Interpersonal Skills in Medicine

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Questions and Answers

What role does eye contact play in non-verbal communication?

Eye contact demonstrates attentiveness and respect, allowing for better connection with the speaker.

How can open and closed postures affect interpersonal communication?

Open posture signals receptiveness and interest, while closed posture can convey defensiveness or anger.

What are the three components of empathy?

The three components of empathy are cognitive, emotional, and compassionate.

Identify two negative behaviors that hinder verbal communication in a healthcare setting.

Rushing through explanations and treating the patient impersonally are two negative behaviors. Signup and view all the answers

How does therapeutic communication differ from general communication?

Therapeutic communication is tailored to ensure patients understand information, while also using appropriate technical terms for team communication. Signup and view all the answers

What is one benefit of being silent during patient communication?

It allows the patient time to think without pressure. Signup and view all the answers

List one fundamental element of the patient-physician relationship.

The right to confidentiality. Signup and view all the answers

What is a key consideration when discussing treatment options with a patient?

The positive and negative effects of medicine must be expressed. Signup and view all the answers

Identify the first stage of grief according to Elisabeth Kubler Ross & David Kessler.

Denial. Signup and view all the answers

How can anger contribute to the grief process?

Anger is a necessary stage that can lead to healing by allowing individuals to confront their pain. Signup and view all the answers

What should be assessed before and after communicating significant information to a patient?

The patient's knowledge and expectations. Signup and view all the answers

What is an important right of patients regarding their health care?

The right to receive adequate health care. Signup and view all the answers

In the stages of grief, what does bargaining often involve?

It involves wishing that a loved one could be spared from a loss. Signup and view all the answers

What should be done immediately after disclosing bad news to a patient?

The patient should be given privacy and time to be alone with relatives to express their feelings. Signup and view all the answers

How can bad news be softened when communicating with a patient?

By balancing the bad news with good news that provides hope, without giving false hope. Signup and view all the answers

Which approach is recommended for engaging patients in decision-making regarding their treatment?

Patients should be encouraged to express their questions and actively participate in decision-making. Signup and view all the answers

What is the importance of seating arrangements during a medical consultation?

Seating should ensure exclusivity and involve significant others to create a supportive environment. Signup and view all the answers

What is the purpose of the 'Perception' step in patient communication?

To assess the patient's understanding and feelings about their medical condition before sharing information. Signup and view all the answers

How should healthcare providers prepare patients before breaking bad news?

Providers should give a warning to prepare the patient emotionally for the information to be discussed. Signup and view all the answers

What is a recommended strategy to help patients cope with their situation?

Engaging in frequent short interviews to provide continuous support and information. Signup and view all the answers

Why is it important to avoid technical jargon when communicating with patients?

Using simple, familiar language ensures that patients fully understand their condition and the treatment options. Signup and view all the answers

What percentage of preventable hospital deaths is attributed to communication errors?

60% to 70% Signup and view all the answers

Name one type of communication that is largely innate.

Nonverbal communication Signup and view all the answers

What is an essential strategy for breaking bad news to patients?

Using appropriate communication skills with empathy. Signup and view all the answers

How does active listening contribute to effective communication?

It ensures understanding and demonstrates attentiveness. Signup and view all the answers

What is one defining characteristic of verbal communication?

It is symbol-based. Signup and view all the answers

Identify a special group with which doctors need to adapt their communication.

Mentally ill patients Signup and view all the answers

What role does the doctor-patient relationship play in clinical care?

It enhances trust and promotes better health outcomes. Signup and view all the answers

What aspect of communication is largely learned?

Verbal communication Signup and view all the answers

Why do people bargain with God after a significant loss?

People bargain with God to express their desperation and desire to reverse the pain of their loss. Signup and view all the answers

What is a common misconception about depression following a loved one's death?

A common misconception is that depression is a sign of mental illness, whereas it is a natural response to loss. Signup and view all the answers

How does acceptance differ from feeling 'all right' after a loss?

Acceptance involves recognizing the reality of the loss, not necessarily feeling 'all right' about it. Signup and view all the answers

What are the key aspects of the bio psychosocial model in breaking bad news?

The model addresses informational care and effective communication principles. Signup and view all the answers

Why is it important for doctors to communicate bad news effectively?

Effective communication decreases uncertainty and prepares patients for grief. Signup and view all the answers

What role does a doctor play when delivering bad news?

A doctor should be honest, warm, and aware of cultural values, providing ongoing support. Signup and view all the answers

When should a senior doctor deliver bad news?

A senior doctor should deliver bad news as soon as the diagnosis is certain. Signup and view all the answers

What should a doctor encourage from patients after delivering bad news?

Doctors should encourage questions and express hope for a valuable life despite the diagnosis. Signup and view all the answers

Study Notes

Interpersonal Skills & Doctor-Patient Relationship

Communication errors in medicine are a major factor in preventable hospital deaths, contributing to 60-70% of such cases.
A quote by Albert Einstein highlights the danger of technology surpassing human interaction.
Effective communication is crucial in the medical field, as it greatly influences patient care and outcomes.
Objectives for a session include explaining basic communication skills, discussing the role of doctor-patient relationships, and emphasizing communication with special groups (mentally ill, children, elderly, those with hearing/visual impairments).
Other objectives include discussing the stages of grief and how to effectively deliver bad news.
There is an assignment to reflect on personal interpersonal skills with friends and family, and ways to improve them.

Definition

Communication is defined as the imparting or exchanging of information through speaking, writing, or other mediums.

Communication Model

Communication involves a sender, a message (including both verbal and nonverbal elements), a context (stimuli), and a receiver.
The sender (encoder) considers the process, what to say, when and why, whom, where and how. The receiver (decoder) will take the meaning out and plan a response.

Types of Communication

Communication can be verbal, nonverbal, or written.

Importance of Communication Components

Nonverbal communication makes up 55% of the message.
Verbal content only makes up 7% of communication impact.
Vocal elements (pitch, rate, tone, volume, rhythm) contribute 38% to the overall conveyed meaning.

Characteristics of Effective Communicators

Effective verbal communicators clarify, listen empathetically, acknowledge, encourage, and restate/repeat information.
Effective nonverbal communicators are relaxed, open, and attentive towards the patient; maintain eye contact and appropriate facial expressions.

Types of Communication (Verbal vs. Nonverbal)

Verbal communication is symbol-based and largely learned, with more conscious control.
Nonverbal communication is gesture-based and largely innate, with partial control.

Active Listening

Active listening involves specific strategies such as proper seating and body language, attentiveness, careful listening, and asking clarifying questions and responding to answers.
Examples include maintaining appropriate eye contact and using appropriate facial expressions.

Nonverbal Communication (Body Language)

Facial expressions are the most expressive body language component.
Maintaining eye contact shows engagement and attention.
Open posture (relaxed arms/chest, facing the patient, leaning forward) conveys receptiveness, friendliness, and interest.
Closed posture (rigid arms/chest, leaning back, avoiding eye contact) can convey anger or disinterest.

Empathy

Empathy is the ability to understand and share the feelings of another person.
Key components of empathy include cognitive (understanding the thoughts and feelings of others), emotional (experiencing feelings similar to the other), and compassionate (caring and wanting to help).
The process of empathy involves truly listening to and understanding another person’s emotions.

Negative Verbal Communication

Negative verbal communication examples: ignoring others, avoiding eye contact, interrupting, rushing through explanations, impersonal treatment, making others feel rushed, forgetting common courtesies, and showing boredom, stereotypes, judging, defensive challenging, and rejecting.

Doctor-Patient Relationship

Fundamental elements of the relationship include the patient's right to information, the ability to make decisions, respectful treatment, and responsiveness and timely attention, confidentiality, continuous care, and appropriate health care access.

Patient Information Needs

Essential questions patients might ask in regards to their care include their diagnosis, the risk of spreading illness to others, available treatments, the safety of treatments, alternative treatments, the length to recovery, any treatment restrictions, or abstinence recommendations.

Steps to Provide Information

First, assess patient knowledge and expectations.
Next, give evidence-based information, include both positive and negative impacts of treatment, and avoid giving false hopes.
Include discussing the prognosis of the disease/condition appropriately.
Summarize provided information and check for comprehension.

Stages of Grief

Grief stages, developed by Elisabeth Kübler-Ross and refined by David Kessler, include denial (initial shock, making sense of the situation, a way to cope with loss), anger (valid emotion during grieving process, potentially towards others, God, loved one), bargaining (desperate effort to make things right to avoid pain), depression (deep sorrow, withdraws, wondering about future), and acceptance (recognizing physical loss and adjusting to a new reality, adjusting to loss and starting a new chapter).

Breaking Bad News

Considerations for breaking bad news include choosing the appropriate person to deliver the news (a senior member fully trained in delivering difficult news), ensuring the news is timely and delivered with consideration for the patient and/or their family, being honest, being warm, being aware of religious or cultural values, and employing basic counseling skills.
Further instructions on communicating news appropriately include softening the bad news with good news, including patient feelings, avoiding technical jargon, not trying to give an exact diagnosis, arranging next appointment within 24-48 hours, continuing dialogue, instilling hope for a meaningful life, and creating a supportive environment for exploring meaning.

Biopsychosocial Model

Addressing all aspects of informational care and effective communication and counseling.

Discussing Communication with Special Groups

Special groups to consider during communication include mentally ill, difficult children, elderly, those hard of hearing, and silent patients.

Specific Steps

Step 1: Setting: exclusivity, involvement, seating arrangement, attentiveness, composure, and availability
Step 2: Perception: getting a sense of patient understanding of his/her condition prior to providing a diagnosis
Step 3: Invitation: respecting the patient wishes to be told or not told about their diagnoses or treatment
Step 4: Knowledge: using simple language to clarify condition and prognosis and address patient concerns/questions
Step 5: Empathy: active listening and acknowledging patient feelings
Step 6: Summarize: reflecting and confirming what was discussed and acknowledging patients feelings and concerns through questions and answers.
Step 7: Plan for Action: developing and following a plan that will further move the situation forward.

Additional Considerations

Doctors should be honest, warm, respectful of religious/cultural values, and skilled in counseling.
Encourage patients, recognize and acknowledge patient concerns and feelings, and use clear, simple language.
Provide a plan for next steps concerning treatment, while also considering the need for follow-up care with another patient with similar condition and/or written information.

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Description

This quiz explores the importance of effective communication in the doctor-patient relationship and how it impacts patient care. It covers basic communication skills, the stages of grief, and strategies for delivering bad news, aimed at improving interpersonal skills. Reflect on your own communication abilities and discover ways to enhance them in personal interactions.