Communication Skills

Vikas Gupta Junior Resident

Contents • Introduction • Communication

– Definitions– Communication cycle– Channels of communication– Types of communication

• Communication skills– Transmission skills– Reception skills

• Communication barriers• Importance of communication skills in public health • Conclusion

Introduction • I'm a great believer that any tool that enhances

communication has profound effects in terms of how people can learn from each other, and how they can achieve the kind of freedoms that they're interested in.” - Bill Gates

Introduction • In recent years good

doctor–patient communication has been linked to improved patient satisfaction, better patient care and a decrease in malpractice lawsuits.

Introduction • In medical profession

communication is most essential skill.

• Effective communication helps professionals to easily arrive at diagnosis.

Introduction • Effective communication

skills may relieve doctors of some of the pressures of dealing with the difficult situations encountered in this emotionally demanding profession.

• Patients are less likely to complain if doctors communicate well. There is, therefore, a reduced likelihood of doctors being sued.

DEFINITIONS

• Communication is a process of transmitting ideas, information, attitudes which we have formulated for ourselves, by the use of symbols, words, pictures, images, figures from the source to a receiver, for the purpose of influencing with intent.

DEFINITIONS

• Health communication is the study and practice of communicating promotional health information, such as in public health campaigns, health education, and between doctor and patient.

• Public health communication is the scientific development, strategic dissemination, and critical evaluation of relevant, accurate, accessible, and understandable health information communicated to and from intended audiences to advance the health of the public.

Health communication functions

• Raising morals• Organization• Motivation• Education

Health communication functions

• Counseling• Health development• Information • Persuasion

Communication Cycle

Source Conte

nt

MediumAudience

Effect

Communication Cycle A good message : • Must be in line of objectives, meaningful,

based on felt needs, clear and understandable, specific and accurate, timely and adequate, fitting the audience, interesting, culturally and socially appropriate

Channels of communication 1. Interpersonal

Communication – A. It is the process of face-to-

face interaction between sender and receiver such as group meetings, interviews, conversations among individuals.

B. Most effective and persuasive

Channels of communication 2. Mass Communication- directed simultaneously to a large, heterogeneous and anonymous audience on a massive scale.

The mass media includes:A. Print media- newspapers,

magazines, books, etc.B. Electronic media- radio programs,

audio recordings, television programs, cinema theatres, Internet.

Channels of communication 3. Folk media • Folk dances, singing,

dramas, Nautanki in UP, Burrakatha in AP, and Harikatha in Western India

TYPES OF COMMUNICATION

Types of Communication1. Verbal communication

A. Oral communication, such as dialogue, discussion, telephone calls.

B. Visual communication, such as maps, graphics, traffic signals, advertisement.

C. Written communication, such as letters, reports, papers.

D. Electronic communication, facilitated by an interface with a computer, modem, fax, E-mail.

Types of Communication2. Non verbal communication:• It is communication that

occurs without words• Four main aspects of

nonverbal communication:– Facial expression– Postures – Eye contact– Gestures

Types of Communication• 3. One way

communication(Didactic)Drawbacks = knowledge is imposed, learning is authoritative, little audience participation, no feedback, does not influence human behaviour.

• 4. Two way communication(socratic)

Types of Communication5. Formal communication : follows lines of authority6. Informal communication (grape-vine)A. Flexibility B. Rapid communicationC. No recordD. DistortionE. Spontaneous

Communication skills 1. Transmission Skills

– Presentation Skills• Verbal Skills• Non verbal Skills

2. Reception Skills– Listening– Feedback

• Verbal• Nonverbal

Presentation Skills1. Structure your presentation

A. OpeningI. Welcoming courtesiesII. Self-identification III.The intention of the presentation

B. Attention grabbing, creative openingsC. Memorize your opening to maintain eye

contact

Presentation Skills

2. Rehearse your Presentation and get familiar with it, you don’t have to memorize it

A. Strategies:I. Speak in a mirrorII. Speak to a friendIII. Speak to in a tape recorder, or better a

video cameraB. Check face, eyes, posture and

gestures.C. Check tone and transition.

Presentation Skills3. Make the arrangements

A. Notify audienceB. Room and seating

arrangementC. Check visual aidsD. Check handouts or materialE. Prepare what you’ll wear

according to the occasion, make sure it gives you comfort and self confidence.

Verbal Skills

Verbal Skills

Non verbal skills

Non verbal skills

Non verbal skills

Non verbal skills

Non verbal skills

Reception Skills Listening Types of Listening

1. Selective Listening (e.g. TV)

2. Comprehensive Listening (e.g. Lecture)

3. Critical Listening (e.g. for analysis of speech)

4. Appreciative Listening (e.g. music)

Poor Listening1. Condemning the subject as

uninteresting without hearing (Prejudice)

2. Criticizing the speaker's delivery or aids

3. Getting Personal (Criticizing the speaker himself)

4. Interrupting!!5. Selective listening6. Day Dreaming7. Evading the difficult or technical

(giving up to listen when you don’t understand)

8. Sleeping

Good Listening1. Find Area of Interest2. Judge content, not delivery3. Hold Your Fire = Control

Yourself!!!4. Listen for Ideas5. Be flexible6. Work at Listening7. Resist Distractions8. Exercise Your Mind9. Keep your mind open10. Use your thought speed

Feedback• It tells us if we are on track or not• Feedback gives us indications to what extent

did receivers understand our messages• Communicators should always encourage the

audience to give their feedback (by questions)• It can be verbal and non verbal

Verbal Feedback1. Productive

Interruptions– Clarification.– Elaboration.– Bringing to focus.– Reinforcement,

encouragement.– Questions

2. Non-Productive Interruptions

– Put-Downs.– Objection.– Joking.– Corrections.– Judgments.– Jumping to

conclusions– Changing the

subject

Nonverbal Feedback1. Eyes: open, focused shows

agreed. Shut eyelid – boredom, tired

2. Crossed Arms: are a clear sign that this person is resistant to what you say.

3. Purposeful positive head movement: is an excellent signal, e.g. nodding.

4. “Ah-hah!" experience

Nonverbal Feedback5. Shaking heads: It's OK, but a bad thing to disagree on all points.

6. You want to see people leaning forward, not leaning back. Leaning bad in seats means apathy, waiting for something interesting.

COMMUNICATION BARRIERS

1. Physiological Barriers2. Emotional Or Psychological Barriers 3. Environmental Barriers4. Cultural Barriers

Emotional Or Psychological Barriers

1. Neurosis2. Levels of intelligence3. Inattention4. Loss of transmission & poor

retention5. Undue reliance on the written

word6. Distrust of communication7. Failure to communicate

Environmental Barriers1. Noise 2. Invisibility3. Congestion

Cultural Barriers1. Illiteracy 2. Customs and beliefs 3. Religions 4. Attitude 5. Language 6. Social class differences

Importance of Communication Skills in Public health

• Delivery of health education 1. Supportive supervision 2. School health program 3. Training of health care professionals4. IEC activities for outbreak and epidemics5. Behavior change communication

Importance of Communication Skills in Public health

• Academically 1. Conferences- national/ international 2. Thesis/ Publications 3. Key speaker in conferences• Socially 1. Reviewing maternal and infant deaths 2. Population surveys(NFHS) 3. Program implementation

Conclusion• Communication is important not only to

professional-patient interaction but also within the healthcare team.

• The benefits of effective communication include good working relationships and increased patient satisfaction.

• Effective communication may increase patient understanding of treatment, improve compliance and, in some cases, lead to improved health.

Conclusion• Recognized its importance,

medical schools/colleges have strived to teach students not only the science of medicine, but also the art of communication.

• Unfortunately, creating methods for teaching communication skills that are effective and enjoyed by most students is challenging.

Conclusion• Students must have opportunities to practice

communicating in different ways, including spoken, written and electronic methods.

• There should also be guidance about how to cope in various circumstances.

• Some examples are listed below: a. during house visit/ survey

b. breaking bad newsc. dealing with difficult and violent patients, mental illnessd. helping vulnerable patients

Conclusion• Communication skills are now regarded as a

core competence. Assessment of communication skills will be necessary as part of the doctors appraisal and personal development plans.