Communications 1 & 2: Essential Communication Skills (incomplete)

Question 1

what are the aims of communication skills? x8

Answer 1

• encourage right atmosphere to establish rapport
• encourage patient to volunteer information, to feel involved in own care
• identify and negotiate dental health goals with patient
• use a style and language that is appropriate to each patient at each stage of interaction
• avoid jargon, explain meaning of medical/dental terms
• recognize when an interview is going wrong and make the right adjustments
• understand and use non-verbal communication
• seek patient’s compliance with treatment and health goals

Question 2

communication can be broken down into what 3 aspects?

Answer 2

• the way it is said (38%)
• actions that accompany words (55%)
• the words (7%)

Question 3

why is knowledge about communication useful? what is poor communication associated with?

Answer 3

• good communication improves patient health outcomes, satisfaction and adherence
• strong association with complaints and litigation

Question 4

3 basic models of clinician-patient interaction?

Answer 4

1. activity-passivity model
2. guidance-cooperation model
3. mutual participation model

Question 5

clinician’s and patient’s role in the activity-passivity model of interaction?

Answer 5

clinician’s role: does something to patient - active role

patient’s role: accepts treatment offered - passive role

Question 6

clinician’s and patient’s role in the guidance-cooperation model of interaction?

Answer 6

clinician’s role: tells patient what to do - active role

patient’s role: patient cooperates - passive role

Question 7

clinician’s and patient’s role in mutual participation model of interaction?

Answer 7

clinician’s role: helps patient help himself - active/passive role
patient’s role: is empowered to participate in care - active role

*adult to adult prototype

Question 8

psychodynamic model:
what does it appreciate most?
what is the dentist-patient relationship like?
what does this model allow?

Answer 8

• appreciates active quality of dentist and patient interaction
• dentist & patient are equally autonomous, negotiate a way forward, sharing information and coming to a joint decision (mutual participation model)
• allows for flexibility within interaction, dentist-patient relationship does not remain static, but changes with time of acquaintance and during treatment

Question 9

what are the 3 elements to the psychodynamic model?

Answer 9

• the real relationship
• treatment alliance
• transference and regression

Question 10

what is the “real relationship” based on?

Answer 10

based on patient’s recognition of the qualities possessed by the dentist in terms of clinical skills

• dentist’s patient management skills and technical skills led to the patient selecting the practice.
• adult to adult relationship

Question 11

what is the “transference and regression” relationship?

Answer 11

• transference is the change that occurs when the treatment begins.
• patients past feelings are being relived in the current moment
• no longer a relationship between adults, but one where the dentist is in a position of power
• patient may start to perceive dentist as caring parent
• regression: change from emotional state of more control to one of less control
• temporal state of affairs: changes when treatment has ended

Question 12

what is the “treatment alliance”?

Answer 12

• it is the working relationship
• patient aligns himself with dentist
• adult-adult relationship
• patient is able to use treatment (???)

Question 13

what are the 6 steps to forging a treatment alliance?

Answer 13

1: establish empathy
2: dentist communicate effectively
3: patient encouraged to speak openly and freely
4: dentist appreciating patient’s fears
5: patient trusting dentist and building rapport
6: joint decision making

Question 14

what are some examples of verbal communication? x6

Answer 14

explaining
questioning
listening
clarifying
repeating 
goal setting

Question 15

what are some examples of non-verbal communication? x6

Answer 15

body language
eye contact
proximity (personal space)
level and posture 
non-verbal cues
empathy

Question 16

what are the 6 components of the calgary-cambridge approach?

+ what does each component entail?

Answer 16

1. initiating the session
2. gathering information
3. building the relationship
4. providing structure
5. explanation and planning
6. closing the session

Question 17

open questions: what do they allow? what do they facilitate?

Answer 17

allow:
- patient to talk, pt in control can bring as much information they feel is necessary
- patient to set agenda
- patient to ventilate their anxieties and concerns
can also facilitate information gathering

Question 18

focused questions: what do they help in?

Answer 18

• guide interview/conversation

- help patient tell clinician about topic they have difficulty speaking about

Question 19

closed questions: what are they like? when are they used? what are they useful for?

Answer 19

• yes/no question
• used late in the conversation. cannot be used to early because it prevents patient from volunteering information
• help to clarify important points brought to conversation by patient
• can also close down a rambling or wordy response

Question 20

what are the general guidelines for questioning?

Answer 20

• think before you speak
• move between open, focused and closed questions
• avoid jargon
• one question at a time
• avoid leading questions, may intimidate patient
• ask the right question to get the right answer

Question 21

explaining: what is the most important thing? what should be kept in mind?

Answer 21

clarity - to be clear about your objectives

• what changes you want your pt to make
• what you want your patients to know, feel, be able to do

Question 22

general guidelines for explaining?

Answer 22

• be realistic in objectives
• give most important information first
• repeat key points
• use short words and sentences
• avoid jargon
• structured information
• visual aids (posters, models)
• be friendly
• establish rapport, understanding and feedback

Question 23

listening to a patient: what are some things to take note of while listening?

Answer 23

• the way words are being said
• conscious of feelings underlying the words spoken
• recognize hidden feelings
• to be aware of what is left unsaid
• be aware of non-verbal communications

Question 24

listening: what are the dos?

Answer 24

• encourage pt to talk
• give attn to what is being said, remain interested
• paraphrase the pt’s words to clarify what is being said
• sum up, summarize

Question 25

listening: what are the don’ts?

Answer 25

• jumping to conclusions
• hearing what you want to hear
• tuning out opposing opinions
• formulating and rehearsing your own response
• not paying attn to what the pt is saying
• excessive talking or interrupting

Question 26

non-verbal communication cues: what are they and what does each establish?

Answer 26

• facial expression: convey emotions
• eye contact: engagement
• posture: establish rapport
• paralinguistics: voice, speech, rate, articulation, pitch, emphasis, volume

Question 27

barriers to effective communication?

Answer 27

• language barriers
• misunderstanding
• language: colloquiallisms, jargon
• environment
• anxiety
• expectations

Question 28

what does CLASS stand for?

Answer 28

context
listening 
acknowledging the patient's emotions
strategy
summary of topics discussed