Communication SkillsMBBS Semester I

Lab 2

Dr. Mahmood Y. HachimDr Abubakr H Mossa

2012

Outline • Steps of patient management • Patient-centered communication • Personal appearance • Timing• Setting • Getting started

– Greeting & naming – Demeanor (behavior)– Attitude – Questioning – Stay on topic – Eye contact – Note taking

Patient management

• History taking • Physical examination • Investigation • Treatment and follow up

Personal appearance-Dress

Extreme tastes in fashion to be avoided

Men wear (shirt and tie)

Women wear (skirt or trouser with shirt)

The belly and shoulders ( to be covered)

Hair conservatively styled, no hair over the face, wear long hair tied up.

Personal appearance-Accessories

Name badge to be visible Stethoscopes in coat pocketTry not to tuck items in your beltShoes shine and cleanClean surgical scrubs may be worn if appropriate.

Personal appearance and accessories

Timing Avoid an allocated quiet time

Avoid mealtimes

Avoid when the patient's long-lost relative visit.

Inform other when you take the patient from bed

Timing

Setting PrivacyQuiteComfortableNo intervening furniture Seating

Setting of the room

Greeting & Naming Shaking handsStandingRemember the nameTitle themTitle you

Demeanor Give the patient your full attention.Appear encouraging with a warm, friendly manner. Use appropriate facial expressions don't look bored!Define your roleAvoid medical jargon

Demeanour (behavior)

Attitudes ConfidentFriendlyCompetentTrustworthy.Be aware of a person's cultural background

Personal attitude

Style of questioning Prepare Your Clients for QuestionsOpen questions versus closed questionsMultiple choice questions Clarifying questionsDifficult questions with courtesy

? Questioning ?

Open questions versus closed questions• Open questions are those where any answer is possible• What's the problem? • How does it feel? • These allow the patient to give you the true answer in

their own words. • Be careful not to lead them with closed questions.• Compare How much does it hurt? to Does it hurt a lot? . • The former allows the patient to tell you how the pain

feels on a wide spectrum of severity, the latter leaves the patient only two options and will not give a true reflection of the severity

Multiple choice questions• Often, patients have difficulty with an open question if

they are not quite sure what you mean. • What sort of pain is it , What does it feel like, exactly?.• Give them a few examples but leave the list open-ended

for them to add their own words. • You must be very careful not to give the answer that you

are expecting from them. • For example, in a patient who you suspect has angina

( crushing pain), you could ask:• What sort of a pain is it burning, stabbing, aching, for

example?

Clarifying questions• Use clarifying questions to get the full details:• When you say dizzy, what exactly do you mean?

Difficult questions• Apologize for potentially offensive or embarrassing

questions:• I'm sorry to have to ask you this but

Staying on topic InterruptionsReflective commentsEye-contactAdjusting your mannerDon't take offence or get annoyed

Eye-contact• Make eye-contact and look at the patient when they are speaking.• In the medical situation, whilst the patient is speaking, you may be

tempted to make notes, read the referral letter, look at a test result, or similar you should resist and stick to the normal rules of eye-contact.

Adjusting your manner• You should try to adjust you manner and speech

according to the patient's educational level.• This is can be extremely difficult you should not make

assumptions on intellect or understanding solely on educational history.

• A safe approach is to start in a relatively neutral way and then adjust your manner and speech based on what you see and hear in the first minute or two of the interaction but be alert to whether this is effective and make changes accordingly.

InterruptionsApologize to the patient if you are interrupted.

Don't take offence or get annoyedAs well as being directly aggressive or offensive, people may be thoughtless in their speech or manner and cause offence when they don't mean to. As a professional, you should rise above this.

Reflective commentsUse reflective comments to encourage the patient to go on and reassure them that you are following the story:Yes, I see that.

Note Taking Not to interfere with interview Explain the purpose of note taking or not to take notes.Never hide or cover your notes Never write anything that you do not want them to read. Stick to the facts

TAKING NOTES

Thanks