Psychology - communication Flashcards
What are the 3 most important things a DF1 trainer wants?
Communication
Diagnostic
Communication with staff (DFS)
Key things to remember about communication:
- Take masks down
- Only a minority of the time spent in the dental surgery involves the technique of treatment, the rest is to manage the patient, puth them and ease, talk them through the procedure and building up their confidence of you as a clinician
Whats the problem with communication?
- Student communication skills deteriorate during training (focus on technical stuff)
- 71% ptients would like to know more about what the dentist is doing and why (ADHS, 1998 & no improvement in more recent study)
- Avoid telling truth (e.g. lesions/additional teeth need extracting)
- <60% of patients concerns identified
- court cases often due to breakdown in communication
Is communication nature or nuture?
Some of both
Through experience & personality
Taught
What does good communication achieve?
Communication = core clinical skill (GDC)
- Consultations = increased accuracy, efficency & support and improved compliance
- Improved health outcomes (psychosocial adjustment = more accepting & adapt more easily)
- Enhance satisfaction
What are the different characterisitics of communication?
- Verbal/non verbal
- Sender/reciever
- Communicating with who (different skills needed e.g. family, nurse, patient, receptionist)
- Influenced by what (age, gender, language, social/professional position, ethnic group, socioeconomic status, emotion, health, special needs, context)
What are the different constiuents of communication?
- Content (what) e.g. words = 7%
- Process (how) e.g. vocal tone = 33%
- Perception (what we think and feel) e.g. facial expression and body language = 60%
Its not so much what you say but how you say it
Tactile communication:
- Primative social interaction expressing meanings = ebracing, kiss, hold, guide, shake hands (what we will be doing!)
- Socially constrained/culturally specific = acceptable/not acceptable
- Specialised in function (distances: intimate - 45cm, personal 45cm -1.3m, impersonal 3-4m, public 4m)
- Subjective
What are the different components of non verbal communication?
- Facial expression
- Gesture
- Eye contact
- Posture
Shows emotional state & state of interaction
Can use to see if a person is uncomfortable, distressed, etc. by looking at them
What are words used for in communication?
- Social interaction (develop/maintain comfortable relationship, no factual content is neccessary)
- Express emotion (empathy/sympathy)
- Communicate ideas
- Recording facts (charts, re-iterate symptoms, treatment planning)
KEY THING:
WORDS CAN HAVE DIFFERENT MEANINGS
so make sure on same track and there is an understanding
What happens when communication goes wrong?
Complaints (Struck off)
e.g.
- Misunderstanding/misinterpretation (effects of anxiety and shock = difficult to hear, retain and understand information)
- Not explaining procedure sufficiently (result in errors, insufficient info prior to treatment, surgeons behaviour when complaint made i.e. angry/offended, not taken seriously)
- Not encouraging questions
- Regional, social and cultural differences (should be age and gender appropriate, with inappropriate authority, under- emphasis)
What are the different features of an attentive listener?
SOLER
Square
Open
Leaning
Eyes
Relaxed
What should an attentive listener do?
- Same level
- Facing the speaker
- Leaning in slightly
- Appropriate eye contact
- Appropriate feedback (verbal and non verbal)
Look for mixed messages (what is not being said)
What are the different stages of an appointment?
Initiating session
Gathering information
Exploring patients perspecitive (ratings)
How should you iniate a session?
- Greet patient (name, date of birth etc.)
- Introduce self and role (handshake or not)
- Demonstrate respect
- Identify and confirm problems list (how can I help, what brings you here today)
- Negotiates agenda
How should you gather information?
- Encourage patient to tell story
- Move from open to closed questions appropriately
- Listen attentively
- Facilitate verbal and non verbal responses
- Easily understood questions and comments
- Clarifies statements
- Establishes dates
How should you explore the patients perspective?
- Determines & acknowledge patient ideas r.e. cause (do you know how this happened/what caused it?)
- Explores patients concerns (how does that seem/feel?)
- Encourages expression of emotion (you seem a little upset/ cross/ concerned)
- Picks up and responds to non verbal cues
Should you be caring or dominant?
Low dominance
High caring
What is dominance?
Control:
- information, appointments, treatment decisions
- closed questions, no confirmation of understanding
- = reduced patient satisfaction
What is caring?
Responding to patient cues and emotion:
- Rapport & empathy
- Open-ended questions/facilitation
- = increased patient satisfaction
