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Block 2 > M2: Principles of communication (More G2K on Trans) > Flashcards

M2: Principles of communication (More G2K on Trans) Flashcards

1
Q

imparting of information between a sender and a receiver

A

Communication

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2
Q

3 reasons why good communication

is important:

A
  1. To provide better healthcare for patients
  2. To address the needs or concerns of the patient effectively
  3. Have a positive effect on the patient’s physical condition
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3
Q

7 characteristics of the

interviewer that patients prefer: (G2K)

A
  1. Warm and sympathetic
  2. Easy to talk to
  3. Introduces themselves
  4. Self-confident
  5. Does not repeat themselves
  6. Listens to them and responds to verbal cues
  7. Asks questions that were easily understood and
    were precise
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4
Q

FREQUENT COMPLAINTS

OF DISSATISFIED PATIENTS

A
  1. Not listening
  2. Not given information
  3. Lack of concern to the patient
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5
Q

Difficulties medical students encountered during interviewing their patient included (G2K)

A
  1. Not enough information
  2. Forgot to ask influence of the patient’s problem
  3. Fail to observe verbal cues
  4. Bored during interview
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6
Q

The following are the most effective ways/methods for learning communication skills:

A
  1. Set the goal of the training
  2. Teacher acts first
  3. Students follow by practice
  4. Students receive feedback
  5. Students discuss their performance with a tutor
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7
Q

Factors by which people cope with illness in different ways are the following:

A

(PUSEL)

  1. Personality
  2. Upbringing
  3. Social class
  4. Ethnicity
  5. Life experiences
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8
Q

5 Patient related factors

A

(CAPPP)

  1. Current experience
  2. Anxiety
  3. Physical symptoms
  4. Psychological factors
  5. Previous experience
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9
Q

Ideal distance between seating arrangements

A

1.25 to 2.75 meters (4 to 9 feet).

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10
Q

How to interview bed ridden patients

A
  1. Don’t stand over them as much as possible

2. Get a chair and sit the same level as them

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11
Q

Verbal cue that may signify problem areas when talking to your patient

A

“Slips of the tongue”

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12
Q

It sometimes surfaces as a last, desperate attempt to

communicate because, with a hand on door, escape is readily accessible if the physician’s reaction is unfavorable.

A

HAND-ON-DOORKNOB SYNDROME

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13
Q

Because of fear of rejection or humiliation, the patient may test the physician with minor complaints before mentioning the real reason for the visit

A

HAND-ON-DOORKNOB SYNDROME

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14
Q

It is a good practice to ask the patient routinely at the

end of the visit (G2K)

A

“Is there anything we have not covered

or anything else you would like to ask me?”

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15
Q

voice effect that accompanies or modifies talking and often communicates meaning

A

Paralanguage

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16
Q

These 8 are conveyed by qualities of voice

A
  1. Urgency,
  2. sincerity,
  3. confidence,
  4. hesitation,
  5. thoughtfulness,
  6. happiness
  7. sadness,
  8. apprehension
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17
Q

action that can reverse the meaning of words.

A

Tone of voice

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18
Q

3 vocal messages

A
  1. Emotional quality
  2. Tone of Voice
  3. Length of pauses
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19
Q

is a common example of a contradiction

between vocal and verbal messages

A

Sarcasm

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20
Q

the study of nonverbal gestures, or body
movements, and their meaning as a form of
communication

A

Kinesics

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21
Q

5 body languages

A
  1. Posture
  2. Head motion
  3. Facial expression
  4. Eye contact
  5. Gestures
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22
Q

The tense person sits ___

A

erect with a fairly rigid posture

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23
Q

person who is moderately relaxed has a ____ sitting position

A

forward lean of approximately 20 degrees and a side lean of up to 10 degrees.

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24
Q

Higher patient satisfaction is associated with a _____ sitting position

A

physician’s forward body lean and rotation of the torso to-ward the patient.

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25
Q

A very relaxed position (usually too relaxed for

physicians interacting with patients) is a _____

A

back- ward lean (i.e., recline) of 20 degrees and a side- ways lean of more than 10 degrees.

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26
Q

found that “the patient also responds more favorably to the physician who relaxes his chin in his hands and gazes directly at the patient,

A

Larsen and Smith

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27
Q

Rapport is improved if the physician does not _____

A

Intimidate the patient

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28
Q

When good rapport exists between two people, each

will be _____ the other’s movements

A

MIRRORING

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29
Q

When listening to a patient, the physician should show interest and concern by an attentive position, which is best illustrated by _____

A

sitting forward in the chair with an interested, attentive facial expression and the head slightly tilted.

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30
Q

are least affected by
these cultural disguises and are the most consistently
dependable indicators of emotion.

A

The eyebrows, eyes, and forehead

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31
Q

can be a physician’s most effective weapon for
breaking down resistance or apprehension, especially in
children or young adults.

A

A smile

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32
Q

Micro-expressions last only about

A

one-fifth (1/5) of a

second

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33
Q

can easily be missed if physician is

not carefully observant of the patient.

A

Micro-expressions

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34
Q

2 Instances when micro-expressions occur are when

emotions are concealed by:

A
  1. Repression (unwittingly)

2. Suppression (deliberately)

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35
Q

The briefest expression

A

Surprise

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36
Q

Facial expression for Fear

A

Upper eyelids raised

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37
Q

Facial expression for Disgust

A

Nose wrinkled

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38
Q

Facial expression for Anger

A

Jaw thrust forward

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39
Q

Facial expression for Determination

A

Lips pressed

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40
Q

Facial expression for Sadness

A

Eyebrows drawn up or lip corners down

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41
Q

In most cultures, 60% to 70% of the time, good rap-port is enhanced when

A

Eye contact is made

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42
Q

90% of gaze will be in a

A

triangular area between eyes

and mouth

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43
Q

Pupils ___ when person sees something pleasant, and ____ when unpleasant.

A

Dilate, contract

44
Q

is the best method for conveying sincerity; it is the most appropriate technique used when listening to another person.

A

Frequent eye contact

45
Q

shown when patient’s eyes blink frequently or dart back and forth

A

Anxiety

46
Q

shown when patient maintains eye contact only one-fourth as long as non-depressed patients

A

Depression

47
Q

The following are cues for patients with abdominal pain

caused by organic disease

A
  1. They are more likely to keep eyes open during
    palpation of the abdomen than those with nonspecific
    pain.
  2. Patient with genuine abdominal tenderness may
    apprehensively watch the physician’s hand as it
    approaches the tender area.
48
Q

distinguished when hands are fidgety and grasping, when they shake when holding a pain, twitch,
or braced unnaturally.

A

Anxiety

49
Q

tightly-locked fingers that can

be an effort to mask anxiety

A

White-knuckle pose

50
Q

when speaker joins her/his hands, with

fingers extended and fingertips touching

A

Steepling

51
Q

index finger along the lips or extended along the cheek

A

“The thinker” position

52
Q

a defensive gesture that can indicate disagreement with another’s view

A

Crossed arms

53
Q

common leg position of comfort

A

Crossed legs

54
Q

gestures that can be an attempt to (establish

rapport) and good interpersonal relations

A

Preening

55
Q

the frequent clearing

of the throat even when no phlegm/mucus is present

A

Respiratory avoidance response

56
Q

a reflection of the fact that a (split) is being

forced between inner thoughts and outward action

A

Nose flick

57
Q

when what patient says

does not match his/her facial expression or gestures

A

Verbal-nonverbal mismatch

58
Q

Example of Verbal-nonverbal mismatch

A

Asymmetric facial expressions and a prolonged smile

59
Q

Enable one to obtain information and allow patients

to tell their own story

A

Open questions

60
Q

Reasons why open questions are more preferable

A
  1. More relevant information can be obtained
  2. Patients feel more involved in the interview.
  3. Patients can express themselves
61
Q

Questioning that Give patients little choice

A

Specific or closed questions

62
Q

Type of interview conducted as if the interviewer and

interviewee were close friends or relatives

A

Cambridge style

63
Q

during a consultation indicates to the

patient what you want to discuss next.

A

Signposting

64
Q

is a powerful therapeutic tool during interview

A

Empathy

65
Q

7 How to demonstrate empathy

A

(EMPATHY)

  1. Eye contact
  2. Muscle of facial expression
  3. Posture
  4. Affect
  5. Tone of voice
  6. Hearing the whole patient
  7. Your response
66
Q

imparting ideas or thoughts through verbal and

nonverbal means

A

Communication

67
Q

Clinical competence includes

A
  1. Medical technical knowledge
  2. Physical examination
  3. Medical problem solving
68
Q

categories of skills

A
  1. Content skill
  2. Process Skill
  3. Perceptual skill
69
Q

(Skills develop) on what doctors like you do. The (substance) of the questions you ask and the answers you receive

A

Content Skills

70
Q

Skills develop on (how doctors like you to do it)

Ex:
• How you ask questions
• How well you listen

A

Process Skills

71
Q

What doctors like you are thinking and feeling, or the (awareness of your own decision making) and other thought. It also Processes, (awareness) of, and response to your own attitudes and emotions during an interview

A

Perceptual Skills

72
Q

for the well-conceived,

well-delivered message

A

Shot-put (unilateral) approach

73
Q

for interaction, feed-back,

relationship, confirmation, common ground

A

Frisbee (bilateral) approach

74
Q

5 FRAMEWORK OF THE CALGARY CAMBRIDGE GUIDE

A
  1. Initiate
  2. Gather info
  3. Build relationship
  4. Explain
  5. Close
75
Q

In the 1970s, there were a series of studies on

medical students during their clerkship in psychiatry. Before training, students experienced difficulties in

A

obtaining histories from patients.

76
Q

2 Results for students who received feedback training with regards to communicating with patients are as follows:

A
  1. Feedback group = 3x accurate info on patient problem

2. Feedback group = given high ratings

77
Q

3 Results for doctors who received video feedback training as students showed the following:

A
  1. More empathetic.
  2. More self assured
  3. Better communication skills
78
Q

4 Factors that contribute to anxiety

A
  1. Unfamiliar environment
  2. Loss of personal space
  3. Separation from family and friends
  4. Loss of independency
79
Q

6 Doctor related factors in communicating

A
  1. Training in communication
  2. Self-confidence
  3. Personality
  4. Physical factors (e.g. tiredness)
  5. Psychological factors (e.g. anxiety)
  6. Preoccupation
80
Q

is extremely important (since it explains why patients believe they need the physician’s
help).

A

The chief complaint

81
Q

These 4 are primarily transmitted verbally during consultations.

A
  1. Symptoms,
  2. past medical history,
  3. family medical history
  4. psychosocial data
82
Q

Patients who do not mention a concern and who withhold requests are _______

A

Less satisfied with their care and less improved on their symptoms

83
Q

Korsch and Negrete (1972) found that some of the longest interviews between physician and patient were caused by

A

failures in communication

84
Q

Examples of paralanguage

A
  1. Velocity of speech
  2. Tone and volume
  3. Sighs and grunts
  4. Pauses
  5. Inflections
85
Q

There is a _____ duration in which two people who meet will scan each other’s face before gazing
downward.

A

3 second

86
Q

What do locked ankles signify?

A

Defensiveness

87
Q

Anger may be seen when feet are….

A

placed widely apart in

a position of stability

88
Q

Sadness is seen when feet are…..

A

Moving in slow circular pattern

89
Q

Examples of preening

A

→ Male pulling up socks, adjusting a tie, or combing hair
→ Female adjusting clothing or using a mirror to
review makeup

90
Q

Respiratory avoidance response means

A

indication of disgust or rejection

91
Q

Nose Rubbing means

A

Lying or struggle to appear calm

92
Q

9 Indications of lying (G2K)

A
  1. Nose rub
  2. pulling earlobe
  3. rub eye
  4. scratch neck side
  5. cover mouth with hand
  6. Micro expression
  7. Using arm and hand less
  8. Defensiveness
  9. Changing posture abruptly
93
Q

when the patient answers “fine” to the question “how are things between you and your husband” while looking sad and avoiding eye contact. This gesture signifies

A

Verbal-nonverbal-mismatch

94
Q

3 behaviors about asking questions that

studies of medical students and doctors have found

A

→ Too many questions = not giving chance
→ Too complicated/confusing questions
→ Ignoring questions that patients may ask

95
Q

“ How you have

been feeling in the past few days?” is an example of what kind of question?

A

Open ended question

96
Q

3 Disadvantage of open question

A
  1. Too Long interview
  2. Irrelevant info
  3. Difficult in recording
97
Q

“Have you been feeling unwell today?” is an example of what question?

A

Closed question

98
Q

3 Disadvantage of close style of questioning

A

→ Info is restricted to the question
→ The interview is controlled by the interviewer
→ The interviewee has little opportunity to express themselves

99
Q

Guidelines in an interview

A
  1. Set atmosphere
  2. Facilitate the patient
  3. Use open Q (Beginning)
  4. Use close Q (when appropriate
  5. Listen carefully
  6. Clarify
  7. Be alert for cues
  8. Encourage relevancy
100
Q

“What you’ve just told me about your job is interesting, but I’d like to hear more about the headaches you’ve been having. It would
help me to know more about the circumstances that
bring on your chest pain.” Is an example of

A

Relevancy

101
Q

What to do when the situation is silent

A
  1. Observe the patient
  2. Reflect
  3. Plan
  4. Dont rush
102
Q

“And now I would like to ask you a few more questions

about…” and “Thank you for discussing your problems with me and now I would like to examine you.” are examples of

A

SIGNPOSTING

103
Q

a powerful means of communication and Expresses a range of emotions including tender-ness,
love, and anger

A

Touch

104
Q

5 Essentials needed to learn skills and change behavior are as follows

A
  1. Systematic presentation of skills
  2. Observation
  3. Detailed feedback
  4. Practice
  5. Reiterate
105
Q

4 GOALS OF MEDICAL COMMUNICATION

A
  1. Collaboration
  2. Increase accuracy and efficiency
  3. Enhancing patient and physician satisfaction
  4. Improving health outcomes

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