Communication Flashcards
Define Communication
a process by which information is exchanged between individuals through a common system of symbols, signs, or behaviors
Importance of communication as care provider
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
Importance of communication as a professional
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
Importance of communication as a person
build and maintain relationships
Helps develop trust
Effective Communication
The receiver interprets the message the way the sender intended
Expressive Components of Communication
- Word choice (use ones that patient will understand)
- Tone
- Pitch (important for how message is received)
- Inflection
- Pace (slowly enough to be understood but not so slow that its demeaning)
- Nonverbals
Word Choice can depend on
- Language
- Language comprehension
- Level of education
- Culture/ethnicity
- Health literacy (tailor things to 8th grade level)
Define Health Literacy
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
Verbal vs. Nonverbal
35% Verbal
65% Nonverbal - more powerful, but more ambiguous
Nonverbal Communication
Body Language
Facial Expression
Receptive Components of Communication
Hearing vs. Listening
Interpretation of the speakers verbal and nonverbal cues
Listening
A learned skill
Belief that one is being listened to = better outcomes, long term professional relationships, and reduced risk of litigation
Most powerful protector?
Creating the belief that you are listening to your patients
Aspects of listenign
Eye Contact
Body Language/Facial Expression
Reduce Distractions (External and Internal)
Use of encouraging words/questions
Avoid interrupting (hard with PT cuz of time)
Communication “Noise”
Attitudes Self Focused (cant listen if you are thinking about what you will say next) Lack of trust Environment Hearing impairment
Communication Tips
Active/Reflective Listening
Use “I” Statements
Avoid assumptions, ask for clarification
Consistent verbal and nonverbal
Crucial Conversations
Examine motives
Create safety - pool of shared meaning
Master your stories
Speak tentatively
Intentional COmmunication
Advise and evaluate Analyze and interpret Reassure and support Question and clarify Paraphrase and understand
- Advise and Evaluate
To evaluate performance or behavior and provide recommendations
Telling individuals what they should do - tell them our recommendation for them
- Analyze and Interpret
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
- Reassure and Support
Demonstrating empathy and compassion
Providing encouragement
- Question and Clarify
The goal is to gain additional detail
Open ended and closed ended questioning - funnel approach
- Paraphrase and Understand
Active/reflective listening
The interview process
If done well, interview is most important component of the initial examination
Interviewing: An Essential Skill
- Establishing trusting therapeutic relationship
- Getting to know your patient
- Determinng patient understanding of PT
- Determining patient understanding of their condition
- Determining status of condition
- Listening for clues and red flags
- Determining exam components
- Determining exam intensity
- Establighing differential diagnosis list, categorize as probable, possible and rule out
Common Interviewing Traps
Providing false assurance Giving unwanted advice Distancing/avoidance Use of professional jargon Asking leading or biased questions Talking too much Interrupting
Preparation of Settign
Patient comfort
Patient privacy
Minimal distractions
Preparation of self
Avoid fillers or distracting mannerisms Wear professional attire Be prepared for anything Recognize personal bias Meet patients where they are Provide empathy
Your role as an interviewer
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
Pre interview Tasks
Review pertinent information
Patient Observation- informal observation
The interview
non-linear
may overlap with examination
Initial Introduction
Name How you prefer to be addressed Status as PT student or intern Confirm patient's identity Identify how they prefer to be addressed
Clarify Reason for visit
Include why the patient believes he or she is attending PT
Confirm presence or absence of referral
Patient understanding of PT
Has patient experienced PT
Does patient feel comfortable elaborating on prior PT
Vital Information
DOB Medications Allergies Diagnostic Tests PMH Family History
Chief Complaint
Primary complaint
Onset/mechanism of injury: how, what, when, where
Description of signs and symptoms: location, quality, quantity, exacerbating/relieving factors
Status of complaint
Work and Social History
Use of tobacco, alcohol, recreational drugs
Occupation
Leisure pursuits
Impact of condition on work and leisure
Home Environment
are there other individuals living at home
patient responsibilities at home
Description of home: entrance/exit, layout, accessibility
Impact of condition on home life
Activity level
Prior to onset of condition
Currently
Patient Goals
What does patient hope to achieve with PT
Are the goals appropriate/realistic
Verbal Review of Systems
Muscular
Cardio/Pulm
Integumentary
Neuro
Closure of interview
Summarize what you gained from interview
Give patient opportunity to provide additional info
Provide opportunity to ask questions
Explain what will occur next
Effective questioning
Open ended
Closed ended
Graded response
Multiple option
