MBBS 2nd Semester-HEALTH SCIENCES COMMUNICATION SKILLS IN ENGLISH CHAPTER1- What is Communication? DR.

ZITA LOBO

By the end of the chapter YO shou!d "e a"!e to #. Write the definition of communication $. %&p!ain the comp!ete process of communication '. nderstand the (arious !e(e!s) purposes communication for a medica! professiona! *. Team +or,

and

importance

of

-eanin./Definition/0rocess/0urpose/ -ethods of communication/1oises MEANING: COMMUNICARE to transmit, to s are, to ma!e !no"n, to #on$e% t e !no"&ed'e or in(ormation o(, to )arta!e, to #a&&, to )*t into #onne#tion, to &i$e to'et er, to #orres)ond "it + ,e(inition- IM.ARTING, CON/E0ING OR E1CHANGE O2 IN2ORMATION, I,EAS OR O.INIONS B0 THE USE O2 S.EECH, 3RITING OR GRA.HICS

.+S+ .ERKINS4 COMMUNICATION STAIRCASEExplain in detail the following: INTRAPERSONAL NON VERBALINTERPERSONAL SMALL GROUP ORGANISATIONAL PUBLI! PRESENATION MASS INTER!ULTURAL 2ac, 3i""4s theory of 5upporti(e and Defensi(e C!imates 3roups can "e identified "y o"ser(in. "eha(iors characteristic of supporti(eness or of defensi(eness After identifyin. these characteristics) you +ant to enhance supporti(e "eha(iors and e!iminate or reduce defensi(e ones Description6 7focus on 8+hat 9 ho+: 0ro"!em Orientation6 7tas, focus) each mem"er does her/his part: 5pontaneity6 openness) se!f;disc!osure: %mpathy6 7concern for others) perspecti(e ta,in.: %<ua!ity6 7!itt!e status differences) say 8+e)= 8us)= 8our=: %(a!uation6 7"!amin.) findin. fau!t) 8+hy=:

Contro!6 7manipu!ation of other to do my +or,: 5trate.y6 7+ithho!din. information cautious +ordin.:

1eutra!ity6 7impersona!) 8+hate(er= attitude: 5uperiority6 7us (s. them competition

THE COMMUNICATION CYCLE an information source) +hich produces a messa.e. -essa.e A transmitter) +hich encodes the messa.e into si.na!s 5i.na! f!o+s throu.h the channe! A channe!) to +hich si.na!s are adapted for transmission. A recei(er) +hich >decodes> 7reconstructs: the messa.e from the si.na!. A destination) +here the messa.e arri(es.

5It is t e )ro#ess 6% " i# # anne& to a re#ei$er+7

a transmitter sends a messa'e t ro*'

-eans and -ethods of communication/The process #The sender has an idea 7co.nition: that she +ants to re!ate $. The sender forms and encodes the idea ; 7+ords) e&pressions) .estures /"ody !an.ua.e: '. The sender notes the !istener>s readiness 7"ody !an.ua.e) other cues: and transmits the messa.e ; spea,s the +ords) communicates throu.h "ody !an.ua.e) intonation: *. The recei(er ta,es in the messa.e 7!istenin.) hearin.:

?. The recei(er decodes/understands the messa.e @. Aeed"ac, to sender "y recei(er 7throu.h "ody !an.ua.e) (er"a! response:

REASONS 2OR GOO, COMMUNICATION IN HEALTH CARE+

TO MA"E A!!URATE# !OMPRE$ENSIVE %IAGNOSIS %ETE!T EMOTIONAL %ISTRESS&&&& RESPON% PATIENT SATIS'A!TION (IT$ $EALT$ !ARE $AVE PATIENTS TO AGREE AN% 'OLLO( A%VI!E

0 R0O5%5 OA CO-- 1ICATIO1

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TO 5OLB% 0ROBL%-5

TO AORA1D -AI1TAI1 R%LATIO15 DI05

TO ALL%BIAT% DI5TR%55

CO-- 1IC A TIO1

TO CO1B%Y A%%LI135

TO 3IB% I1AOR-ATI O1 D%CI5IO1 -ACI13

TO 0%R5 AD%

BARRI%R5 71oises: TO CO-- 1ICATIO1 o DI5TORTIO1 o I1AD%E AT% CO-- 1ICATIO1 5CILL5 o LACC OA LI5T%1I13 ABILITY o ATTIT D%5 o I1CORR%CT I1AOR-ATIO1 o OTD%R BARRI%R5 o ADBIC% o 5OL TIO15 o E %5TIO15 o CRITICI5o TDR%AT o ALATT%RY o 5Y-0ATDY

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MBBS 2nd Semester-HEALTH SCIENCES COMMUNICATION SKILLS IN ENGLISH CDA0T%R $6 Basic communication s,i!!s DR. ZITA LOBO

0atient re!ated 0hysica! symptoms/psycho!o.ica! factors re!ated to i!!ness. 0re(ious e&perience of medica! care Current e&perience of medica! care Doctor re!ated6 Trainin. in communication s,i!!s 5e!f confidence in a"i!ity to communicate 0ersona!ity 0hysica! factors 0sycho!o.ica! factors The inter(ie+ settin.6 re<uirements 0ri(acy comforta"!e surroundin.s Appropriate seatin. arran.ement Other factors The patient4s "e!iefs a"out hea!th and i!!ness The pro"!em they +ish to discuss Their e&pectations of +hat the doctor +i!! do most often "ased on pre(ious e&perience Do+ they percei(e the ro!e of the doctor

Asking questions: Open and C osed !uestions "# questions When? Time Where? 0!ace Who? 0erson

Why? Reason Do+? -anner What? Which 7one:? Whose? Whom? Do+ much? Do+ many? Do+ !on.? Do+ often? Do+ far? What ,ind 7of:? In(ert the order of the su"Gect and the first au&i!iary (er". As,in. Euestions Open and C osed !uestions These are t+o types of <uestions you can use that are (ery different in character and usa.e. C&osed 8*estions $e%inition There are t+o definitions that are used to descri"e c!osed <uestions. A common definition is6 A c!osed <uestion can "e ans+ered +ith either a sin.!e +ord or a short phrase. Thus >Do+ o!d are you?> and >Where do you !i(e?> are c!osed <uestions. A more !imitin. definition is6 A c!osed <uestion can "e ans+ered +ith either >yes> or >no>. Thus >Are you happy?> and >Is that a ,nife I see "efore me?> are c!osed <uestions) +hi!st >Do+ are you?> and e(en >Do+ o!d are you?> are not) "y this definition) c!osed. This !imited definition is a!so sometimes ca!!ed a >yes or no> <uestion) for o"(ious reasons. Using & osed questions C!osed <uestions ha(e the fo!!o+in. characteristics6 They .i(e you facts. They are easy to ans+er. They are <uic, to ans+er. They ,eep contro! of the con(ersation +ith the <uestioner. This ma,es c!osed <uestions usefu! in the fo!!o+in. situations6

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 Acti(e and trained !istenin. is the )o*t i)po+tant a,ilit- any person shou!d use in discussions +ith patients. As it is more difficu!t to !isten than to spea,) !istenin. is a!so the more difficu!t component of discussion. A specific characteristic of the .ood hea!th careta,er is that he has a .ood !istenin. sty!e. Acti(e !istenin. means a Hready;to;recei(eH attitude) or Hattenti(e "eha(iourH. This does not on!y in(o!(e ta,in. in +hat is said) "ut a!so de(e!opin. an ear for the "ac,.round) and +hat is not said) as +e!! as the semi;tones or emphases. ' )re#onditions asso&iated (it# a&ti)e istening 6 #. Inte+e*t $. Readine** to !isten '. A,ilit- to !isten *. To "e comp!ete!y p+e*ent or Ha!! thereH. Three main e!ements %mphathic understandin.6 *+,pat#+ focuses on sharin. 7e&periencin.: a person4s "ad ne+s or fee!in.s) fee!in. sorry for the person suffer rin. the "ad ne+s/fee!in.s and +hether the sympathiIer a.rees +ith any of the person4s "e!iefs) opinions or .oa!s +hereas e,pat#+ focuses on sharin.7e&periencin. a person4s "ad and .ood ne+s or fee!in.s and understandin. the "ad or .ood ne+s/ fee!in.s rather than fee!in. sorry for the persons "ad ne+s/fee!in.s or a.reein. or disa.reein. +ith the person4s "e!iefs) opinions or .oa!s. nconditiona! positi(e re.ard Con.ruence Mi*ta.e* in !istenin. ha(e the fo!!o+in. far;reachin. conse<uences for patients or any other person6 The person is not a!!o+ed to e&press himse!f The person cannot utter his fee!in.s The person fee!s he is not ta,en serious!y

,EMONSTRATING A#ti$e Listenin' 9+ 2+ :+ ;+ =+ >+ ?+ A+ B+ 2a#i&itatin' C&ari(i#ation Re(&e#tionMirrorin' and )ara) rasin'< He&)in' t e )atient to 6e re&e$ant Si&en#e S*mmari@in' Si'n)ostin' Endin' an inter$ie"

9C+ Em)at % HEALTH *CIENCE* COMMUNICATION IN EN-LI*H P.o/ e, *o )ing C.iti&a t#inking $R0 1ITA LO2O !UE*TIONIN-3 ACTI4E LI*TENIN- AN$ 5ACILITATIN- PRO2LEM *OL4IN- a.e t#e &o.e ski s %o. &o,,uni&ating e%%e&ti)e + (it# patients0 A se$en-ste) )ro6&em so&$in' #%#&e There are a (ariety of pro"!em so!(in. processes "ut each process consists of a series of steps) inc!udin. identif-ing an i**/e# *ea+0hing fo+ option* and p/tting a po**i,le *ol/tion into a0tion. It is usefu! to (ie+ pro"!em so!(in. as a cyc!e "ecause) sometimes) a pro"!em needs se(era! attempts to so!(e it) or the pro"!em chan.es. To so!(e a pro"!em) ta,e the steps) one at a time. You can pro"!em so!(e anytime you ha(e a pro"!em to so!(e or a .oa! to achie(e. You can use the pro"!em so!(in. mode! to !oo, for so!utions to issues connected +ith your study) re!ationships) +or, or sport. You can ta,e the pro"!em so!(in. steps "y yourse!f) +ith a friend) or in a .roup. 0ro"!em so!(in. +ith others is often (ery effecti(e "ecause you ha(e access to a +ide (ariety of (ie+points and potentia! so!utions. The pro"!em so!(in. mode! is a usefu! resource for you to uti!ise in your persona!) academic and professiona! !i(es. 0ro"!em so!(in. is a s,i!! and a process +hich you can !earn. You can imp!ement the process to he!p you so!(e a pro"!em "y fo!!o+in. the se(en steps out!ined in this Learnin. 3uide. Once you ha(e !earned the steps and "e.un to imp!ement the process) pro"!em so!(in. +i!! "e a ne+ s,i!! +hich you ha(e ac<uired and can "e used not on!y +hen you are at the uni(ersity) "ut a!so in your !ife a!+ays.

II se, HEALTH *CIENCE* COMMUNICATION IN EN-LI*H C.iti&a t#inking $R0 1ITA LO2O

It is o% g.eat )a ue %o. t#e /ette. use o% ,edi&a kno( edge /ase t#ose ,edi&a p.o%essiona s in nu.tu.e & ini&a 6udg,ent3 &.iti&a t#inking and .e% e&ti)e p.a&ti&e0 O% t#ese &.iti&a t#inking %o.,s t#e &o.e o% ,edi&a de&ision ,aking p.o&ess0 7C.iti&a 8 in Latin and -.eek ,ean 7to de&ide o. 7to 6udge8 T#e o9%o.d Eng is# di&tiona.+ 7A &.iti&a 6udg,ent is ,ade /+ e9pe.ien&e and p.uden&e and .eason o. dis&ou.se8 Meaning o% 7t#ink8:to &on&ei)e3 %ee To ,editate3 tu.n o)e. in t#e ,ind To e9e.&ise t#e ,ind espe&ia + t#e unde.standing in an+ a&ti)e (a+: to %o., &onne&ted ideas o% an+ kind To i,agine3 &on&ei)e3 %an&+3 pi&tu.e To .e% e&t To /e o% opinion3 dee,3 6udge *o &.iti&a t#inking o. no( to sa+ it anot#e. (a+3 ,aking sound 6udg,ents3 (#i&# a.e not &enso.ious3 not &a.ping3 not %au t %inding3 /ut ski %u in 6udging0

C.iti&a t#inking is t#e pu.pose%u and .e% e&ti)e 6udg,ent a/out (#at to /e ie)e o. (#at to do in .esponse to o/se.)ations3 e9pe.ien&e3 )e./a o. (.itten e9p.essions3 o. a.gu,ents. CRITICAL THIN;IN- is t#e a&ti)e and s+ste,ati& p.o&ess o% Communication 0ro"!em;so!(in. %(a!uation Ana!ysis 5ynthesis Ref!ection "oth indi(idua!!y and in community to Aoster understandin. 5upport sound decision;ma,in. and 3uide action

Uses o% C.iti&a T#inking Critica! thin,in. under!ies readin.) +ritin.) spea,in.) and !istenin.. These are the "asic e!ements of communication. Critica! thin,in. a!so p!ays an important part in socia! chan.e. Consider that the institutions in any society ; courts) .o(ernments) schoo!s) "usinesses ; are the products of a certain +ay of thin,in.. Any or.aniIation dra+s its !ife from certain assumptions a"out the +ay thin.s shou!d "e done. Before the institution can chan.e) those assumptions need to "e !oosened up or rein(ented. Critica! thin,in. a!so he!ps us unco(er "ias and preGudice. This is a first step to+ard communicatin. +ith peop!e of other races and cu!tures. Critica! thin,in. is a path to freedom from ha!f;truths and deception. You ha(e the ri.ht to <uestion +hat you see) hear) and read. Ac<uirin. this a"i!ity is one of the maGor .oa!s of a !i"era! education. 5,i!!ed students are thorou.h thin,ers. They distin.uish "et+een opinion and fact. They as, po+erfu! <uestions. They ma,e detai!ed o"ser(ations. They unco(er assumptions and define their terms. They ma,e assertions carefu!!y) "asin. them on sound !o.ic and so!id e(idence. A!most e(erythin. that +e ca!! ,no+!ed.e is a resu!t of these acti(ities. This means that critica! thin,in. and !earnin. are intimate!y !in,ed. Critica! thin,in. in medicine means usin. !o.ic to understand hea!th pro"!ems and ma,e reasona"!e decisions in patient and community care

A T#inking Is $e%ined /+ t#e Eig#t E e,ents T#at Make It Up0 %i.ht "asic structures are present in a!! thin,in.6 Whene(er +e thin,) +e thin, for a purpose

+ithin a point of (ie+ "ased on assumptions !eadin. to imp!ications and conse<uences. We use concepts) ideas and theories to interpret data) facts) and e&periences in order to ans+er <uestions) so!(e pro"!ems) and reso!(e issues. T#inking3 t#en: .enerates purposes raises <uestions uses information uti!iIes concepts ma,es inferences ma,es assumptions .enerates imp!ications em"odies a point of (ie+

T#ink A/out000 Pu.pose I0 E e,ent: Pu.pose A .easoning #as a PURPO*E0 #. Ta,e time to state your purpose c!ear!y. $. Distin.uish your purpose from re!ated purposes. '. Chec, periodica!!y to "e sure you are sti!! on tar.et. *. Choose si.nificant and rea!istic purposes. You. pu.pose is +ou. goa 3 +ou. o/6e&ti)e3 (#at +ou a.e t.+ing to a&&o,p is#0 "e a so use t#e te., to in& ude %un&tions3 ,oti)es3 and intentions0 You shou!d "e c!ear a"out your purpose) and your purpose shou!d "e Gustifia"!e. !uestions (#i&# ta.get pu.pose What is your) my) their purpose in doin.JJJJJJJJ? What is the o"Gecti(e of this assi.nment 7tas,) Go") e&periment) po!icy) strate.y) etc.:? 5hou!d +e <uestion) refine) modify our purpose 7.oa!) o"Gecti(e) etc.:? What is the purpose of this meetin. 7chapter) re!ationship) action:? What is your centra! aim in this !ine of thou.ht? What is the purpose of education? Why did you sayK?

*tate t#e !uestion II0 E e,ent: !uestion A .easoning is an atte,pt to %igu.e so,et#ing out3 to sett e so,e !UE*TION3 to so )e so,e p.o/ e,0 #. 5tate the <uestion at issue c!ear!y and precise!y. $. %&press the <uestion in se(era! +ays to c!arify its meanin.. '. Brea, the <uestion into su";<uestions.

*. Distin.uish <uestions that ha(e definiti(e ans+ers from those that are a matter of opinion or that re<uire mu!tip!e (ie+points. T#e question a+s out t#e p.o/ e, o. issue and guides ou. t#inking0 "#en t#e question is )ague3 ou. t#inking (i a&k & a.it+ and distin&tness0 The <uestion shou!d "e c!ear and precise enou.h to producti(e!y .uide our thin,in.. !uestions (#i&# ta.get t#e question What is the <uestion I am tryin. to ans+er? What important <uestions are em"edded in the issue? Is there a "etter +ay to put the <uestion? Is this <uestion c!ear? Is it comp!e&? I am not sure e&act!y +hat <uestion you are as,in.. Cou!d you e&p!ain it? The <uestion in my mind is this6 Do+ do you see the <uestion? What ,ind of <uestion is this? Distorica!? 5cientific? %thica!? 0o!itica!? %conomic? OrK? What +ou!d +e ha(e to do to sett!e this <uestion?

III0 E e,ent: In%o.,ation and E4I$ENCE0 #. Restrict your c!aims to those supported "y the data you ha(e. $. 5earch for information that opposes your position as +e!! as formation that supports it. '. -a,e sure that a!! information used is c!ear) accurate and re!e(ant. *. -a,e sure you ha(e .athered sufficient information. In%o.,ation in& udes t#e %a&ts3 data3 e)iden&e3 o. e9pe.ien&es (e use to %igu.e t#ings out0 It does not ne&essa.i + i,p + a&&u.a&+ o. &o..e&tness0 The information you use shou!d "e accurate and re!e(ant to the <uestion or issue you are addressin.. !uestions (#i&# ta.get in%o.,ation What information do I need to ans+er this <uestion? What data are re!e(ant to this pro"!em? Do +e need to .ather more information?

-at#e.000 In%o.,ation A .easoning is /ased on $ATA3 IN5ORMATION

Is this information re!e(ant to our purpose or .oa!? On +hat information are you "asin. that comment? What e&perience con(inced you of this? Cou!d your e&perience "e distorted? Do+ do +e ,no+ this information 7data) testimony: is accurate? Da(e +e !eft out any important information that +e need to consider?

"at&# You.000 In%e.en&es I40 E e,ent: Inte.p.etation and In%e.en&e A .easoning &ontains IN5ERENCE* o. INTERPRETATION* /+ (#i&# (e d.a( CONCLU*ION* and gi)e ,eaning to data0 Infer on!y +hat the e(idence imp!ies. Chec, inferences for their consistency +ith each other. Identify assumptions under!yin. your inferences. #. In%e.en&es a.e inte.p.etations o. &on& usions +ou &o,e to0 In%e..ing is (#at t#e ,ind does in %igu.ing so,et#ing out0 Inferences shou!d !o.ica!!y fo!!o+ from the e(idence. $. Infer no more or !ess than +hat is imp!ied in the situation. !uestions to &#e&k +ou. in%e.en&es What conc!usions am I comin. to? Is my inference !o.ica!? Are there other conc!usions I shou!d consider? Does this interpretation ma,e sense? Does our so!ution necessari!y fo!!o+ from our data? Do+ did you reach that conc!usion? What are you "asin. your reasonin. on? Is there an a!ternati(e p!ausi"!e conc!usion? 3i(en a!! the facts +hat is the "est possi"!e conc!usion? Do+ sha!! +e interpret these data?

C a.i%+ You.000 Con&epts 40 E e,ent: Con&epts A .easoning is e9p.essed t#.oug#3 and s#aped /+3 CONCEPT* and I$EA*0 Con&epts a.e ideas3 t#eo.ies3 a(s3 p.in&ip es3 o. #+pot#eses (e use in t#inking to ,ake sense o% t#ings0 Be c!ear a"out the concepts you are usin. and use them Gustifia"!y #. Identify ,ey concepts and e&p!ain them c!ear!y. $. Consider a!ternati(e concepts or a!ternati(e definitions of concepts. '. -a,e sure you are usin. concepts +ith precision. . !uestions +ou &an ask a/out &on&epts What idea am I usin. in my thin,in.? Is this idea causin. pro"!ems for me or for others? I thin, this is a .ood theory) "ut cou!d you e&p!ain it more fu!!y? What is the main hypothesis you are usin. in your reasonin.? Are you usin. this term in ,eepin. +ith esta"!ished usa.e? What main distinctions shou!d +e dra+ in reasonin. throu.h this pro"!em? What idea is this author usin. in his or her thin,in.? Is there a pro"!em +ith it?

C#e&k You.000 Assu,ptions BI. E e,ent: Assu,ptions A .easoning is /ased on A**UMPTION*0 Assu,ptions a.e /e ie%s +ou take %o. g.anted0 T#e+ usua + ope.ate at t#e su/&ons&ious o. un&ons&ious e)e o% t#oug#t0 #. C!ear!y identify your assumptions and determine +hether they are Gustifia"!e. $. Consider ho+ your assumptions are shapin. your point of (ie+.

'. -a,e sure that you are c!ear a"out your assumptions and they are Gustified "y sound e(idence. !uestions +ou &an ask a/out assu,ptions What am I assumin. or ta,in. for .ranted? Am I assumin. somethin. I shou!dn4t? What assumption is !eadin. me to this conc!usion? What isK 7this po!icy) strate.y) e&p!anation: assumin.? What e&act!y do socio!o.ists 7historians) mathematicians) etc.: ta,e for .ranted? What is "ein. presupposed in this theory? What are some important assumptions I ma,e a"out my roommate) my friends) my parents) my instructors) my country?

T#ink T#.oug# t#e000 I,p i&ations and Consequen&es 4II0 E e,ent: I,p i&ations A .easoning eads so,e(#e.e o. #as IMPLICATION* and CON*E!UENCE*0 I,p i&ations a.e & ai,s o. t.ut#s t#at ogi&a + %o o( %.o, ot#e. & ai,s o. t.ut#s0 I,p i&ations %o o( %.o, t#oug#ts0 Consequen&es %o o( %.o, a&tions0 Imp!ications are inherent in your thou.hts) +hether you see them or not. The "est thin,ers thin, throu.h the !o.ica! imp!ications in a situation "efore actin.. #. Trace the imp!ications and conse<uences that fo!!o+ from your reasonin.. $. 5earch for ne.ati(e as +e!! as positi(e imp!ications. '. Consider a!! possi"!e conse<uences. !uestions +ou &an ask a/out i,p i&ations If I decide to do 8L=) +hat thin.s mi.ht happen? If I decide not to do 8L=) +hat thin.s mi.ht happen? What are you imp!yin. +hen you say that? What is !i,e!y to happen if +e do this (ersus that? Are you imp!yin. thatK? Do+ si.nificant are the imp!ications of this decision? What) if anythin.) is imp!ied "y the fact that a much hi.her percenta.e of poor peop!e are in Gai! than +ea!thy peop!e?

Unde.stand You.000 Point o% 4ie( 4III0 E e,ent: Point o% )ie( is ite.a + 7t#e p a&e8 %.o, (#i&# +ou )ie( so,et#ing0 It in& udes (#at +ou a.e ooking at and t#e (a+ +ou a.e seeing it0 #. -a,e sure you understand the !imitations of your point of (ie+ and that you fu!!y consider other re!e(ant (ie+points. !uestions to &#e&k +ou. point o% )ie( Do+ am I !oo,in. at this situation? Is there another +ay to !oo, at it that I shou!d consider? What e&act!y am I focused on? And ho+ am I seein. it? Is my (ie+ the on!y reasona"!e (ie+? What does my point of (ie+ i.nore? Da(e you e(er considered the +ay JJJJ72apanese) -us!ims) 5outh Americans) etc.: (ie+ this? Which of these possi"!e (ie+points ma,es the most sense .i(en the situation? Am I ha(in. difficu!ty !oo,in. at this situation from a (ie+point +ith +hich I disa.ree? M$NNO Aoundation Aor Critica! Thin,in.. ; Freference materia! from The Thin,er>s 3uide to Ana!ytic Thin,in. !UE*TION* ON CRITICAL THIN;IN-< $e%ine &.iti&a t#inking0 "#at is pu.pose< !uestion at issue< In%o.,ation< In%e.en&e and inte.p.etation< Con&epts< Assu,ptions< I,p i&ations and &onsequen&es< Point o% )ie(< FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF