Communications 1 & 2: Essential Communication Skills (incomplete) Flashcards
what are the aims of communication skills? x8
- 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
communication can be broken down into what 3 aspects?
- the way it is said (38%)
- actions that accompany words (55%)
- the words (7%)
why is knowledge about communication useful? what is poor communication associated with?
- good communication improves patient health outcomes, satisfaction and adherence
- strong association with complaints and litigation
3 basic models of clinician-patient interaction?
- activity-passivity model
- guidance-cooperation model
- mutual participation model
clinician’s and patient’s role in the activity-passivity model of interaction?
clinician’s role: does something to patient - active role
patient’s role: accepts treatment offered - passive role
clinician’s and patient’s role in the guidance-cooperation model of interaction?
clinician’s role: tells patient what to do - active role
patient’s role: patient cooperates - passive role
clinician’s and patient’s role in mutual participation model of interaction?
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
psychodynamic model:
what does it appreciate most?
what is the dentist-patient relationship like?
what does this model allow?
- 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
what are the 3 elements to the psychodynamic model?
- the real relationship
- treatment alliance
- transference and regression
what is the “real relationship” based on?
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
what is the “transference and regression” relationship?
- 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
what is the “treatment alliance”?
- it is the working relationship
- patient aligns himself with dentist
- adult-adult relationship
- patient is able to use treatment (???)
what are the 6 steps to forging a treatment alliance?
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
what are some examples of verbal communication? x6
explaining questioning listening clarifying repeating goal setting
what are some examples of non-verbal communication? x6
body language eye contact proximity (personal space) level and posture non-verbal cues empathy
what are the 6 components of the calgary-cambridge approach?
+ what does each component entail?
- initiating the session
- gathering information
- building the relationship
- providing structure
- explanation and planning
- closing the session
open questions: what do they allow? what do they facilitate?
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
focused questions: what do they help in?
- guide interview/conversation
- help patient tell clinician about topic they have difficulty speaking about
closed questions: what are they like? when are they used? what are they useful for?
- 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
what are the general guidelines for questioning?
- 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
explaining: what is the most important thing? what should be kept in mind?
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
general guidelines for explaining?
- 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
listening to a patient: what are some things to take note of while listening?
- 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
listening: what are the dos?
- 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
listening: what are the don’ts?
- 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
non-verbal communication cues: what are they and what does each establish?
- facial expression: convey emotions
- eye contact: engagement
- posture: establish rapport
- paralinguistics: voice, speech, rate, articulation, pitch, emphasis, volume
barriers to effective communication?
- language barriers
- misunderstanding
- language: colloquiallisms, jargon
- environment
- anxiety
- expectations
what does CLASS stand for?
context listening acknowledging the patient's emotions strategy summary of topics discussed
