INTRODUCTION TO

BLOCK MEDICAL
COMMUNICATION
PUTU SUTISNA

 Communication
imparting, conveying or exchanging of
ideas, news, knowledge etc.
Methods of communication?
Purposes of communication?

Purposes of Communication

to form & maintain relationship

to give information
to convey feelings
to persuade
to solve problems
to alleviate distress
to make decisions
to give reassurance

Communication in Medicine
Doctor patient/family
Doctor doctor
Doctor community

Main areas covered

1. Medical consultation:
1.1Taking medical history and review of body
systems
1.2 Giving information to patient
1.3 Special approach to specific
patient/situation
2. Writing medical letters & notes, and CV
3. Scientific writing
4. Paper presentation and discussion
5. Health education/promotion

Good communication skills can be

learnt.
Provided, there are
Written instructions /references
Opportunities to practice
Feedbacks & discussion on performance
(SGD)

Students who were given communication

training
Get more accurate information from patient
Are more emphatic
More self-confident
More able to use open questions and respond
to verbal cues
Given higher ratings by patients

BASIC CONCEPTS OF

COMMUNICATION
WITH PATIENT
AND FAMILY
PUTU SUTISNA

Lectures main objectives:

To describe the importance of good
communication with patients
To describe the factors that may influence
the outcome of communication between
the doctor and patient
To explain the technique of conducting
effective communication with patients that
involves questioning, listening and
facilitating

Doctor-Patient Communication,
Influencing Factors
Patient-related factors
- Physical symptoms
- Psychological factors related to illness
- Previous experience of medical care
- Current experience of med care

 Doctor-related factors
-Training in communication skills
- Self-confidence in ability to communicate
- Personality
- Physical factors (e.g. tiredness)
- Psychological factors (e.g. anxiety)

 Interview setting requirements

- Privacy
- Comfortable surroundings
- Appropriate seating arrangement

Guidelines for conducting

interview with patient
A. Beginning
1. Greet patient by name
2. Ask patient to sit down
3. Introduce yourself
4. Explain purpose of interview
5. Say how much time available
6. Explain need to take notes

B. Main part of interview

1. Maintain +ve atmosphere, warm manner,
eye contact
2. Use open questions, esp at beginning
3. Listen carefully
4. Be alert and responsive to verbal & non
verbal cues
5. Facilitate patient verbally & non-verbally
6. Use closed questions when appropriate

7. Clarify what patient has told you

8. Encourage patient to be relevant

C. Ending
1. Summarize what patient has told you
2. Ask if patient wants to add anything
3. Thank patient

 Key skills for communicating

effectively with patient
Questioning
Listening
Facilitating

Questioning
Main purpose of interviewing patient:
to obtain information about patients
condition that is accurate, complete and
relevant
Good communication with patient alone
contributes to correct diagnosis in about
80% of cases

 Open questions
should be used as much as possible
to obtain great deal of information from patient
Would you please tell me how you have been
feeling in the past few days?
I understand that you have had pain. Would
you please tell me more about it?
Can you tell me what brings it on?etc

 Closed questions
Give patient little choice in the way to answer
Usually elicits little information, only yes or
no.
I see from your GPs notes that you have had
chest pain. Do you still have the pain?
Was it tight or dull pain?
Did it go down your arm?
Did it get worse when you exercised?

Advantages of open questions

More relevant information in given time
Patient feels more involved
Patient can express all concerns and
anxieties about problems
When to use close questions?
To obtain specific information not yet given
by patient
In emergency cases

Listening
Features of active and effective listening:
Gathering and retaining information
accurately
Understanding implications for patient of
what is being said
Responding verbal & non-verbal signals or
cues
Demonstrating you are paying attention
and trying to understand

Non-verbal cues:
Eye contact
Posture
Gestures
Facial expressions
Way voice is used

Facilitating
Part of effective listening. Aims to help patient to
talk fully about problems.
By verbal way
Please go on and tell me more about your
pain.
Yes, I understandplease continue.
By non verbal ways:
Leaning slightly forward toward patient
Making eye contact
Nodding head at appropriate time

Pitfalls in communication
Asking too many or complicated questions
Not allowing patient to tell story in his/her
own words
Unnecessary interruption
Failing to pick up important verbal & nonverbal cues

Patients appreciate/respect doctors

who
are warm and sympathetic
are easy to talk to
introduced themselves
appear self-confident
listen to the patients and respond to their
verbal cues
ask easy-to-understand questions

Patients complain about doctors who

would not listen
would not give information
showed lack of concern or lack of respect
for the patients

Summary
1.The ability to communicate effectively and
sensitively is essential in medicine
2. Communicating effectively with patients involves
the core skills of questioning, listening and
facilitating
3. Good communication leads to: accurate history
taking and diagnosis, patients compliance with
treatment plan, patients satisfaction with the
care given
4. The skills of good communication can be learnt
and retained

Aim of a doctor
since ancient time:
To cure sometimes,
relieve often,
comfort always

THANK YOU

 How to show youre active listening:

eye contact
posture; sitting slightly forward
nodding head
saying: hmm...go on
asking question directly related to
patients last statement

Communication with Family

How family can help?
Provide emotional & social support
Provide practical support
Provide understanding of beliefs about
illness & treatment
Provide information about family history

 Help avoid/overcome bad patient

compliance
Overcome difficulties arising from secrets
Anticipate/address problems that may
affect other family members