INTRODUCTION TO CLINICAL COMMUNICATION SKILLS

Dr RM Abraham

Clinical skills

NRMSM UKZN

CLINICAL COMMUNICATION SKILLS(CCS)

AIM:

To promote the practice of effective communication within healthcare with patients, carers, collegues and other professionals.

EFFECTIVECOMMUNICATION/GOOD CONSULTATION

involves: Understanding the

patients problems from his/her perspective by allowing the patients to narrate their story in their words and at the same time demonstrating interest, empathy, respect and attending to their comfort at all times.

Sharing information with the patients with regards to:

a)Explaining procedures that would be necessary to help make a diagnosis.

b)Discussing the various treatment options and their effects.

GOOD DOCTOR

Remember that the success of a good doctor depends not only on his/her medical knowledge but also the way he/she communicates with his/her patients e.g the way he explains the problems, diagnosis and treatment to his patients.

Since Medicine is a subject that is learnt from the interaction with patients, it is therefore essential that medical students develop their communicating capacity at the undergraduate level.

We would therefore be teaching and providing you with the building blocks that are necessary to create a Good consultation.

CCS-OBJECTIVES

To explore the basics of what makes a good doctor.

Importance of a medical interview in clinical practice from the point of view of

a)The doctorb)The patient

A-WHAT MAKES A GOOD DOCTOR? Think of a previous

medical encounter you had with a doctor

1)How did the consultation go?

2)How was the Doctor-patient relationship and what do you perceive should be a good doctor-patient relationship?

3)What do you really value and need in a good doctor?

4)Why does a good doctor-patient relationship matter?

5)What did the doctor do to make the interview go well?

6)What could the doctor do to make the interview go better?

7)What message about being a good doctor did you take away from the experience?

GOOD DOCTOR-PATIENT RELATIONSHIP Achieved by:1)Establishing a good rapport with the patient: Greet the patient Obtain patients name Intrd yourself, clarify your role and the nature of the

interview Obtain consent2)At all times demonstrating interest,empathy,respect and

attending to the patients physical comfort.3)Good communication with patient: Gives the patient the chance to tell you what is wrong with

them in their words. They will tend to open up as they have the impression that

you are honest with them and hence they trust you and feel more confident to tell you what is exactly going on in their mind

GOOD COMMUNICATION

Skills:1)Encouraging the patient to

tell his/her story of the problem from when it started to the present in their words using a more open questioning technique.

2)Listening attentively without interrupting by:

Wait time-give pt adequate time to respond

Facilitative response-encourage pt to say more using phrases "uh-huh", "go-on","I see","yes"

Non-verbal skills-gives the pt a clue of your level of interest

E.g. body posture,eye contact, gesture,facial expression,touch

Picking up pts verbal and non-verbal cues and responding to them-often pts ideas,concern and expectations are provided in these cues.

3)Use of appropriate language.4)Clarifying statements that

appear vague.5)Summarizing periodically to

verify your understanding and also gives pt the feeling that you are listening to them attentively.

B-IMPORTANCE OF A MEDICAL INTERVIEW

AIM: TO OBTAIN FACTUAL ACCOUNT OF PATIENTS ILLNESS AS WELL AS THE PATIENTS PERSPECTIVE OF THE ILLNESS B4 SUGGESTING AND AGREEING TO A PLAN OF MANAGEMENT

Doctors agenda:a)Develop a good

relationship with the pt.b)Make a diagnosis- by obtaining the

sequence of events and analyzing the symptoms etc(History taking)

Examination of pt. Investigating pt.c)Manage the pt.- Pharmacological Non-pharmacological

Patients agenda:To discuss a)Ideas and thoughts

of the illness.b)Concerns about the

illness.c)Expectations from

the consultation.d)Feelings about the

illness.e)Effects the illness is

having on their life.

ANALYZING A CONSULTATION

Watch a DVD clipping of a medical consultation to help explore the

a) Purposeb) Difficultiesc) Strengths andd) WeaknessesFrom both the doctor's and patient's view point

THANK YOU