionToCommunicationSkillsCommunicationSkills-Peer_Training.pdf [Accessed 21 Oct. 2014].
19
Shukla, A. K., Yadav, V. S., & Kastury, N. (2010). Doctor-Patient Communication: An

Important but Often Ignored Aspect in Clinical Medicine, 11(3), 208211. [online]
Available at: http://medind.nic.in/jac/t10/i3/jact10i3p208.pdf [Accessed 21 Oct. 2014].
Stewart, M. A. (1995). I Effective Physician-Patient Communication And Health Outcomes: A
Review,
Can
Med
Assoc
J,
152(9),
14231433.
[online]
Available
at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1337906/ [Accessed 21 Oct. 2014].

Wong, S. and Lee, A. (2006). Communication skills and doctor patient relationship. Medical
Bulletin, 11(3), pp.7--9. [online] Available at: http://www.fmshk.org/database/articles/607
[Accessed 21 Oct. 2014].
20
4.2 APPRAISAL
4.3 V.I.A. Table (Validity, Importance, Applicability)
For
Searching
Informa Validity
answering
Method
tion
Founda
type
tion
Scholar.goo
Digital
Idea
om.uinsby.ac.i
gle.com and
(pdf)
d/
Reference
questions
http://jurnalilk
LI 1
Importance
Result Founda
Applicability
Result Founda
tion
tion
Content Yes
Is it
of
applica
search
Informa
ble?
komunikas
tion
Yes
Result
Doubt
i
kesehatan.
http://www.me LI 2
Scholar.goo
Digital
d.unc.ed
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
Effective
tion
Doubt
communicat
ion between
doctor and
patient
http://www.oc
LI 2
Scholar.goo
Digital
hsnerjournal.o
gle.com and
(pdf)
rg
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
Effective
tion
Doubt
communicat
ion between
doctor and
patient
http://www.nc
bi.nlm.nih.gov
LI 3
Scholar.goo
Digital
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
Doubt
21
search
Informa
Communic
tion
ble
ation
Skills,
Methods to
improve
doctors
communicat
ion skill.
www.peer.hd
LI 4
wg.org
Scholar.goo
Digital
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
communic
tion
Doubt
ation,
communic
ation
skills,
verbal
communicat
ion, non
verbal
communicat
ion,
paraverbal
communicat
ion.
www.cw.routl
edge.com
LI 4
Scholar.goo
Digital
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
communic
tion
Doubt
ation,
22
communic
ation
skills,
verbal
communicat
ion, non
verbal
communicat
ion,
paraverbal
communicat
ion.
http://www.nc
LI 5
Scholar.goo
Digital
bi.nlm.nih.gov
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
communic
tion
Doubt
ationskills,
effective
communicat
ion,
Doctors
communicat
ion skills.
www.nhmrc.g
ov.au/
LI 5
Scholar.goo
Digital
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
communic
tion
Doubt
ationskills,
effective
communicat
ion,
23
Doctors
communicat
ion skills.
www.fmshk.or LI 5
Scholar.goo
Digital
g/
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
communic
tion
Doubt
ationskills,
effective
communicat
ion,
Doctors
communicat
ion skills.
www.bmj.com
LI 6
Scholar.goo
Digital
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
Health
tion
Doubt
Outcomes
http://www.nc
LI 7
Scholar.goo
Digital
bi.nlm.nih.gov
gle.com and
(pdf)
search
Idea
Yes
Content Yes
Is it
of
applica
Informa
ble?
Doubt
tion
www.ncbi.nlm
.nih.gov
LI 8
Scholar.goo
Digital
gle.com and
(pdf)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
the effect
tion
Doubt
of effective
communicat
ion to health
outcomes
24
www.medind.
nic.in
LI 8
Scholar.goo
Digital
gle.com and
(Html)
Idea
Yes
Content Yes
Is it
of
applica
search
Informa
ble?
the effect
tion
Doubt
of effective
communicat
ion to health
outcomes
.
25
4.4 APPENDIX
1. Lukman Hakim
Apakah bapak memiliki pengalaman yang mengesankan saat berkunjung ke

dokter?
Jawaban : Ya, saya punya pengalaman yang mengesankan. Suatu saat ketika saya
sakit, saya melakukan kunjungan ke seorang dokter swasta. Kemudian saya ditanyai
beberapa pertanyaan mengenai kesehatan saya. Saya pun menjawab, dan dokter itu
bertanya secara normal dan cepat. Kemudian saya diberi resep dan selesai. Waktunya
terasa sangat cepat.
Peristiwanya adalah saya mengetahui apa yang sebenarnya seorang dokter pikirkan
ketika sedang dibelakang pasien nya. Meskipun dokter itu di depan saya terlihat normal,
namun ternyata tidak ketika sedang di belakang saya. Saya sangat kecewa dengan sikap
dokter tersebut.
Siapakah dokter yang bapak kunjungi?

Jawaban : Dokter yang saya kunjungi adalah seorang dokter yang masih muda. Beliau
ternyata adalah seorang dokter yang baru 3 tahun lulus dari pendidikannya.
Dimanakah bapak berkunjung dengan dokter itu?

Jawaban : Saya berkunjung kepada dokter itu di sebuah rumah sakit swasta, kebetulan
saya kenal dengan salah satu pegawai rumah sakit swasta itu. Sehingga sayapun
berkunjung berobat ke rumah sakit swasta itu.
Kapan bapak berkunjung ke dokter itu?

Jawaban : Saya berkunjung sekitar 4 tahun yang lalu.
Mengapa bapak merasa tersinggung dengan hal-hal tersebut?

Jawaban : Saya merasa tersinggung dan kecewa karena dokter tersebut tidak
memberikan pelayanan yang semaksimal ia bisa berikan. Setelah saya ketahui dari
teman saya, ternyata dokter itu memberikan obat yang tidak seefektif layaknya obat
yang lain. Dokter itu berkeinginan agar pasiennya kembali datang lagi dan membeli obat
lagi. Sepertinya itu merupakan strategi ekonomis. Dan saya sebagai pasien merasa
dirugikan.
26
Bagaimana saran bapak agar masalah ini tidak terulang lagi kedepannya?
Jawaban : Saran saya adalah memerbaiki kompetensi dokter yang sudah ada. Memang
boleh seorang dokter untuk berorientasi pada bisnis. Namun orientasi tersebut tidak
boleh merugikan pasien manapun. Karena pada hakekat nya, seorang dokter ada untuk
melayani pasien. Bukan untuk mempermainkan pasien.
2. Fildzah Dini Atikah S
Selamat malam. Perkenalkan nama saya Fildzah Dini Atikah, mahasiswa fakultas
kedokteran Universitas Airlangga. Bolehkah anda menjadi narasumber saya
mengenai kemampuan komunikasi dokter ?
Jawaban : Iya, silahkan.
Terima kasih. Baik, pertama apakah anda pernah konusltasi ke dokter ?

Jawaban : Iya, baru kemarin saya konsultasi ke dokter.
Bagaimana menurut anda mengenai dokter ?

Jawaban : Menurut saya, dokter sangat baik dan ramah.
Mengapa anda mengatakan demikian ?

Jawaban : Karena selama saya mengunjungi rumah sakit dan bertemu dengan dokter,
dokter selalu bersikap sangat ramah kepada saya. Saya belum pernah bertemu dengan
dokter yang berkelakuan buruk di depan pasien.
Terima kasih, jadi menurut anda, apakah komunikasi dokter sudah baik ?
Jawaban : Iya, sudah sangat baik. Tapi, terkadang ada satu atau dua dokter yang
mengalami mis komunikasi dengan pasien.
Mengapa anda mengatakan demikian ? Bisakah anda berbagi pengalaman?

Jawaban : Iya, tetapi ini bukan pengalaman saya, melainkan pengalaman almarhumah
saudara saya. Semalam sebelum meninggal, dokter yang menangani menyuntiknya
tanpa memberitahu dan meminta izin kepada keluarga saya.
Apakah saya bisa tahu, almarhumah saudara anda disuntikkan apa ?

Jawaban : Maaf, saya juga kurang tahu. Tetapi, keluarga pasien yang lain mengatakan
bahwa hal itu telah menjadi malpraktik yang dilakukan oleh dokter.
Oh, baik. Saya minta maaf sebelumnya. Jadi, apa yang anda dapat simpulkan
terhadap kemampuan komunikasi oleh dokter Indonesia ?
27

Jawaban : Iya. Yang dapat saya simpulkan mengenai dokter Indonesia yaitu mereka
sudah sangat baik dan ramah kepada pasien, tetapi saya berharap, kasus pada
almarhumah saudara saya tidak terjadi lagi oleh dokter kedepannya.
Baik, semoga dokter Indonesia dapat jauh lebih baik kedepannya seperti yang
anda dan semua masyarakat harapkan. Terima kasih banyak atas waktunya. Saya
meminta maaf jika ada salah kata dan mengganggu aktivitas anda.
Jawaban : Sama-sama.
3. Rana Hanifah Harsari
Selamat malam mbak. Mohon maaf mengganggu waktu Anda. Apakah Anda ada
waktu luang untuk dapat menjadi narasumber saya?
Jawaban : Malam. Tentu, silahkan saja.
Saya ingin mewawancarai Anda perihal komunikasi antara dokter dan pasien.
Sebelumnya, apakah Anda memiliki pengalaman berkonsultasi dengan seorang
dokter?
Jawaban : Iya, kira-kira seminggu yang lalu saya pergi ke klinik untuk
menkonsultasikan masalah saya
Bagaimana sikap dan perilaku dokter tersebut saat berkonsultasi dengan Anda?
Jawaban : Menurut saya, dokter tersebut kurang menunjukkan keramahan kepada
pasien. Ini terlihat dari kesan awal yang ditunjukkan. Pada awal saya masuk ruang
periksa, dokter tersebut tidak menyapa atau menyampaikan sapaan/salam pada saya.
Selain itu, dokter tersebut tidak memperkenalkan diri terlebih dahulu dan tidak berusaha
mencari tahu nama saya, sehingga saya merasa kurang diperhatikan. Selama konsultasi,
dokter tersebut tidak menggunankan nama saya dalam sebutannya sehingga
menimbulkan kesan yang kurang dekat dengan pasien. Kemudian, dokter tersebut juga
tidak mempersilahkan saya untuk duduk di tempat yang disediakan. Oleh karena itu,
saya merasa kesan awal saya pada dokter tersebut kurang baik.
Bagaimana yang Anda rasakan saat berkomunikasi dengan dokter tersebut?

Apakah Anda puas dengan pelayanan dan konsultasinya?
Jawaban : Untuk masalah pelayanannya, saya rasa masih kurang. Selain yang telah
saya sebutkan sebelumnya, sang dokter tidak berusaha mendekatkan diri dengan pasien
28

dengan mengangkat topik-topik ringan yang dapat mejadikan suasana lebih nyaman.
Selain itu, dokter tersebut masih sempat mengecek smartphonenya di tengah
pembicaraan kami. Sebenarnya saya berkonsultasi dengan dokter tersebut sebanyak dua
kali, yang pertama saya sendiri dan yang kedua didampingi oleh orang tua saya. Pada
pertemuan pertama, sikap sang dokter sama seperti yang saya sampaikan sebelumnya,
namun pada pertemuan kedua, dokter tersebut lebih menunjukkan keramahan pada saya
dan orang tua saya. Untuk masalah konsultasinya, saya rasa sudah cukup baik. Terjadi
tanya jawab diantara saya dan dokter agar sang dokter memahami keadaan yang saya
alami. Saya cukup puas dengan analisis yang dilakukan dokter tersebut. Dokter tersebut
menjelaskan bagaimana penyakit tersebut bisa saya derita dan bagaimana perawatan
terbaik atas penyakit yang saya derita tersebut.
Apakah Anda dilibatkan dalam keputusan akhir tindakan treatment yang akan
Anda lakukan?
Jawaban: Saya memang tidak terlalu dilibatkan karena penyakit yang saya derita tidak
terlalu parah sehingga tidak memunculkan beberapa opsi yang harus saya ambil dalam
treatment saya. Dokter menjelaskan perawatan yang akan saya ambil dengan jelas,
sehingga saya dapat memahami , menerima, dan melakukan treatment tersebut .
Apakah Anda merasa konsultasi yang Anda lakukan tersebut dapat membantu
proses penyembuhan penyakit Anda?
Jawaban: Iya, saya rasa konsultasi tersebut sangat membantu saya sehingga saat ini
penyakit saya mulai perlahan sembuh. Namun yang sangat disayangkan adalah
pelayanan yang kurang ramah dari sang dokter membuat kesan yang kurang baik di mata
pasien.
Apakah yang Anda harapkan agar komunikasi antara dokter dan pasien dapat
berjalan dengan baik?
Jawaban : Selain memang dari kepandaiannya dalam menganalisis suatu penyakit,
dokter tersebut juga harus menerapkan sikap ramah pada pasien. Ingat kesan awal pasien
terhadap dokter sangat penting, baik bagi reputasi dokter itu sendiri maupun dalam
proses penyembuhan dari penyakit pasien yang datang kepadanya. Karena dengan
suasana yang nyaman, membuat pasien lebih rileks dan secara tidak sadar mengurangi
sakit yang dirasakan karena penyakitnya. Selain itu, setidaknya dokter berusaha
29

mendekatkan diri dengan pasien, sehingga pasien merasa nyaman dalam menceritakan
segala keadaan yang menyangkut tentang penyakitnya. Dengan begitu, proses
komunikasi (konsultasi) antara dokter dan pasien dapat berjalan dengan baik.
Baiklah.
Terima
kasih
mbak,
atas
kesempatan
yang
diberikan
untuk
mewawancarai Anda. Mudah-mudahan Anda dapat segera sembuh.

Jawaban : Sama-sama. Semoga tugas kuliah Anda dapat berjalan lancar.
4. Ibrahim Syamsuri
Hari ini saya akan mewawancarai anda tentang bagaimana kinerja dokter ,
apakah anda bersedia?
Jawaban : baik , saya akan menjawab sesuai yang pernah saya alami.
Aapakah anda pernah ke dokter ?

Jawaban : pernah.
Untuk apa kegiatan anda ke dokter tersebut ?

Jawaban : untuk mengecek kondisi badan saya , karena saya sedang tidak enak badan
pada saat itu.
Dan apakah ada kendala saat periksa di dokter tersebut ?

Jawaban : sebenarnya tidak terlalu terkendala , tapi yang saya rasakan bahwa dokter
nya agak terlalu cuek.
Maksud anda dokter nya cuek ?

Jawaban : dokter nya bermuka datar dan hanya bertanya yang diperlukan saja setelah
itu langsung memberi resep.
Boleh dijelaskan lebih detail ?

Jawaban : ketika itu saya sedang sakit , kondisi saya tidak enak badan dan tubuh saya
panas , maka saya langsung pergi ke puskesmas untuk memperiksakan kondisi saya ,
setelah menunggu saya dipersilakan masuk , saya langsung dipersilakan duduk tetapi
dengan bahasa yang agak tegang . Setelah itu dokter langsung menanyai bagaimana
kondisi saya , disaat ini saya sebenarnya senang bahwa dokter bertanya , tapi yang tidak
saya suka adalah bagaimana dokter tersebut menentukan keputusan secara cepat tanpa
bertanya hal yang lebih detail kepada saya bahkan dia langsung memberikan saya resep
padahal saya ingin bertanya lebih banyak lagi . jadi saya ragu untuk meminum obat
30

tersebut . Mungkin akibat pasien dia yang sangat banyak sehingga dia bekerja dengan
cepat tanpa peduli pribadi pasien.
Apakah ada dampak positif terhadap anda ?

Jawaban : ya alhamdulillah obat tersebut manjur , tetapi tetap saja saya tidak puas
dengan kinerja dokter.
Lalu bagaimana saran anda untuk dokter-dokter disana

Jawaban : saya berharap dokter-dokter di luar sana lebih all-out dalam menangani
pasien , lebih peduli dalam kondisi pasien , dan lebih ramah terhadap pasien , saya juga
berharap dokter tidak hanya mencari keuntungan semata tetapi juga peduli segala hal
tentang pasien seperti kepribadiannya.
Baik , terima kasih atas sarannya

Jawaban : oke.
5. Emil Prabowo
Bolehkah saya mewawancarai anda?

Jawaban : Boleh.
Siapa dokter yang anda percaya untuk berobat.

Jawaban : dr. S.
Dimanakah anda berobat?

Jawaban : Di tempat praktek di samping rumah di Jl. K.
Bagaimana kesan pelayanan dokter tersebut?

Jawaban : Memuaskan tapi sedikit terburu-buru.
Kapan terakhir berobat ke dokter tersebut?

Jawaban : Bulan Mei 2014.
Kenapa anda memilih berobat disana?

Jawaban : Karena tempatnya dekat, punya rekap medis.
Apa yang anda rasakan pada saat berobat di dokter tersebut?

Jawaban : Dokternya cukup komunikatif namun kurang sopan.
Apa kendala dan kekurangan dalam komunikasi dokter tersebut?

Jawaban : Dokter tersebut masih ada kekurangan pada cara berkomunikasi yang baik
dan nada yang tepat. Karena saya jujur orangnya agak mudah tersinggung dan saya
31

cukup tersinggung ketika beliau dalam memberikan pesan dengan nada yang menurut
saya tinggi. Dan saya tidak berani untuk mengatakan pada beliau. Namun saya cukup
puas dengan komunikasi pada perawat/pembantunya karena cukup membuat saya
paham dan lebih enak didengar.
Apa saran untuk cara dokter berkomunikasi?

Jawaban : Seharusnya dokter lebih membuat pasien tenang, apalagi pasien datang
dalam kondisi yang sakit. Dengan dokter yang baik dalam menyampaikan pesan maka
kita sebagai pasien akan lebih percaya pada dokter tersebut.
6. Nuzula Fikrin Nabila
Apakah dokter secara umum sudah berkomunikasi dengan baik?

Jawaban : Ya
Apakah dokter pernah memotong pembicaraan Anda? Jika ya, berapa kali?
Jawaban : Pernah, sekali dua kali.
Apa Anda memberikan informasi kepada dokter tanpa ditanya terlebih dahulu atau
harus ditanya?
Jawaban : Ditanya dulu
Apakah dokter terlihat acuh dengan apa yang Anda sampaikan?

Jawaban : Tidak, dokter terlihat mendengarkan dengan seksama dan penuh perhatian
Apakah dokter memberikan opsi treatment atau langsung pada satu pilihan saja?
Jawaban : Memberikan opsi
Apakah dokter memberikan opsi obat generic atau bermerk?

Jawaban : Ya
Apa dokter memberikan penjelasan tentang diagnosisnya?

Jawaban : Ya
Apa dokter memberikan penjelasan tentang kekurangan atau kelebihan tiap opsi
treatment atau obat?
Jawaban : Ya
Apa dokter menggunakan media untuk memperjelas informasi yang disampaikan?

Jawaban : Tidak, hanya berupa kata-kata saja
32

Apa dokter bertanya memastikan apakah Anda sudah memahami penjelasannya

atau belum?
Jawaban : Ya
Apa dokter mau menerima saran dari Anda atas treatment atau obat yang akan
diberikan?
Jawaban : Ya
Apa dokter memberikan sumber informasi lebih jauh jika Anda masih ingin tahu
lebih dalam tentang kondisimu?
Jawaban : Ya
Apa yang menurut Anda masih kurang dari proses komunikasi yang terjadi?
Jawaban : Tidak ada
7. Oretha Istiqomah Sunarto
Selamat malam saya mahasiswa univ airlangga disini saya ingin mewawancarai
anda mengenai pengalaman anda saat pergi kedokter untuk menyelesaikan tugas
EBL.
Sudah
berapakali
anda
pergi
kedokter?
Jawaban : kira-kira lebih dari dua puluh kali.
Kapan terakhir kali anda pergi kedokter?

Jawaban : sekitar tiga bulan yang lalu.
Apa
kesan
pertama
anda
saat
berkunjung
ke
dokter
tersebut?
Jawaban : saya merasa percaya karena dokternya beribawa.
Apa
pelayanan
pertama
yang
dilakukan
dokter
tersebut?
Jawaban : mengucapkan salam dan memperkenalkan diri.
Apa kalimat atau pertanyaan pertama yang dokter tersebut ucapakan kepada anda?
Jawaban : apa yang dirasakan?
Apa
keluhan
anda
saat
itu?
Jawaban : pusing berat, demam tinggi, nyeri pada perut.
Apakah anda merasa sudah mendapatkan waktu yang cukup untuk menyampaikan
keluhan
anda?
Jawaban : sudah
33
Apa yang dilakukan oleh dokter tersebut pada saat anda menyampaikan keluhan
anda?
Jawaban : mendengarkan dengan baik, tanpa penyelaan sedikitpun.
Apakah
anda
merasa
nyaman
dengan
tindakan
dokter
tersebut?
Jawaban : sudah
Setelah anda menyampaikan keluhan anda, apakah dokter tersebut memberikan

penjelasan secara jelas kepada anda mengenai penyakit yang anda derita?
Jawaban : iya
Media apa saja yang digunakan dokter tersebut untuk memberi penjelasan kepada
anda mengenai penyakit yang anda derita?
Jawaban : Hanya berupa kata-kata saja
Apakah setelah diberi penjelasan anda merasa lebih memahami tentang penyakit
yang
anda
derita?
Jawaban : iya
Apa
obat
yang
disarankan
oleh
dokter
tersebut?
Jawaban : saya lupa
Apakah dokter tersebut menyampaikan saran-saran lain kepada anda selain

pemberian
obat?
Jawaban : iya
Apa
yang
disaran
oleh
dokter
tersebut?
Jawaban : Banyak istirahat, jangan makan yang asem-asem atau pedes, makan yang
teratur.
Apakah menurut anda perlayanan yang dierikan oleh dokter tersebut sudah baik?
Jawaban : sudah
Apa harapan anda terhadap pelayanan dokter di Indonesia saat ini?

Jawaban : Sekarang ini banyak dokter yang telah lupa akan tugas utamanya sebagai
dokter yaitu, mengabdi kepada masyarakat. Jadi mereka cenderung melupakan kualitas
pelayanan yang membuat pasien merasa nyaman. Saya berharap dokter-dokter baru
dimasa depan memberikan pelayanan yang lebih baik, lebih ramah, dan lebih peduli
dengan kesehatan pasiennya.
34

8. Elsa Fauziyah
Selamat pagi, saya dari mahasiswa kedokteran Universitas Airlangga akan mengajukan
beberapa pertanyaan kepada anda,
Apakah anda bersedia?

Jawaban : Ya.
Apakah anda pernah berobat ke dokter?

Jawaban : Pernah.
Kapan terakhir anda ke dokter?

Jawaban : Dua tahun yang lalu.
Dimana dokter terakhir yang anda temui?

Jawaban : Di salah satu RS di Surabaya.
Bagaimana respon dokter pertama kali?

Jawaban : Ramah, baik.
Keluhan apa yang anda rasakan?

Jawaban : Panas tinggi, nyeri.
Apakah dokter memberikan options?

Jawaban : Ya.
Apa anjuran dokter?

Jawaban : Opname.
35

Apakah anda setuju dengan anjuran dokter?

Jawaban : Iya.
Kenapa anda setuju?

Jawaban : Karena sudah pernah pergi ke dokter itu, jadi sudah percaya.
Bagaimana layanan dari dokter?

Jawaban : Enak, bagus.
Apa yang anda rasakan?

Jawaban : Saya merasa nyaman.
36

Effective Communication Between Doctor and Patient

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Effective Communication Between Doctor and Patient

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Table of Contents

Table of Contents .....................................................................................................................................................1

MAIN PROBLEMS ..................................................................................................................................3

EARLY HYPOTHESIS ............................................................................................................................3

ADDITIONAL QUESTIONS OR INFORMATION ...............................................................................3

LEARNING ISSUES ................................................................................................................................3

CHAPTER 2 : PROBLEM ANALYSIS ..................................................................................................................4

THE ANSWER OF LEARNING ISSUES ...............................................................................................4

Definition of Communication skill ...................................................................................................4

Definition of effective communication between doctors and patients..............................................4

Methods to Improve Doctors Communication Skill .......................................................................7

Definition of health outcomes .................................................................................................... 10

How communication skill can affect in health outcomes. ............................................................. 10

Effective Communication .............................................................................................................. 13

Ineffective Communication ........................................................................................................... 14

SUMMARY OF LITERATURE REVIEW .......................................................................................... 15

CHAPTER 3 : PROBLEM SOLVING ................................................................................................................. 17

CONCEPT MAPPING AND FINAL HYPOTHESIS .......................................................................... 17

Concept Mapping .......................................................................................................................... 17

Final Hypothesis ............................................................................................................................ 18

PBL Group 9B Medical Faculty of Airlangga University

DESCRIPTION OF CONCEPT MAPPING ......................................................................................... 18

CHAPTER 1 : BRAINSTROMING AND COGNITIVE STRATEGY

1.1 MAIN PROBLEMS

CHAPTER 2 : PROBLEM ANALYSIS

THE ANSWER OF LEARNING ISSUES

Definition of Communication skill

Definition of effective communication between doctors and patients

How communication between doctors and patients can be done effectively

PBL Group 9B Medical Faculty of Airlangga University

Methods to Improve Doctors Communication Skill

PBL Group 9B Medical Faculty of Airlangga University

expectations of treatment, or involvement in treatment planning. In addition,

How communication skill can affect effectiveness of the communication between

doctors and patients.

have a positive impact in the health outcomes. Doctors communication skill is

Definition of health outcomes

How communication skill can affect in health outcomes.

PBL Group 9B Medical Faculty of Airlangga University

Thus, effective patient-doctor communication can impact on several aspects of

TWO STORIES REPRESENTING EFFECTIVE AND INEFFECTIVE PATIENT

SUMMARY OF LITERATURE REVIEW

CHAPTER 3 : PROBLEM SOLVING

3.1 CONCEPT MAPPING AND FINAL HYPOTHESIS

Bad Speaking skill

Bad Listening skill

Good Speaking skill

Video tutorial on how

3.1.2 Final Hypothesis

Effective Communication that suggested are :

Hear the patient well

Ascertain the patient can understand the doctors explanation well

3.2 DESCRIPTION OF CONCEPT MAPPING

CHAPTER 4 : CRITICAL APPRAISAL

http://jurnalilkom.uinsby.ac.id/index.php/jurnalilkom/article/view/42/36 [Accessed 8 Oct.

[Accessed 26 Oct. 2014].

handouts/Improving%20the%20Patient-Doctor%20Relationship.pdf [Accessed 25 Oct.

http://dx.doi.org/10.1136/bmj.324.7351.1417 [Accessed 22 Oct. 2014].

http://www.ochsnerjournal.org/doi/pdf/10.1043/TOJ-09-0040.1 [Accessed 25 Oct. 2014].

Shukla, A. K., Yadav, V. S., & Kastury, N. (2010). Doctor-Patient Communication: An

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1337906/ [Accessed 21 Oct. 2014].

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