Communication Skills in Clinical Settings

Communication Skills in Clinical Settings

• Effective communication is crucial in doctor-patient interactions, often navigating unknown territory of disease.
• Problems arise from communication barriers, like doctors using medical jargon while patients may not understand it.
• Responsibility for effective communication lies with the physician.

Attending and Listening

• Attending involves focusing on the patient, actively listening to their words and implied meaning.
• Effective attending requires a setting of exclusivity, meaning avoiding distractions during interaction.
• Distractions like side conversations, eating, or other tasks can signal lack of focus on the patient.
• Creating an appropriate environment—a quiet room or corner—improves the quality of communication.

Active Listening

• Active listening goes beyond hearing and involves simultaneous attention to linguistic and paralinguistic aspects of speech.
• Linguistic aspects concern spoken words (content).
• Paralinguistic aspects include non-verbal cues like timing, volume, pitch, pauses, etc., and these indicate emotional state and understanding.
• Paying attention to body language (facial expressions, gestures, body position, and eye contact) is key to understanding the patient's unspoken concerns.

Verbal Techniques

• Verbal techniques are crucial for an effective therapeutic interaction.
• These techniques enhance the overall interaction by using various components (e.g., questions).

Questions

• Closed-ended questions (yes/no) establish basic details and familiarity.
• Open-ended questions allow for more in-depth discussions of patient experiences.

Important Communication Principles

• Leading questions should be avoided as they can influence responses.
• "Why" questions should be used cautiously.
• Effective communication uses questions starting with what, when, where, and how.
• Techniques like funneling guide conversations to specified areas of concern.
• Paraphrasing summarizes a patient's points, ensuring understanding.
• Selective reflection echoes patient's feelings, acknowledging their emotions.
• Empathy building conveys understanding and validation to patients.

Checking for Understanding

• Checking for understanding periodically validates understanding of the problem.
• Patients' associated feelings need explicit consideration.

Factors that Improve Communication

• Minimal prompts.
• Position that is focused and supportive.
• Open body posture.
• Attentive eye contact.
• Relaxed demeanor and listening.
• Attention to non-verbal cues.

Factors that Obstruct Communication

• Lack of focus/exclusivity.
• Preoccupied or anxious professionals.
• Uncomfortable seating environments.
• Disregard to patient non-verbals.
• Offensive remarks and judgmental tone.
• Frequent interruptions and selective listening.
• Lack of attention to non-verbal cues during listening.

Overall

• Good communication builds trust and rapport between doctor and patient.
• Patient's illness may be alleviated by doctor-patient interaction with effective communication skills.
• Effective communication enhances clinic interactions considerably.
• These principles maximize interaction benefits in clinical settings