1. Communication Sadath Khan

2. Definition. Exchange of information. Derived from Latin ‘communicare’ Involves the process of generation of message,its transmission,reception, understanding & response. understanding & response.

3. Types of communication. VerbalNon-verbal Small groups 3-20 Mass communication-newspapers,radio, TV,internet TV,internet

4. Why is it important? Cornerstone of Doctor-Patient relationship Fundemental to be a Doctor GMC stresses the need for good communication skills in its guaidance Improves health understanding & outcomes

5. Principles of effective communication Ensures interaction rather than transmission Reduce unnecessary uncertainty Demonstrates dynamism Follows a helical model

6. Benefits of good communication Improved doctor-patient relationship Improves concordance Improves health understanding & health outcomes Reduces pressures on doctors Reduces burnout Improves job satisfication Reduces clinical error & litigation Ensures continuity of care Deepens professional understanding between collagues

7. Barriers to communication. Language & culture Lack of time,pressure of work,interruptions Uncomfortable topics,lack of confidence & issues about confidentiality Negative attitudes of doctors Lack of knowledge about illness Personality differences Human failings-stress,tiredness,politics

8. GMC Benchmark Listening to patients,carers,partners, relatives & other healthcare staff Explaining & providing Patients & relatives with adequate information Mediating & negotiating with patients,carers & collagues Handling complaints appropriately Liasing with other members of healthcare

9. Stott and Davis Management of presenting problems Management of continuing problems Health education Opportunistic health promotion

10. Balint Patients problems have psychological and physical components Psychological problems manifest physically Doctors have feelings which can be used in the consultation

11. Pendleton Define the reason for attendence Consider any other problems Choose an appropriate action Achieve a shared understanding Involve patient in management Use time & resources appropriately Establish & maintain relationship

12. Neighbour Connecting-Noticing,not judging Summarising-in patients language Handover-sell in by negotiation Safety netting-What if I am wrong? Housekeeping-dealing with own feelings

13. Calgary-Camdridge Guide Initiating-rapport/reason Gathering information-history Building relationship-involve patient Explanation-providing information,shared decision making,negotiating End summary Safety netting Final checking