communication ch. 5ftc-drthorson.weebly.com/uploads/5/5/4/4/55444029/communication_pp_ftc.pdfverbal...

Communication

Ch. 5

Dr. Thorson

Lesson Objectives

Lesson Objectives

Upon completion of this lesson, students should be able to:

1.Define and spell the terms for this chapter.

2.Explain the importance of communication in health care today.

3.Define the terms values, attitudes, and behavior, and explain their roles in self-awareness.

Lesson Objectives

Lesson Objectives

Upon completion of this lesson, students should be able to:

4.Compare and contrast verbal and nonverbal communication.

5.List five examples of nonverbal communication conveying impatience.

Critical Thinking Question

1.How might you describe an individual who has a holistic approach to medicine?

The Holistic Approach to Medicine

• Holistic medicine focuses on the whole patient

• Addresses patient's social, emotional, and spiritual needs, as well as physical needs

• Treats everyone with respect, dignity, and courtesy

Interpersonal Dynamics

• Self-Awareness

• Character: sum of values, attitudes, behaviors a person exhibits

• Values: set of standards a person uses to measure the worth or importance of someone or something

• Attitudes: opinions that develop from our value system

Interpersonal Dynamics

• Self-Awareness

• Prejudice

• Preformed unfavorable belief or attitude toward members of a certain culture or group while having little or no experience with or information about the culture or group

• Behavior

• The actions others see, is based on our attitudes

Learning Styles

• Auditory

• Learn by hearing

• Difficulty retaining information presented in written format

• Visual

• Learn by seeing

• Visuals aids helpful

Learning Styles

• Kinesthetic

• Involves movement and assimilates knowledge through hands-on activities

The Communication Process

• SMCR

• S stands for the sender of the communication

• M represents the message

• C indicates the channel or method by which the message moves from sender to receiver

• R stands for the receiver of the message

FIGURE 5-1 Face-to-face communication is the richest channel to relay a message from the sender

to a receiver.

Verbal and Nonverbal Communication

• Verbal Communication

• Spoken words

• Sounds

• Tone of voice

• Word selection

• Positive attitude



• Empathy

• Ability to understand what patient is feeling because you have experienced the same feelings.

FIGURE 5-4 Empathy draws a more positive response from the patient because it is based on the willingness of the medical assistant to understand what the patient is experiencing.



• Sympathy

• Acknowledging patient's feelings and difficulties even though you have not had the same experience or can't really imagine yourself being in that person's position.

• Pity is feeling sorry for a person.


• Nonverbal Communication

• Facial expressions

• Gestures

• Body language

• Eye contact

• Grooming

• Mannerisms


• Communication Messages Conveying Impatience

• Interrupting people when they are speaking

• Answering telephone calls curtly

• Finishing another person's sentence

• Rushing the patient


• Communication Messages Conveying Impatience

• Looking at your watch or the clock

• Doing two things at once

• Not looking up from your work when someone approaches

• Rushing around the office

Communication Techniques

• Goal of the communication

• Message you want to send

• Channel or method the message will be delivered

• Listening skills to be used

• Receiving clarification and feedback

• Assessing if goal was met

Listening Skills

• Active listening

• Passive listening

Guidelines for Good Listening

• Avoid distractions

• Face the speaker

• Give the person your full attention

• Maintain eye contact

• Do not be judgmental

• Be aware of nonverbal cues

Guidelines for Good Listening

• Note anything that seems unclear

• Do not interrupt

• Maintain personal space

• Ask questions if you do not understand

Effective Listening Skills to Obtain the Chief Complaint

• Identify the patient

• Smile and establish eye contact

• Seat patient in an appropriate area

• Focus full attention on the patient

• Ask patient the reason for the current appointment

• Ask open-ended questions

• Do not interrupt the patient

Effective Listening Skills to Obtain the Chief Complaint

• Provide feedback by paraphrasing what the patient says

• Observe the patient for signs of needing to give more information

• Restate the chief complaint before leaving the patient

• Conclude patient interview in appropriate manner

• Document the chief complaint

Types of Questions

• Close-ended

• Can be answered with a yes or a no answer

• Open-ended

• Require more than just a yes or no answer

• Known as a directive method of questioning

Types of Questions

• Probing

• Asked to gain further information

• Leading

• Questions that contain part of the answer

Directive Communication Techniques

• Open-ended question

• Close-ended question

• Probing question

• Reflecting

• Acknowledgment

Directive Communication Techniques

• Restating

• Add to an implied statement

• Seek clarification

• Silence

Assertive versus Aggressive Behavior

• Assertive

• Making a point in positive manner by standing firm and based on your principles or values

• Trusting one's own ideas or instincts

• Possible to be assertive without being unpleasant

Assertive versus Aggressive Behavior

• Aggressive

• Imposing one's view point on another

• Manipulative and pushy

• Thought of as a negative behavior

• Has been compared with bullying

• Bossy and inconsiderate of feelings of others

Assertive Behavior Guidelines

• Take a few deep breaths to calm yourself

• In unemotional tones, describe the behavior that you would like the other person to change

• Describe how you feel when the behavior occurs

• State the positive behavior you would like to see

Assertive Behavior Guidelines

• Describe the appropriate, reasonable, and enforceable consequences that will result if person does not change his/her behavior

• Follow through with consequences if the behavior does not change

• Commend individual for behavioral change

• Evaluate your confrontation

A Customer-Friendly Environment

• Use good interpersonal skills to establish a positive environment in health care setting

• Patient should be greeted within one minute of entering the office

• Know your patient

Barriers to Communication

• Distractions such as noise

• Defensive behaviors

• Use of medical terminology

• Multicultural issues

• Language

• Diverse viewpoints

• Bias, prejudice, and stereotyping

• Religious beliefs and practices

Defensive Behaviors

• Compensation

• Denial

• Displaced anger

• Dissociation

• Introjection

• Projection

Defensive Behaviors

• Rationalization

• Regression

• Repression

• Sublimation

Avoid Prejudging and Stereotyping

• Be aware of one's own beliefs

• Learn about other cultures, races, nationalities

• Be sensitive to the feelings of others

• Evaluate information before accepting it as a belief

Avoid Prejudging and Stereotyping

• Avoid ethnic jokes

• Be open to differences

• When unsure of a patient's cultural beliefs, ask the patient to help you understand

Communication in Special Circumstances

• The Angry Patient

• Fearful of the diagnosis

• Frightened of the equipment

• Unwarranted fear of pain

• Loss of control

• Short-tempered



• Remain calm

• Use positive communication and professional techniques

• Try to defuse patient's anger

• Take patient into a private office



• Listen carefully, without judging, to assist in solving the problem

• Use a quiet, calm voice that projects concern


• The Anxious Patient

• White coat syndrome

• Anxiety patient feels when encountering medical staff


• The Anxious Patient

• Signs of anxiety

• Trembling

• Flushing

• Perspiring

• Fidgeting

• Talking excessively

• Remaining unusually quiet


• To deal with anxious patients:

• Speak calmly

• Reassure patients

• Smile

• Touch them respectfully on the hand

• Be empathetic

Patients with Sensory Impairment

• Hearing-Impaired Patient

• Select a quiet environment to communicate with patient

• Reduce outside noise

• Never shout; speak slowly and clearly

• Rephrase statements

• Explain everything carefully before performing a procedure


• Hearing-Impaired Patient

• Face the patient when speaking

• Make sure light is on your mouth and not behind you

• Have a paper and pen available so that the patient can communicate in writing

• Always provide written instructions or pamphlets for patient education purpose


• Visually Impaired Patient

• Speak to announce your presence

• Offer to guide patient into exam room

• Face patient and speak clearly

• Describe patient's surroundings

• Explain procedures in detail before beginning


• Visually Impaired Patient

• Do not to leave patient alone for any length of time

• Provide large print materials

• Do not be condescending

The Mentally and Emotionally Impaired Patient

• Determine what level of communication the patient can understand

• Speak slowly and clearly

• Stay calm

• Keep messages short

• Explain procedures prior to beginning

• Ask the patient's caregiver for assistance when necessary

The Patient Who Does Not Speak English

• Smile at the patient

• Determine if he or she has any ability to speak or understand English

• Speak in normal tones

• Use pantomime or pictures to demonstrate

• Ask a family member for assistance

The Physically Challenged Patient

• Allow patient to ambulate and move on their own

• Offer assistance only when necessary

• Treat patient with respect and dignity

• Allow extra time with this patient

• Do not appear to be impatient or rushed

Intraoffice Communication

• Establish trust

• Be open

• Honest

• Firm in convictions

• Present a professional image

• Use positive body language to help create a positive environment

Intraoffice Communication

• Good staff communication depends on positive and respectful interactions

• Be assertive not aggressive

• Gossip is unnecessary and unprofessional

Staff Communication

• Communication is vitally important to:

• Keep conflict to a minimum

• Establish a positive environment

• Provide quality health care

• Clearly defined areas of responsibility and authority should be established

Conflict Resolution

• Conflicts occur when miscommunication or misunderstanding of the message occurs

• Conflict can stem from prejudices or preconceived ideas

Conflict Resolution

• Conflict interferes with establishing rapport and cooperation

• Conflict can be a positive experience if it resolves issues of disagreement in an appropriate manner

Steps for Problem Solving

• Recognize that a problem exists

• Describe the problem and clarify what the basic issue is and factors affecting issue

• Identify alternative methods for solving the problem

Steps for Problem Solving

• Select the best solution for the problem

• Implement the solution

• Evaluate the results and adjust as needed

Elements of Critical Thinking

• Ask questions

• Define a problem

• Examine evidence

• Avoid emotional reasoning

• Analyze assumptions and bias

Elements of Critical Thinking

• Avoid oversimplification

• Consider other interpretations

• Tolerate ambiguity

• Think about one's own thinking

Steps in Conflict Resolution

• Communicate your needs in simple terms

• Know when to express your feelings

• Do not assume you know the other person's feelings

• Look at the issue from the other person's perspective

Communicating with Superiors

• Communication should be kept positive

• Be direct and to the point

• Do not promote gossip you have heard

• Ask for help if necessary

• Show initiative

• A loyal employee protects and defends an employer

Communication and Patients' Rights

• All patients have the right to have their personal privacy respected and their medical records handled with confidentiality


• Human dignity of each patient preserved regardless of patient's:

• Socioeconomic background

• Race

• Age

• Nationality

• Sexual orientation

• Gender


• Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 by Congress

• HIPAA Privacy Rule provides for federal protection of health information

• It allows patients to have:

• Better access to their medical records

• More control about how and to whom the information can be released

Protected Health Information (PHI)

• Name and address

• Phone and fax numbers

• Dates

• Social Security number

• E-mail address

• Medical record numbers

• Health plan beneficiary numbers

Protected Health Information (PHI)

• Account numbers

• Certificate or license numbers

• Vehicle identifiers, serial numbers, and license plate numbers

• Device identifiers and serial numbers

• URLs

• IP address numbers

Advising Patients

• As medical assistant, you are not permitted to:

• Offer your opinion about physician's diagnosis

• Discuss the course of action the physician has set forth

• Tell the patient what you would do in his or her position

Patient Decision Making

• As medical assistant, your role is to:

• Listen empathetically to the patient

• Ask him or her reflecting or clarifying questions

• Make clear the information the physician has related to the patient to help him or her come to a decision on a course of treatment

Risk Management

• Risk management: planning and implementing strategies for reducing physician's risk of a lawsuit in medical setting

• Communicate effectively with patient

• Keep all matters relating to patients' personal health information confidential

communication ch. 5ftc-drthorson.weebly.com/uploads/5/5/4/4/55444029/communication_pp_ftc.pdfverbal...

Documents