Introduction to Clinical Communication Vertical Theme Year 1

Aims of Workshop Importance of good communication Importance of good communication Effective communication – how to do it Effective communication – how to do it Problems in doctor-patient communication Problems in doctor-patient communication Key communication skills/ strategies Key communication skills/ strategies Video review for learning about communication Video review for learning about communication

Ice Breaker: Communication in practice Divide into pairs; 1 speaker, 1 scribe Divide into pairs; 1 speaker, 1 scribe Sit back to back Sit back to back Speaker describes ground floor of the flat or house where they live in 3 minutes Speaker describes ground floor of the flat or house where they live in 3 minutes Scribe draws a floor plan Scribe draws a floor plan Speaker can only answer “yes or no” to scribe’s questions Speaker can only answer “yes or no” to scribe’s questions

Why is good communication important? Think about: Patients and families Patients and families Doctors Doctors Colleagues Colleagues Society Society

Why is good communication important? Key part of clinical practice (GMC) Key part of clinical practice (GMC) Diagnostic tool & therapeutic tool Diagnostic tool & therapeutic tool Team working Team working Diversity & adapting to different kinds of people with different needs Diversity & adapting to different kinds of people with different needs Research evidence Research evidence

What do we mean by effective communication? Verbal skills? Verbal skills? Non-verbal behaviours? Non-verbal behaviours? Manner and approach? Manner and approach? Structure? Structure?

Key communication skills Questioning Questioning Active listening Active listening Facilitating Facilitating Empathy/ courtesy Empathy/ courtesy Giving information Giving information Offering advice & reassurance Offering advice & reassurance Negotiating Negotiating Summarising & checking Summarising & checking

Exercise: potential communication problems Split into 2 groups (or 4) Split into 2 groups (or 4) Task 1: Task 1: What are the differences between patients and doctors?What are the differences between patients and doctors? Task 2: Task 2: What potential communication problems are there?What potential communication problems are there?

Differences between doctors and patients Demographic Demographic Age, gender, social class, ethnicity, religion, disabilityAge, gender, social class, ethnicity, religion, disability Knowledge Knowledge Education, beliefs, experiencesEducation, beliefs, experiences Status Status Changing balance of powerChanging balance of power Agenda Agenda

Potential Problems in communication Poor information gathering/ listening Poor information gathering/ listening Explanation not tailored to patient Explanation not tailored to patient Poor concordance (compliance) Poor concordance (compliance) Lack of empathy/ courtesy Lack of empathy/ courtesy Medico-legal issues Medico-legal issues Dissatisfied patients/ relatives Dissatisfied patients/ relatives Poor team working Poor team working Doctor stress Doctor stress

Learning to communicate effectively Training and reflection Training and reflection Patient-centred consultations Patient-centred consultations I deas /C oncerns / E xpectationsI deas /C oncerns / E xpectations Dialogue & partnership Dialogue & partnership Sharing information & decisions Sharing information & decisions Considering :- Considering :- physical, psychological, social, spiritual physical, psychological, social, spiritual

Consultation Review What communication behaviour did you see? What communication behaviour did you see? What was effective? What was effective? What could have been done differently? What could have been done differently? What was the patient thinking and feeling? Group 1 What was the patient thinking and feeling? Group 1 What was the doctor thinking and feeling? Group 2 What was the doctor thinking and feeling? Group 2

Communication in the Consultation Open the interview Open the interview Gather information Gather information Reach a diagnosis Reach a diagnosis Give information Give information Offer advice/ reassurance Offer advice/ reassurance Agree a management plan Agree a management plan Close the interview Close the interview STRUCTURESTRUCTURE RELATIONSHIPRELATIONSHIP

Summary Students should be able to: Say why good communication is important Say why good communication is important Describe potential problems in communication Describe potential problems in communication Explain importance of patient-centred approach Explain importance of patient-centred approach List key communication skills List key communication skills Review a consultation/ video Review a consultation/ video Any ??????