Communication Skills Ppt @ Bec Doms Mba 1st Sem
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Transcript of Communication Skills Ppt @ Bec Doms Mba 1st Sem
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 1/29
Communication skills
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 2/29
Key communication skills
Let parents express in own words
Observe non verbal clues
Encourage the patient to continue speaking
Establish eye contact
Active listening
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 3/29
Verbal communication
• What to say ?
How to say?
Whom to say?
When to say?
What you should not say?
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 4/29
Important points incommunication
• Feel good about yourself
Learn to avoid using ‘I’ and ‘ME’
Instead use ‘YOU’ and ‘WE’
Pause, pace, pitch, and voice modulation
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 5/29
The SOFTEN technique
S = smiling
O = open body posture
F = friendly energy
T = touching while talking
E = eye contact
N = nodding in affirmation
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 6/29
Non verbal communication(body language)
• Eye contact
Facial expressions
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 7/29
Communication pitfalls
• Using highly technical language
Not showing appropriate concern
Not listening
Failing to verify whether understood
Displaying apathy
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 8/29
Telephonic
consultation
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 9/29
Issues related totelephonic consultation
Convenient for parents (too much time and
energy spent to see the doctor – just for few
minutes)
Convenient for doctors (quality time for clinic
patient - improves outcome)
Should be selective and safe
Must develop methods to avoid interference
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 10/29
Telephonic consultation – when?
Minor problem that may not require physical
examination
Follow-up report after initial consultation
First aid advice in an emergency till parents
reach the doctor
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 11/29
Telephonic consultation whennot?
Patient not known (not a regular patient)
Acute illness in neonate or young infant
When condition can not be judged properly
(exaggerated or ambiguous statements by parents /
symptoms potentially serious such as excessive
crying or lethargy / chronic problems)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 12/29
Telephonic consultationwhen not?
When specific therapy may be
necessary
When parents insist on being seen (even
when you feel otherwise)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 13/29
Ideal way
Have a trained doctor to attend phones who
follows preformed protocol (even simple
advice needs your Ok / you speak if parentsinsist)
Monitor conversation; intervene if necessary
Insist on talking to a treating doctor if
patient is already under treatment
Legality issues? – ideally need for
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 14/29
Counseling parents of
children who are notimproving
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 15/29
General rule
Counseling is an art
Depends on communication skills
Explain in simple language using similesrelated to common life situations (drug
may not work even when chosencorrectly – pencil does not write if givento newborn)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 16/29
General rule
Use words cautiously – ABC – accurate /brief / clear
Balanced statement of prognosis
“Patient” hearing and repeated
explanation
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 17/29
Acute serious illness
At first visit, explain details of illness
and its evolution to present seriousstage
Do not find faults with previous therapy(pneumonia who came in with hypoxia)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 18/29
Acute serious illness
Instill hope and confidence (many such
children improve) with subtle hint (few
may develop problems, let’ s hope we
don’t face it)
Estimate time and course of
improvement – wait for sustained
progress before announcing
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 19/29
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 20/29
Acute illness in office practice
Spend adequate time; explain problem,
anticipated course, and its rational
management
Convince parents about safety of observation
with minimal action (are you sure, is the
question that needs confident answer)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 21/29
Acute illness in office practice
Be transparent; spell out what you don’t
know but add that you know how to
know!
Document provisional diagnosis and itsbasis with instructions for therapy and
follow-up
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 22/29
Chronic disease
Explain in details (like teaching session)
Describe all the options of investigations and
management ( MR / asthma / JCA / epilepsy)
Discuss pros and cons of treating and not
treating or different modes of therapy
Chart out anticipated course on compliant
therapy, limitations of “cure”and adverse
drug reactions along with monitoring
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 23/29
Chronic disease
Leave the choice of other systems of
medicine to parents and do not criticize (but
emphasize on transparency, access to
unbiased information and evidence based
approach in allopathy)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 24/29
Managing death
It is said that -
If one looses a parent, past is lost
If one looses a spouse, present is lost
But if one looses a child, future is lost
Hence parents cannot tolerate death of a
child – they need support
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 25/29
In the event of deathanticipated
Ensure that senior doctor is a spokesperson
and not juniors or resident doctors (other
doctors must repeat what senior has talked)
Parents must be subtly warned about non-
improving situation (we are trying our bestbut so far there is no improvement)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 26/29
In the event of deathanticipated
Confide in 1-2 close relatives about the
inevitable unfavorable outcome
Let parents be a witness to continuous
monitoring and necessary interventions
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 27/29
In the event of death
Do not announce death suddenly (condition is
worsening though we won’t give up / next half
an hour is crucial, if there is no improvementby then, we may not make it)
When death is announced, let parents venttheir feelings (we are sorry we could not save
your child)
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 28/29
In the event of death
Ensure every help to ease the situation
Consider the possibility of subsequent
discussion with parents to make them feel
that everything possible was tried and that
they had not faulted
8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem
http://slidepdf.com/reader/full/communication-skills-ppt-bec-doms-mba-1st-sem 29/29
Summary
Counseling is an art – not taught in medical
school – make an effort to learn
It should not be a casual approach -
especially in serious conditions, ideally
carried out in a specified place with privacy
and not in a hurry
More the serious nature of the disease, more
should be the “talking”