CLD100 Communication in Dentistry - Lecture Notes PDF

Communication in Dentistry Ms N Gordon Department of Oral Hygiene Watch the video below and answer the following questions: 1. Identify the different types of communication. 2. Based on the video, what do you think is the role of the dentist in communicating with the patient in...

Communication in Dentistry Ms N Gordon Department of Oral Hygiene Watch the video below and answer the following questions: 1. Identify the different types of communication. 2. Based on the video, what do you think is the role of the dentist in communicating with the patient in a clinical setting? http://www.youtube.com/watch?v=eVJCa-N1tiE  Outcome of the lecture  Describe the communication process with a focus on the transactional model of communication  Identify and describe types of communication.  Identify and describe settings of communication We communicate to: Develop and maintain relationships, Develop relationships that may be permanent (e.g. family, partner) or transient (e.g. patient) Obtain and share information for a particular purpose (from our patients, the mass media, observations in our environment, conversations etc), Make informed decisions based on information obtained and shared for example during patient interviews, To persuade others (by use of the mass media, advertising, students to change a test date, advise our patients etc) Three definitions of communication is explained below: 1. Technical definition: ‘sending and receiving messages OR transmission of messages from one person to another’. 2. Process definition: ‘a complex and dynamic process of exchanging meaningful messages’. 3. Transactional definition: ‘a transactional process of exchanging messages and negotiating meaning to establish and maintain relationships”. As future dentists the transactional definition is more useful in guiding you in the communication process. You should be able to distinguish between these three definitions The assumption is that there is communicator and receivers who provide feedback to the communicator- look at the other models for comparison.  The Transaction Model of Communication Physical & NOISE Psychological Context NOISE n +-' C: X Q) +-' C.C,: 0 u Co-creation C n of meaning J a 0 u :J rt- 0 m l/) Communicator NelSE Relational Context NOISE Communicator  u ( ii 1, ,-: I. -. r I ----- I I I f I ' II · C ,. · II - r - - - - , , j i ' I - - s_e_nd_in g Q_,_nn_d ,_ , I I...... -4---- Feedbadc Channel., I I - - - - - - - - r ,., , I J I I I I ! I I I -- - - - - I I UN TOR CONTEXT R£C]PIENT I I \ I_ Transactional def. cont Communication is a transaction between participants where relations develops between them, Those communicating are mutually responsible for outcomes as they transmit information, create meaning and obtain responses, Focus is on quality of relationship, the transfer and interpretation of messages, Communication becomes dynamic, reciprocal process -meaning is negotiated through exchange of messages. Concept of transaction -participants mutually agree on meanings of messages for communication to be effective and relationship to be satisfying.  0 0 C Figure 2.3 A transactional model of communication (adapted from Verderber 1990) The model is not substantially different from the circular model - it also depicts communication as a dynamic process in which both participants are actively UN IVERSITVef1.li, engaged in encoding, transmitting, receiving and decoding messages. The main dif WESTERN CAPE ference is that the transactional model highlights that the creation of meaning is negotiated between the participants. The two circles represent the communicator and the recipient. In the centre of each circle is the message: the thought, idea or feeling that is communicated using verbal and nonverbal signs. Surrounding the messages are the participants' values, culture, background, occupation, sex, exper iences, feelings, knowledge and attitudes. These factors influence the meaning that is expressed and the meaning that is interpreted. The outcome of the encounter is determined by the mutual involvement of the participants in negotiating the mean ing of the messages. The bar between the circles represents the medium of communication. Rather than depicting transmission and feedback as two separate processes (compare Osgood & Schramm's model), the transactional model indicates that messages are continually passing between the participants. The area around the communicator and the recip ient represents the context in which the process takes place. While it is taking place, external, internal and semantic noise may be occurring at various places in the model. These noises may affect the abil.ity of communicator and recipient to share meanings (cf. Verderber 1990). The one-to-one transactional model is a basic model of communication. We can, however, apply its principles to communication situations that involve more than two people. Take note that in a group situation the outcome of the encounter may be different for each participant. Consider the following scenario: The chairperson at a business meeting looks at her watch and sees that there are only five minutes left before she has to leave for a lunchtime appointment with the bank manager. She frowns because there are still two items on the agenda that have not been dealt with. Aware that it is too late to begin a discussion, she says, "Let's call it a day", in a frustrated tone of voice. Some members of the group look surprised because meet ings in that organisation usually carry on until all business has been completed, Components of the communication process Messages: signs and codes Encoding and decoding; Meaning; Interpretation Medium and Channel Medium; Channel; Noise: internal, external and semantic; Feedback; Context Language and meaning Connotative and denotative meaning  Messages: signs and codes Signs – something that ‘stands for’ something else. Verbal signs – spoken and written words and sounds Nonverbal signs- cues and signals transmitted without the use of sound In speech, words convey meaning -but is given additional meaning by body movements, facial expression, tone of voice, hand gestures, When listening, nonverbal signs may affect meaning you assign to verbal signs How are you  Messages: encoding and decoding Encoding: process of transforming thoughts to verbal and nonverbal signs so that they can be transmitted as messages to somebody else i.e. we encode to create messages Decoding: process of transforming verbal and nonverbal messages received and giving them meaning i.e. we decode to give meaning to messages from others. We do this without consciously thinking about the process Encod How are you Decode‘ Do you Are there cultural differences in signs and codes? Messages: meaning Messages contain content & relationship information Content-factual information about the topic. Relational –information on feelings on communicator & how content should be interpreted: e.g ‘let’s chat about your dress code’ could be a request from a parent BUT a command when dental staff conveys the same message Similar content but tone of voice and way in which the message is delivered defines the relationship, Relationship level rather than content tells you whether the person is expressing affection/dislike or whether comment is humorous or sarcastic.  Messages: signs and codes- interpretation E.g. If we all attend the same public presentation we may ascribe different meanings to the ideas expressed by the speaker because each of us is a product of our individual background, sex, past experiences, attitudes, feelings, ideas, values, occupation, religion and culture. Now think of a dentist presenting a public talk on the importance of regular check-ups. Will all members interpret the message as he/she intended? Reasons for different views? What about patients seen by the dental student? Messages: interpretation Messages contain meaning that must be interpreted, Interpretation depends on social (shared) meanings and individual (subjective) meanings, To communicate we must have something in common -e.g. understanding of verbal signs, same language, We share an understanding of what certain words mean in our culture/context – examples? the way we use symbols and what we understand by them expresses our personal and individual characteristics, Medium and Channel Medium: physical means by which messages are transmitted between people during communication, E.gs -voice and body movements, technological and electronic means of communication, telephone, newspapers, books, TVs. Channel: route by which the messages travel Light waves that carry TV image; airwaves that carry sound; senses of smell, hearing, sight, touch and taste. Medium and channel are links between communicator and recipient. http://www.comprofessor.com/  Medium and channel: noise Noise-stimulus interfering with transmission and reception of messages by distorting the message so that meaning received differs from that intended, Outcome of communication encounter often depends on how one copes with external, internal and semantic noise, 1. External noises -stimuli in the environment that distract attention eg cold room, noisy surgery, 2. Internal noises- thoughts and feeling in people that may interfere with communication – moods, hunger, personal prejudices, attention paid to others etc, 3. Semantic noises- interferences due to meaning of words e.g use of unfamiliar terms to explain a dental problem – pt uncertain of cause of the problem because professional created semantic noise by using words the patient did not understand. E.g people may react in a way you did not intend to - use of slang, ethnic slurs, swearing thereby distorting the interaction between you. “You are woke” “gross plaque on the teeth” Medium and Channel: Feedback Feedback - participants response may take different forms e.g you tell a person a joke and he/she laughs or frowns? I explain a problem and you ask for more information, Shrug of the shoulders in response to a message; applause of an audience in response to a speaker, So is the means whereby ideas are negotiated and meaning exchanged A smile presents +ve feedback in a conversation whereas a sarcastic remark presents –ve feedback which may cause the person to stop talking.  Medium and channel: context People always communicate within a context, Environment or circumstances of communication encounter, Influenced by situational factors such as time, space, physical properties of meeting space and roles, status and relationships of participants, People express themselves differently depending e.g how they know each other, whether at home/ work/school/university and their formal position. Language and meaning Meaning resides in people not in words – meaning can differ e.g a cat can bring to mind a domestic cat, a lion or a leopard, Think of the meaning to people of the word ‘dirt’ when we talk about a dirty mouth or say that a patient is ‘ignorant’ or ‘stubborn’, ‘difficult’. Stubborn?  Language and meaning: denotive and connotative meaning of words Denotative: literal meaning from dictionary-there may be more than one meaning e.g. strike – workers go on strike, strike (hit) somebody, Connotative: emotions /evaluation associated with a word; personal subjective meaning. Awareness of connotative meanings is important to avoid misunderstandings – a word such as bucks bunny may evoke a +ve connotation or negative connotation.  Settings for Communication The setting where communication takes place will influence the level of communication. For example ▪ How the message is conveyed, ▪ the verbal and non-verbal cues, ▪ whether the meaning of information/the message can be negotiated etc The setting also influences the number of people involved in the communication process and the level of interaction. We will look at 1) intrapersonal, 2) interpersonal, 3) small group, 4) public communication and 5) mass communication  Settings for Communication 1. Intrapersonal communication Intra means ‘within’ or ‘inside’ Individual sends and receives messages internally i.e. person communicates with him/herself, Allows the individual to make sense of the world by expressing and interpreting own messages, This is an on-going process – thinking about what you feel about the lecture? Remember that both practitioner and patient communicate with him/herself during treatment. 2. Interpersonal communication Inter means ‘between’ Occurs in a face-to-face situation-usually between two people e.g. a patient, friend, Participants observe facial expressions, other non-verbal behaviour while exchanging verbal messages, Participants continually provide feedback or respond to each other’s messages, Meaningful relationships are formed and maintained in daily interactions with others, Particularly relevant in the dental environment relationship formed with colleagues, patients etc. 3. Small-group communication Communication within a group of 3-12 people, Usually share a common purpose/goal E.g family group, study group, project group, friends, Members can interact by providing feedback More complex as groups have unique dynamics affecting how people interact. Think of the dynamics within your project groups? (groups within groups, some dominating, not doing their part etc) 4. Public communication Group too large for direct interaction, One person addresses audience in a public setting e.g lecture hall, More formal than interpersonal or small- group communication, the event/lecture is planned in advance to meet a specific goal, Participants are still face-to-face, audience does not usually participate until end of the speech/lecture when questions are invited BUT they can send non-verbal messages and feedback, If an audience does not appreciate or find the speech/lecture useful they often become restless/stop paying attention. They can also provide +ve feedback e.g. laughter/applause. 5. Mass communication Communication for masses: people do not know one another and are usually not in the same place, Message reaches participants through mechanical or electronic medium such as television or print Mass communication differs from interpersonal and group communication in a number of ways, It provides little/no opportunity to interact directly with person or people conveying the message due to difficulty in providing feedback (think of transactional comm model). Media- posters, pamphlets etc Social media – Facebook, WhatsAp, Twitter, Tik-Tok etc What does your social media tell about you as a BDS student?  Post class activity (not for submission) Reflect a conversation/ argument you observed or were involved in (this can be in your personal or learning environment). 1. Did you see the communication to be positive or negative? 2. Populate the transactional model of communication – i.e. draw the model on a sheet of paper and fill in the relevant components. 3. Describe /explain possible reasons for the communication being +ve or –ve and comment what could have been done differently.  Conclusion Communication is a complex skill that has to be practiced in the same manner of any other skill. Practice and continued reflection on our progress should be developed in our personal and professional lives to enable us to become confident and skilled communicators. Good communication between patient and the oral health practitioner leads to increased efficiency a more accurate diagnosis, better patient outcomes and satisfaction with care and less likelihood of complaints or litigation. Oral health practitioners who spend time communicating effectively with their patients and colleagues are likely to have better interpersonal relationships and a more satisfying working life. This, in turn, is likely to make consultations more efficient and improve patient outcomes.  Steinberg, S. 1994. Introduction to communication – the basics. Juta and Co, Cape Town. pp 11-23 Pre-class activity: watch the video below 1. https://www.youtube.com/watch?v=eVJCa-N1tiE