Communication

Question 1

Define Communication

Answer 1

a process by which information is exchanged between individuals through a common system of symbols, signs, or behaviors

Question 2

Importance of communication as care provider

Answer 2

Need to communicate what is going on
Goals that you have for patient
Interpreting what patient is communicating to us
Patient education
Patient safety
Talking with other physicians

Question 3

Importance of communication as a professional

Answer 3

Be a credible source
People will judge your knowledge based on your communication
Share expertise and be recognized as an expert
Advocate for the profession

Question 4

Importance of communication as a person

Answer 4

build and maintain relationships

Helps develop trust

Question 5

Effective Communication

Answer 5

The receiver interprets the message the way the sender intended

Question 6

Expressive Components of Communication

Answer 6

1. Word choice (use ones that patient will understand)
2. Tone
3. Pitch (important for how message is received)
4. Inflection
5. Pace (slowly enough to be understood but not so slow that its demeaning)
6. Nonverbals

Question 7

Word Choice can depend on

Answer 7

1. Language
2. Language comprehension
3. Level of education
4. Culture/ethnicity
5. Health literacy (tailor things to 8th grade level)

Question 8

Define Health Literacy

Answer 8

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
- strongest predictor for someones health

Question 9

Verbal vs. Nonverbal

Answer 9

35% Verbal

65% Nonverbal - more powerful, but more ambiguous

Question 10

Nonverbal Communication

Answer 10

Body Language

Facial Expression

Question 11

Receptive Components of Communication

Answer 11

Hearing vs. Listening

Interpretation of the speakers verbal and nonverbal cues

Question 12

Listening

Answer 12

A learned skill
Belief that one is being listened to = better outcomes, long term professional relationships, and reduced risk of litigation

Question 13

Most powerful protector?

Answer 13

Creating the belief that you are listening to your patients

Question 14

Aspects of listenign

Answer 14

Eye Contact
Body Language/Facial Expression
Reduce Distractions (External and Internal)
Use of encouraging words/questions
Avoid interrupting (hard with PT cuz of time)

Question 15

Communication “Noise”

Answer 15

Attitudes
Self Focused (cant listen if you are thinking about what you will say next)
Lack of trust
Environment
Hearing impairment

Question 16

Communication Tips

Answer 16

Active/Reflective Listening
Use “I” Statements
Avoid assumptions, ask for clarification
Consistent verbal and nonverbal

Question 17

Crucial Conversations

Answer 17

Examine motives
Create safety - pool of shared meaning
Master your stories
Speak tentatively

Question 18

Intentional COmmunication

Answer 18

Advise and evaluate
Analyze and interpret
Reassure and support
Question and clarify
Paraphrase and understand

Question 19

1. Advise and Evaluate

Answer 19

To evaluate performance or behavior and provide recommendations
Telling individuals what they should do - tell them our recommendation for them

Question 20

2. Analyze and Interpret

Answer 20

Goal is to determine what is wrong - what the problem is
Explain the problem to the patient
Interpret the patient’s problem - explain back to the therapist

Question 21

3. Reassure and Support

Answer 21

Demonstrating empathy and compassion

Providing encouragement

Question 22

4. Question and Clarify

Answer 22

The goal is to gain additional detail

Open ended and closed ended questioning - funnel approach

Question 23

5. Paraphrase and Understand

Answer 23

Active/reflective listening

Question 24

The interview process

Answer 24

If done well, interview is most important component of the initial examination

Question 25

Interviewing: An Essential Skill

Answer 25

1. Establishing trusting therapeutic relationship 2. Getting to know your patient 3. Determinng patient understanding of PT 4. Determining patient understanding of their condition 5. Determining status of condition 6. Listening for clues and red flags 7. Determining exam components 8. Determining exam intensity 9. Establighing differential diagnosis list, categorize as probable, possible and rule out

Question 26

Common Interviewing Traps

Answer 26

``` Providing false assurance Giving unwanted advice Distancing/avoidance Use of professional jargon Asking leading or biased questions Talking too much Interrupting ```

Question 27

Preparation of Settign

Answer 27

Patient comfort Patient privacy Minimal distractions

Question 28

Preparation of self

Answer 28

``` Avoid fillers or distracting mannerisms Wear professional attire Be prepared for anything Recognize personal bias Meet patients where they are Provide empathy ```

Question 29

Your role as an interviewer

Answer 29

``` Select appropriate questions Use open and closed ended questions Clarify Do not assume two patients with the same diagnosis are alike Provide culturally responsive care ```

Question 30

Pre interview Tasks

Answer 30

Review pertinent information | Patient Observation- informal observation

Question 31

The interview

Answer 31

non-linear | may overlap with examination

Question 32

Initial Introduction

Answer 32

``` Name How you prefer to be addressed Status as PT student or intern Confirm patient's identity Identify how they prefer to be addressed ```

Question 33

Clarify Reason for visit

Answer 33

Include why the patient believes he or she is attending PT | Confirm presence or absence of referral

Question 34

Patient understanding of PT

Answer 34

Has patient experienced PT | Does patient feel comfortable elaborating on prior PT

Question 35

Vital Information

Answer 35

``` DOB Medications Allergies Diagnostic Tests PMH Family History ```

Question 36

Chief Complaint

Answer 36

Primary complaint Onset/mechanism of injury: how, what, when, where Description of signs and symptoms: location, quality, quantity, exacerbating/relieving factors Status of complaint

Question 37

Work and Social History

Answer 37

Use of tobacco, alcohol, recreational drugs Occupation Leisure pursuits Impact of condition on work and leisure

Question 38

Home Environment

Answer 38

are there other individuals living at home patient responsibilities at home Description of home: entrance/exit, layout, accessibility Impact of condition on home life

Question 39

Activity level

Answer 39

Prior to onset of condition | Currently

Question 40

Patient Goals

Answer 40

What does patient hope to achieve with PT | Are the goals appropriate/realistic

Question 41

Verbal Review of Systems

Answer 41

Muscular Cardio/Pulm Integumentary Neuro

Question 42

Closure of interview

Answer 42

Summarize what you gained from interview Give patient opportunity to provide additional info Provide opportunity to ask questions Explain what will occur next

Question 43

Effective questioning

Answer 43

Open ended Closed ended Graded response Multiple option