Pharmaceutical Care and Communication Skills

Basics for Development

• David Dunning and Justin Kruger research interpreted to DK effect (6 stages): a cognitive bias where people of low ability have illusory superiority and mistakenly assess their cognitive ability as greater than it is.
• Professional Development = (CXC)R: Competence (Knowledge + Skills) × Commitment (Motivation + Confidence)
• Johari Window: a tool to understand self-awareness, understanding others, and others' understanding of oneself

Feedback

• Feedback is the process that ensures the receiver has received the message and interpreted it correctly as intended by the sender
• Types of feedback: Positive, Developmental, Description, and Corrective
• Barriers to delivering feedback: unawareness of its value, lack of knowledge and skills, and fear of negative reactions
• Tips to deliver feedback: be clear, specific, and future-focused

Leadership Theory of 5 Stages

• Level 1: Position (leadership by appointment)
• Level 2: Permission (leadership by relationships)
• Level 3: Production (leadership by results)
• Level 4: People Development (leadership by reproducing leaders)
• Level 5: Pinnacle (leadership by legacy)

Listening Skills and Empathy

• Hearing vs. Listening: receiving sounds vs. paying attention to understand
• Active Listening: repeating, rephrasing, paraphrasing, and reflecting
• Responsible Listening: taking responsibility and implementing good actions
• Empathy vs. Sympathy: understanding and sharing feelings vs. feeling sorry for someone

Basic Communication (2) Mehrabian Theory

• Mehrabian formula: Total acceptance (liking) = 55% Visual + 38% Vocal + 7% Verbal
• A) 55% Visual: Nonverbal communication (Proxemics, Kinesics, Oculesics, Olfactics, Chromatics, Haptics)
• B) 38% Vocal: Volume, Clarity, Variety, Tone, Pace, Pitch, and Emphasis
• C) 7% Verbal: using professional and scientific vocabulary to build rapport with the patient

Motivational Interviewing

• Definition: a goal-oriented, patient-centered counseling style to elicit behavior change

• Principles: Express empathy, Develop discrepancy, Avoid argumentation, Roll with resistance, and Support self-efficacy

• Strategies: Open-ended questions, Reflective listening, and Summary reflections### Motivational Interviewing

• Designed for situations where patients need to make a behavior change but are unsure or resistant to the idea

• First introduced by Bill Miller in 1983, rooted in his clinical practice

• Focuses on understanding patient's resistance as a product of the counseling session rather than a lack of motivation

Definition of Motivational Interviewing

• A goal-directed, patient-centered counseling style for eliciting behavior change by helping patients explore and resolve ambivalence
• (Rollnick and Miller, 1995)

Principles of Motivational Interviewing

• Principle 1: Don't tell people what to do; people do what they want to do
• Principle 2: Listen is more important than talking
• Principle 3: Let the patient tell you they need to change; people are more persuaded by their own reasons
• Principle 4: Cognitive dissonance; people struggle with choices, leading to discomfort
• Principle 5: Most people need to feel confident before trying to change
• Principle 6: Ambivalence is normal

Strategies in Motivational Interviewing

• Four principles:
  • Get a conversation going through reflective listening
  • Develop discrepancy between patient's goals/values and current behavior
  • Avoid argument and direct confrontation; adjust to resistance instead
  • Support self-efficacy and optimism; focus on patient's strengths

Techniques and Approaches

• OARS Technique:
  • Open Questions
  • Affirmations (recognizing patient strengths)
  • Reflective Listening
  • Summaries
• FRAMES Technique:
  • Feedback regarding personal risk
  • Responsibility for change is placed with the individual
  • Advice about changing is given in a non-judgmental manner
  • Empathic counseling, emphasizing warmth, respect, and understanding
  • Self-efficacy or optimistic empowerment is encouraged

Change Formula: Equation of Change

• DVF > R+C+1
  • D: Dissatisfaction with the current situation
  • V: Vision of the new status
  • F: First, concrete steps towards the vision
  • R: Resistance of change
  • C: Cost of change or change requirements

Examples of Resistance Talk

• Disagreeing
• Discontinuing
• Interrupting
• Side-tracking
• Unwillingness
• Blaming
• Arguing
• Challenging
• Minimizing
• Pessimism
• Excusing
• Ignoring

Six Levels of Training

• Introduction to MI: Experience the basics of MI and decide level of interest in learning more
• Application of MI: Learn one or more specific applications of MI
• Clinical Training: Learn the basic clinical style of MI and how to continue learning in practice
• Advanced Clinical Training: Move from basic competence to advanced clinical skillfulness in MI
• Supervisor Training: Learn to guide an ongoing group in learning MI
• Training for the Trainers: Learn a flexible range of skills and methods for helping others learn MI

Personalized Communication

• Understanding patient's description of medication: individual patient's trait, preference, and perception
• Advanced skilled practice: understand patient's insight, cognitive orientation (introverted or extroverted), and attitude towards receiving information (intuition or sensing)

This quiz is based on lecture notes by Dr. Mohanad Odeh, covering pharmaceutical care and communication skills, including topics like Dunning-Kruger effect, professional development, and Johari window.