Session 2 - communication skills and the doctor-patient relationship

Question 1

List the 6 CanMEDs key competencies required of all healthcare practitioners

Answer 1

1. Scholar
2. Professional
3. Communicator
4. Collaborator
5. Leader and Manager
6. Health Advocate

Question 2

What is the goal of communication in an ethical therapeutic relationship?

Answer 2

To improve the patient’s health and medical care

Question 3

What do patients feel in an ethical therapeutic relationship?

Answer 3

Patients feel valued, understood and motivated to co-operate.

Question 4

What is a ethical therapeutic relationship based on?

Answer 4

The core ethical principles as prescribed by the Health Professions Council of South Africa

Question 5

What are the core ethical principles as prescribed by the HPCSA?

Answer 5

1. Respect for persons
2. Beneficence
3. Non-maleficence
4. Confidentiality
5. Informed consent
6. Privacy
7. Compassion
8. Tolerance
9. Autonomy
10. Human rights

Question 6

Name the common problems leading to patient complaints.

Answer 6

1. failure to demonstrate an empathetic response.
2. intolerance
3. gaps in listening, caring, time spent with patients

Question 7

What are the 3 types of communication skills in healthcare practices?

Answer 7

1. Content skills
2. Process skills
3. Perceptual skills

Question 8

Describe patient-centered care.

Answer 8

A relationship where patients are treated as partners in a two-way relationship, involved in decision-making and are respected for their individual values and concerns. Patients’ responsibility is enlisted for their care and the focus is not mainly on the technical aspects of care.

Question 9

What does Content skills entail?

Answer 9

What the Healthcare practitioner communicates i.e. the substance of Q&As, information, treatments discussed

Question 10

What does Process skills entail?

Answer 10

How healthcare practitioners communicate i.e. verbal & non-verbal skills, relationship, structure of communication

Question 11

What does Perceptual skills entail?

Answer 11

What healthcare practitioners think or feel i.e.
internal decisions
problem-solving
reasoning
attitudes
personal capacity for compassion, respect etc.
self-awareness
self-confidence
own biases

Question 12

Discuss the first aim of communication in healthcare.

Answer 12

Communication is fundamental to healthcare:

it is used for information gathering, diagnosis and treatment, patient education and health team interactions

Question 13

Discuss the second aim of communication in healthcare

Answer 13

Communication is an international requirement in medical education:

communication skills in medical encounters are critically important and patients expect good communication. As a result we must define, teach and evaluate communication skills for physicians in training.

Question 14

Discuss the third aim of communication in healthcare.

Answer 14

Effective communication is the foundation of a doctor-patient relationship:

We should always honour the patient’s trust, avoid the abuse of power and treat them with politeness and consideration. The patient should be given information they need in an understandable way and at their level. Their right to be involved in their own healthcare should be respected.

Question 15

What are the 7 benefits of effective communication for the patient?

Answer 15

1. increased satisfaction
2. greater symptom resolution
3. lower referral rates
4. improved functional status
5. enhanced health outcomes
6. increased compliance
7. reduced anxiety, distress and vulnerability

Question 16

What are the 5 benefits of effective communications for the physician?

Answer 16

1. increased job satisfaction
2. increased efficacy
3. reduced malpractice claims
4. increased well-beings
5. reduced stress and burnout

Question 17

What are the 3 benefits of effective communication in medical care?

Answer 17

1. improved diagnostic accuracy
2. better doctor-patient relationships
3. reduced errors

Question 18

List the essential communication skills in the medical encounter.

Answer 18

1. Open the discussion
2. Gather information
3. Understand the perspective of the patient
4. Share information with the patient
5. Reach agreement on problems and plans
6. Provide closure

Question 19

Give the 4 barriers to effective communication.

Answer 19

1. Patient health status
2. Diversity
3. Logistics
4. Doctor’s fears

Question 20

Give 5 examples of how the patient’s health status can be a barrier to effective communication.

Answer 20

1. Impeded speech ability or language articulation
2. Altered mental state
3. Medication effects
4. Cerebral-vascular event
5. Psychologic or emotional distress

Question 21

List 8 diversity factors that can be barriers to effective communication.

Answer 21

1.Race
2. Gender
3. Culture
4. Language
5. Education
6. Values
7. Personality
8.Temperament

Question 22

Name 3 logistical factors that can be barriers to effective communication.

Answer 22

1. Time constraints
2. Unavailability to meet face-to-face
3. Venue - interruptions, background noise, personal space

Question 23

Give 4 points that fall under Doctor’s fear with regards to barriers of effective communication.

Answer 23

1. Litigation
2. Abuse
3. Unrealistic patient expectations
4. Burden of work

Question 24

List 3 examples of verbal communication skills.

Answer 24

1. Simple word choices
2. Speech or language patterns
3. Voice - volume, tone, speed, emotion

Question 25

List 8 examples of non-verbal communication skills.

Answer 25

1. Eye contact 2. Facial expressions 3. Body position 4. Personal space 5. Appearance 6. Behaviour/physical contact 7. Gestures 8. Use of objects

Question 26

Name 3 relationship skills.

Answer 26

1. Self-awareness 2. Sensitivity to the needs of others 3. Capacity for critical self-reflection

Question 27

Name the 4 key components to listening well.

Answer 27

1. Give 100% attention 2. Respond 3. Prove understanding 4. Prove respect

Question 28

Explain the 'Give 100% attention' component of listening well.

Answer 28

Care enough to suspend all other activities. Focus and don't judge. Show empathy, slow down to walk with the patient.

Question 29

Explain the 'Respond" component of listening well.

Answer 29

Use verbal and non-verbal communication to prove that you have received the message and affirm.

Question 30

Explain the 'Prove understanding' component of listening well.

Answer 30

Use evidence such as restating what has been said and questioning to show that you understand what is being said. Don't jump to conclusions.

Question 31

Explain the 'Prove respect' component of listening well.

Answer 31

Communicate at the level of the speaker and imagine yourself as being where they are. Don't interrupt.

Question 32

Give an overview on dealing with diversity when communicating.

Answer 32

Diversity may lead to conflict, misunderstanding and distrust. Culture may not be obvious and English is not the primary language of all. Offense is often unintentional. Cultural competence requires an awareness of others and good understanding of self.

Question 33

Describe measures to address communication in crisis situations and when wearing PPE.

Answer 33

1. Effective communication that reduces uncertainty and anxiety is needed. 2. Information needs to be delivered in small amounts while dealing with patient emotions and values. 3. Healthcare workers have to remain updated with trustworthy sources and take responsibility for evidence-based care. 4.