Effective Communication Skills

Bambang Suhariyanto
Lab/SMF.Ilmu Kesehatan Kulit & Kelamin FKUJ/ RSD.Dr. Soebandi Jember

Cleverness Based - Medicine

The Good Physician treats the disease; The Greatest Physician treats patient who has the disease.
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Introduction (1)
Communication looks easy when it is done well. It requires empathy, an ability to listen and respond, and it requires time. There is convincing evidence that it is not always done well in the health service.

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Introduction (2)
Effective Communication : Patients' problems are identified more accurately; Patients are more satisfied and can better understand their problems; Patients are more likely to comply with treatment or lifestyle advice; Patients' distress and the vulnerability to anxiety and depression are lessened;
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Introduction (3)
Effective Communication : The overall quality of care is improved by ensuring that patients' views are taken into account; Fewer clinical errors are made; Patients are less likely to complain; There is a reduced likelihood of doctors being sued.
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Definition of Communication
Communication can be defined in many ways. In simple :
Informed transmitted A verbal or non-verbal message A process by which information is exchanged between individuals through a common system of symbols, signs, or behavior.

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Context of Communication
Intrapersonal communication Interpersonal communication Group communication Public communication Organizational communication (hierarchy) Mass communication

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INTRAPERSONAL COMMUNICATION

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Intrapersonal Communication (1)

In order to successfully communicate with others you must first learn to communicate with yourself. Intrapersonal communication is the most basic level of communication. You must understand who you are and what you think of yourself.

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Intrapersonal Communication (2)

Self-talk is the inner speech that includes the questions and comments you make to yourself. It is a powerful influence. You use it when you:
Think things through Interpret events Interpret messages of others Respond to your own experiences Respond to your interactions with others
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Intrapersonal Communication (3)

Positive self talk increases focus, concentration and performance.
If you believe you cannot do something, your brain will tell your body and it will shut down. When you stay encouraged and positive, your body will also respond in a positive way.
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Factors that influence personal perception & communication

Values reflect your priorities and what you think is important. Beliefs what one believes to be true that often helps you decide what to accept or reject Culture family, community, or organizations to which you belong Bias consistent attitude, viewpoint or pattern of perception. Prejudice preconceived judgment (to pre-judge on opinion rather than facts) Attitudes powerful influences that can be positive or negative. Expectations basing a judgment on what is expected rather than what actually happened. Knowledge what you know influences how your organize & interpret information.

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INTERPERSONAL COMMUNICATION

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Interpersonal Communication (2)

The main elements :
Sender : The Doctor / Physician Receiver : The Patients Message : Information

Medium
Direct medium (face to face interaction) Indirect medium (computer-mediated communication)

Successful interpersonal communication :

Sender and Receivers will interpret and understand the messages being sent on a level of understood meanings and implications.
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4 Basic Communication Tools

1. Listening
The most communication skill that must be developed

2. Speaking 3. Reading 4. Writing

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1. Listening Skills
Patient dont care how much you know, but they know how much you care .. by the way you listen.

Listening Skills
Listening is really where all good communication begins. Most of us are born with good hearing, but not good listening skills. Listening must be learned. Misunderstanding what patient is saying is one of the biggest obstacles to communication.

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Listening Skills : Barriers

Doctors can think faster than a patient can talk, and jump to conclusions; Doctors are easily distracted and allow their minds to wander; Doctors lose patience; Doctors overact to whats said & respond emotionally; Doctors often make interruptions .
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Listening Skills : Improvement (1)

Be aware about your self!!! Be patient for the entire message Be aware of speech cues
who, what, where, when, why, how

Listen for ideas, not just facts

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Listening Skills : Improvement (2)

Verify :
So, you are saying that . If I understand correctly, you said .

Question :
What do you mean when you say .

Acknowledge :
Look at the speaker and nod Occasionally say, hmmm or oh right
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Listening Skills : Improvement (3)

Silence :
Give your undivided attention to the patient Give some non-verbal cues that you are hearing,
Nodding your head Smiling Opening or closing your eyes

Remember :
Patients first need is simply to share their feelings and to have someone listen

Encourage :
Tell me more Would you like to talk about it?
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Listening Skills : Tips

3 tips to help you increase your ability to listen in 50% :
Look at the patient (benefit = 15%) Ask questions (benefit = 15%) Take notes (benefit = 20%)

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2. Speaking Skills
What to say & How to say it

Speaking Skills
Goals :
Get more information Verify message Clarify understand List the alternatives of problem solution

Type :
Open-ended questions Close-ended questions One-point solution questions
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Speaking Skills : VALUE tips Verify what is being said Acknowledge feelings Listen actively Use simple language Eliminate negative, judgmental words
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NONVERBAL COMMUNICATION (1)

To create impressions
Perceptions of competence and character

To manage interactions
Signaling turn-leave taking conversations

To express emotion To send relational message

Convey affection, power, respect, dominance
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NONVERBAL COMMUNICATION (2)

Unspoken More difficult to interpret than verbal messages Body language Often neglected during interpersonal communication Written Communication powerful & lasting

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NONVERBAL COMMUNICATION (3)

Body language :
It is estimated that over 75% of the messages we deliver are communicated non-verbally. Include : facial expressions, dress, and grooming style Simple body language :
Frown on your face A smile Crossing your arms Tapping your pen/fingers on a desk
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NONVERBAL COMMUNICATION (4)

Space : (accepted boundries)
Public space : 12 25 feet Social space : 4 12 feet Personal space : 2 4 feet Intimate space : 1 foot

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Communicate TO or Communicate WITH

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7 Elements of Communication
1. 2. 3. 4. 5. 6. 7. SENDER Formulating the Message MESSAGE Interpreting the Message RECEIVER Context of Communication Relationship between SENDER & RECEIVER
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Seven Elements of Communication

3. MESSAGE

6. CONTEXT

1. SENDER 7. RELATIONSHIP
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5. RECEIVER

7 Elements of Communication
1. SENDER Doctor (DERMATO-VENEREOLOGIST) 2. Formulating the Message 3. MESSAGE Disease, Distress, Disability, Other issues (BIO-PSYCHOSOCIAL-SPIRITUAL) 4. Interpreting the Message 5. RECEIVER Patient 6. Context of Communication Clinical Context 7. Relationship Doctor Patient Relationship

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Improving Communication Skills in Clinical Practice Through Simulation Training

http://www.fammed.wisc.edu/our-department/newsletter/winter-2007/simmersion

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The Goal of Effective Communication

Patient understand the message. Patients knowledge is increased. Patient change their attitude. Patient will have a new, healthier learned-behavior.
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TERIMA KASIH
Thank You
Thank You