Communication Skills VMS 1002 PDF

C O M M U N I C AT I O N SKILLS VMS 1002 EMILY AUGER PRE-READING ACTIVITIES According to section 11 of the RCVS Code of Professional Conduct: 1. Who in the veterinary team can obtain client consent in a small animal practice? 2. How many copies of a consent form sh...

C O M M U N I C AT I O N SKILLS VMS 1002 EMILY AUGER PRE-READING ACTIVITIES According to section 11 of the RCVS Code of Professional Conduct: 1. Who in the veterinary team can obtain client consent in a small animal practice? 2. How many copies of a consent form should there be as a minimum? 3. How old should a client be to be able to sign a consent form? 4. Who has authority to consent to treatment of wildlife? 5. Can you send a patient’s clinical history to directly to another vet who is treating the animal in an emergency? LEARNING OBJECTIVES By the end of this session, students should be able to: Describe models of the communication process. Describe and apply the five core communication skills of reflective listening; non-verbal communication; the pause; open and closed questioning; and empathy. Identify problems that can lead to miscommunication and discuss how to overcome these problems. M O D E L S O F C O M M U N I C AT I O N Interactional Person 1 forms and sends message. model Person 1 modifies message based on feedback received Received and interpreted by 1.Person 2 forms and sends e.g. upset, confused, angry Person 2. reply to message. Context is key here and the Examples: text message Person 1 hears and interprets conversation will be different reminder, written discharge depending on the people message. involved e.g. veterinary report, announcement on AV system. This would be a simple consult. conversation e.g. checking in to reception when arriving for Transmission vaccination appointment. Transactional model model F I V E C O R E C O M M U N I C AT I O N S K I L L S 1. Reflective Listening 2. Non-verbal 5. Empathy communication Core Skills 4. Open and closed 3. The Pause questions REFLECTIVE LISTENING Active process Full Check for participation understanding of listener Reflective Listening Encourage Focussed conversation attention Clarify when necessary  TECHNIQUES TO CHECK FOR U N D E R S TA N D I N G Echoing Paraphrasing Summarising Repeat last few words Restate in your own Presenting a summary Encourages client to words Enables client to keep talking Sharpen confirm accuracy “So Fluffy’s not eaten understanding “So Fluffy hasn’t eaten for 3 days now…” “So Fluffy last ate on now for 3 days, even Sunday, and she’s when you’ve tempted refusing both her her with chicken. This normal food and is unusual for her and chicken?” you are worried there may be something wrong.” N O N - V E R B A L C O M M U N I C AT I O N H O W I M P O R TA N T I S N O N - V E R B A L C O M M U N I C AT I O N ? WHAT DO PEOPLE REMEMBER? What is paraverbal communication? 7% “I didn’t say it was your fault.” “I didn’t say it was your fault.” “I didn’t say it was your fault.” 55% 38% VERBAL PARAVERBAL NON-VERBAL T H E PA U S E The “Golden For Emphasis Minute” It takes on A short pause average 15.3 before delivering seconds for a vet an important to interrupt a piece of client. information can Vets interrupt be effective. client response in 55% of appointments. CLOSED QUESTIONS Would you like How often do me to take an X- you exercise ray? Merlin? Is Willow wormed? When did you What diet do you first notice this feed Scrappy? lump? OPEN QUESTIONS I’d like to talk through your Talk me through Merlin’s usual thoughts about daily exercise this treatment please Describe to me plan Willow’s parasite control. Why did you book this Tell me about appointment Scrappy’s diet today?  WHEN SHOULD YOU USE OPEN AND CLOSED QUESTIONS OPEN QUESTIONS Client perspective Information you might miss otherwise Initial history taking OPEN QUESTIONS CLOSED QUESTIONS Client perspective Clarification Information you might miss otherwise Emergency Initial history taking Client consent Lots of information Specific information 13 #uniofsurrey CLOSED QUESTIONS YOU MIGHT WANT TO ASK Are you giving Does Merlin me consent to ever jump? take an X-ray? Is Willow’s worming product called Drontal®? You first noticed Do you feed this lump 2 Scrappy any weeks ago, is human treats? that correct?  TIPS FOR OPEN AND CLOSED QUESTIONS: Closed Open Questions Questions Can be Often begin Keep the Are useful for Gives people Often begin answered by with “How”, conversation learning facts, the with “Are”, simple “What”, going, help to but tend to opportunity to “Is”, “Do” or “Yes/No” or “Why”, “Tell clarify and stop talk more if “Did” statement of me”, or gather conversations they want to facts “Describe” information  Y O U R T U R N T O TA L K ! Your next patient is Buster for a vaccination appointment. Think of 3 open questions you would like to ask Buster’s owner. Can you think of three closed questions you would like to ask? E M PAT H Y The ability to The ability to communicate that The ability to act on understand the client’s understanding back to that understanding in perspective including the client with ways that are helpful their emotions, empathetic statements for the patient and thoughts, beliefs and and non-verbal client. circumstances. communication.  M I S C O M M U N I C AT I O N A study of 100 complaint cases at the Veterinary Defence Society found that: NUMBER OF COMMUNICATION WHO WAS INVOLVED IN PROBLEMS PER CASE COMMUNICATION PROBLEM? 0 1 >1 Between teams, 8.20% 20%, 20% 48%, 48% Owner, 49.40% Within team, 42.30% 32%, 32% #universityofsurrey  T Y P E S O F M I S C O M M U N I C AT I O N Context Content (information Channel (mode of Systems (other (circumstances of in communication) communication) factors involved) communication) Insufficient Environment e.g. “Hidden Not enough staff for information e.g. discharge in busy communication” proper handovers. when discussing waiting. e.g. writing patient Not using GA potential Sequence over time concerns in poorly checklists or other complications. e.g. ongoing visible part of safety systems. Incorrect miscommunication hospital sheet information e.g. over several visits. instead of speaking dosage error. to vet. Not appropriate for purpose e.g. email copy of blood results instead of speaking to client. FURTHER RESOURCES Communicating empathy in veterinary practice. (2017). McMurray, J., and Boysen, S. Veterinary Ireland Journal, Volume 7 (4). The Value of Empathy. (2019). Donnelly, A. Today’s Veterinary Business. Issue: October/November 2019. Dysart, L. M. A. et al. (2011) Analysis of solicitation of client concerns in companion animal practice. Journal of the American Veterinary Medical Association. [Online] 238 (12), 1609–1615. Russell, E. et al. (2022) Uncovering the ‘messy details’ of veterinary communication: An analysis of communication problems in cases of alleged professional negligence. Veterinary record. [Online] 190 (3).