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Fundamental Communication Skills

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Proxemics. Touch. Nonverbal Communication (continued) Kinesics = body ... Proxemics = physical proximity. 3-foot area around patient considered personal space ... – PowerPoint PPT presentation

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Title: Fundamental Communication Skills


1
Chapter 3
  • Fundamental Communication Skills

2
Fundamental Communication Skills
  • Communication sending and receiving messages
  • Verbal or otherwise

3
Fundamental Communication Skills (continued)
  • Medical assistants role
  • Accurate and appropriate information sharing
  • First point of contact for patients
  • Be positive, pleasant
  • Use good communication skills at all times

4
Basic Communication Flow
  • Three elements
  • Message to be sent
  • Person to send message
  • Person to receive message
  • Two or more people alternate as sender and
    receiver

5
Basic Communication Flow (continued)
  • Medical assistant communicates in therapeutic
    manner
  • Office procedures
  • Policies
  • Patient care

6
Basic Communication Flow (continued)
  • Other communication responsibilities
  • Clarifying messages
  • Validating patient perceptions
  • Adapting messages to patients understanding
  • Verifying message as received

7
Checkpoint Question 1
  • What three elements must be present for
    communication to occur?

8
Answer
  • For communication to occur, these three elements
    must be present a message to be sent, a person
    to send the message, and a person to receive the
    message.

9
Forms of Communication
  • Verbal communication
  • Nonverbal communication

10
Verbal Communication
  • Verbal communication involves an exchange of
    messages using words or language it is the most
    commonly used form and is usually the initial
    form of communication.
  • Oral communication sending and receiving
    messages using spoken language
  • Be pleasant, polite
  • Use proper English and grammar

11
Verbal Communication (continued)
  • Gear your conversation to the patients
    educational level.
  • Consider
  • Heart attack vs. myocardial infarction
  • Do not talk down to patients

12
Verbal Communication (continued)
  • Paralanguage voice tone, quality, pitch,
    volume, range
  • Nonlanguage laughing, sighing, grammatical
    structure, pronunciation
  • Its not what you say, its how you say it.

13
Verbal Communication (continued)
  • Written communication using written language to
    exchange messages
  • Must be clear, concise, and accurate
  • Unclear messages may hinder treatment
  • Example
  • Return to the office if you dont feel better.
  • OR
  • If your temperature is not back to normal in 24
    hours, call to schedule a revisit.

14
Checkpoint Question 2
  • List five examples of paralanguage.

15
Answer
  • Voice tone, quality, volume, pitch, and range are
    five examples of paralanguage.

16
Nonverbal Communication
  • Nonverbal communicationexchanging messages
    without using wordsis sometimes called body
    language.
  • Kinesics
  • Proxemics
  • Touch

17
Nonverbal Communication (continued)
  • Kinesics body movements
  • Facial expressions
  • Gestures
  • Eye movements
  • Can reveal patients true feelings more
    accurately than verbal communication
  • Learn to read patients actions and nonverbal
    clues for information

18
Nonverbal Communication (continued)
  • Proxemics physical proximity
  • 3-foot area around patient considered personal
    space
  • Must enter personal space to deliver care
  • Because some individuals become uncomfortable
    when their space is invaded, it is essential to
    approach the patient in a professional manner and
    explain what you plan to do.

19
Nonverbal Communication (continued)
  • Touch
  • Can be therapeutic
  • Indicates support, concern
  • Some patients threatened by touch
  • Assess patients demeanor for clues before
    applying touch

20
Active Listening
  • Ensures messages are correctly received
  • Give full attention
  • Minimize interruptions
  • Focus on verbal and nonverbal indicators
  • Develop active listening skills with practice

21
Interview Techniques
  • Medical assistants responsibility to gather
    patient information
  • Patient interviewing
  • Ask questions
  • Interpret responses
  • Goal is to gather accurate and pertinent
    information

22
Interview Techniques (continued)
  • New patients
  • Medical and family history
  • Review of body systems
  • Social history
  • Established patients
  • Review chart
  • Make a list of questions
  • Reconfirm medications and treatments

23
Interview Techniques (continued)
  • Conducting an interview
  • Listen actively
  • Ask appropriate questions
  • Record answers
  • Introduce yourself
  • Know what questions to ask and in which order
  • Eliminate distractions

24
Interview Techniques (continued)
  • Six interviewing techniques
  • Reflecting
  • Paraphrasing
  • Clarification
  • Open-ended questions
  • Summarizing
  • Allowing silences

25
Reflecting
  • Repeating what you hear the patient say with
    open-ended statements
  • Allow patients to complete sentences
  • Reflection encourages the patient to make further
    comments.
  • Example
  • Mrs. Rivera, you were saying that your back
    hurts you….
  • Do not overuse

26
Paraphrasing or Restatement
  • Repeat statements using your own words
  • Paraphrasing can help verify that you have
    accurately understood what was said.
  • Allows patients to clarify
  • Example
  • You are saying that….

27
Asking for Examples or Clarification
  • Asking patients to provide examples
  • Such as
  • Can you describe one of those dizzy spells?

28
Asking Open-Ended Questions
  • Requires patient to form answers and elaborate
  • Be careful about asking why questions, because
    they can often sound judgmental or accusing.
  • Example
  • How did you get that large bruise on your arm?

29
Asking Open-Ended Questions (continued)
  • Avoid closed-ended questions
  • Example
  • Are you taking your medications?

30
Summarizing
  • Reviewing information obtained
  • Gives patient chance to clarify or correct
    misinformation
  • Also helps you organize your information
  • Example
  • You told me that you have been feeling dizzy for
    the past 3 days and that you frequently stumble
    when walking.

31
Allowing Silences
  • Silences can be beneficial
  • Silences are natural parts of conversations and
    can give patients time to formulate their
    thoughts, reconstruct events, evaluate their
    feelings, or assess what has already been said.

32
Checkpoint Question 3
  • What are six interviewing techniques?

33
Answer
  • When interviewing patients, you can use six
    techniques. These include reflecting,
    paraphrasing or restatement, asking for examples
    or clarification, asking open-ended questions,
    summarizing, and allowing silences.

34
Factors Affecting Communication
  • Messages may not be received despite best efforts
  • Common causes
  • Clichés
  • Unclear message
  • Anxious patient
  • Environmental distractions

35
Factors Affecting Communication (continued)
  • Clichés
  • Example
  • Dont worry. Rome wasnt built in a day.
  • Patient may interpret message to mean she is slow
    or old
  • Better statement
  • I can see youre making progress.

36
Factors Affecting Communication (continued)
  • Unclear or inappropriate message
  • Example
  • I have scheduled you for a PET scan in radiology
    tomorrow at 800 a.m.
  • Patients may not understand technical language
  • Better statement
  • The doctor wants you to have a test called a PET
    scan here is a brochure that explains it.

37
Factors Affecting Communication (continued)
  • Patients may be anxious or distracted
  • Pain
  • Positive or negative news

38
Factors Affecting Communication (continued)
  • Environmental distractions
  • Noises
  • Interruptions

39
Cultural Differences
  • Patients perceptions and values are influenced
    by cultural, social, and religious beliefs
  • Patients have a variety of ethnic and cultural
    backgrounds
  • Medical assistants must understand differences
    for effective communication

40
Cultural Differences (continued)
  • Consider
  • Personal questions during a medical history
  • Eye contact
  • Shyness

41
Stereotyping and Biased Opinions
  • All patients must be treated fairly,
    respectfully, and with dignity, regardless of
    their cultural, social, or personal values
  • Stereotyping judging all members of an ethnic
    or cultural group based on oversimplified
    negative characterizations
  • Stereotyping and bias prohibit therapeutic
    relationships

42
Stereotyping and Biased Opinions (continued)
  • Treat patients impartially
  • Guard against discrimination
  • Remain nonjudgmental
  • Avoid stereotypes
  • Maintain professional demeanor

43
Language Barriers
  • Because it is crucial for you to give and receive
    accurate information, you will need to use an
    interpreter to help bridge any language barriers.
  • Staff member
  • Family member
  • Phrase book

44
Language Barriers (continued)
  • Additional suggestions
  • Do not shout
  • Demonstrate or pantomime
  • Speak to patient, with interpreter in line of
    vision
  • Speak slowly, simply
  • Avoid slang
  • Avoid distractions
  • Learn basic phrases of other languages in your
    area

45
Special Communication Challenges
  • Assess situation and patients ability to
    comprehend
  • Include patients in exchange
  • Examples
  • Hearing- or sight-impaired patients
  • Speech impairments
  • Mental health illness
  • Distressed patients
  • Children
  • Grieving patients

46
Hearing-Impaired Patients
  • Many forms of impairment
  • Anacusis complete hearing loss
  • Presbycusis partial hearing loss, common in
    older patients
  • Tact, diplomacy, and patience are needed for
    effective communication

47
Hearing-Impaired Patients (continued)
  • Other suggestions for effective communication
  • Touch gently to gain attention
  • Talk directly, face-to-face
  • Illuminate face
  • Lower voice pitch
  • Notepads, demonstrations, pictograms
  • Short sentences
  • Eliminate distractions

48
Checkpoint Question 4
  • What is the term for complete
  • hearing loss?

49
Answer
  • The medical term for complete hearing loss is
    anacusis.

50
What If?
  • You need to call a hearing-impaired patient. What
    should you do?

51
Sight-Impaired Patients
  • Range from complete blindness to blurred vision
  • Lose valuable nonverbal communication

52
Sight-Impaired Patients (continued)
  • Suggestions for improving communication
  • Identify yourself by name
  • Maintain normal speaking voice
  • Keep patient informed notify before touching
  • Allow patient to touch table, chair, counter,
    etc.
  • Offer to escort patient in office
  • Tell patient when entering or leaving room
  • Explain machine sounds

53
Speech Impairments
  • Variety of types
  • Dysphasia difficulty with speech usually a
    neurological problem
  • Dysphonia voice impairment usually a physical
    condition
  • Stuttering

54
Speech Impairments (continued)
  • Suggestions for communicating effectively
  • Allow patient time to gather thoughts
  • Allow time for communicating
  • Do not rush conversation
  • Offer a notepad
  • Consider speech therapist

55
Checkpoint Question 5
  • What is the medical term for
  • difficulty with speech? What does
  • dysphonia mean?

56
Answer
  • The medical term for difficulty with speech is
    dysphasia. Dysphonia is voice impairment.

57
Mental Illness
  • Mental illness can affect communication
  • Outbursts
  • Muteness
  • Patients may hear voices
  • In-depth training required with moderate to
    severe mentally ill patients
  • Keep communication professional, nonjudgmental,
    and encouraging

58
Mental Illness (continued)
  • Suggestions for improving communication
  • Tell patient what to expect and when
  • Focused and professional conversation
  • Do not force patient to answer
  • Alert supervisor if you feel unsafe
  • Do not confirm hearing voices
  • If necessary, orient patient to reality

59
Angry or Distressed Patients
  • With upset patients, prevent escalation of
    problem
  • Keep patients informed
  • Wait times
  • Billing or insurance charges
  • Office policies

60
Angry or Distressed Patients (continued)
  • Most patients take sad news calmly
  • Offer assistance
  • Provide written information
  • Be supportive
  • Be honest
  • Avoid false reassurances
  • Do not belittle patients problem
  • Ensure safety with angry patients

61
Children
  • Tailor communication to childs comprehension
    level
  • Other suggestions
  • Maintain eye contact
  • Use low-pitched, gentle voice
  • Slow, visible movements
  • Rephrase questions as needed

62
Children (continued)
  • Child may return to lower development level for
    comfort
  • Use play to gain cooperation
  • Allow expression (fear, crying)
  • With adolescents
  • Assess situation before including parent
  • Remain objective

63
Communicating With a Grieving Patient or Family
Member
  • Grief great sadness caused by a loss
  • Also called mourning
  • Five stages
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance

64
Communicating With a Grieving Patient or Family
Member (continued)
  • Patients may want to discuss
  • Feelings
  • Fears
  • Concerns for loved ones
  • Allow time for expression
  • Listen actively
  • Offer appropriate education

65
Communicating With a Grieving Patient or Family
Member (continued)
  • Focus on empathy, not sympathy
  • Empathy can help you recognize a patients fear
    and discomfort so you can do everything possible
    to provide support and reassurance.
  • Sympathy can compromise professional relationship
    with patient.

66
Checkpoint Question 6
  • What are the five stages of grieving?

67
Answer
  • The five stages of grieving are denial, anger,
    bargaining, depression, and acceptance.

68
Establishing Positive Patient Relationships
  • To establish and maintain positive relationships
    with patients, speak respectfully and exhibit an
    appropriate demeanor during all interactions.

69
Proper Form of Address
  • Use proper form of address when greeting patients
  • Example
  • Good morning, Mr. Jones.
  • Shows respect
  • Sets professional tone
  • Avoid pet names

70
Proper Form of Address (continued)
  • Referring to the patient as a medical condition
    sends the message that the staff values the
    patient as nothing more than an illness, which
    can lead to increased anxiety.

71
Professional Distance
  • Establish level of communication to deliver
    patient care
  • Personal involvement may jeopardize ability to
    make objective decisions
  • Maintain professional distance
  • Avoid revealing intimate personal details

72
Teaching Patients
  • One of fundamental communication skills necessary
    for medical assistants
  • May be simple or complex

73
Teaching Patients (continued)
  • Guidelines for effective patient education
  • Be knowledgeable
  • Know special services in area
  • Have printed information available
  • Allow enough teaching time
  • Minimize disruptions
  • Be clear, concise, organized
  • Give patient time to assimilate
  • Ask questions to determine patient understanding
  • Invite follow-up call

74
Professional Communication
  • Communicating with peers
  • Communicating with physicians
  • Communicating with other facilities

75
Communicating With Peers
  • Professional and appropriate at all times
  • Avoid nonwork-related topics
  • Be honest, accurate
  • Become involved in local and national
    professional organizations

76
Communicating With Physicians
  • Be professional
  • Address physician as doctor unless otherwise
    specified
  • Use correct medical terminology
  • Be honest
  • If unsure, explain condition rather than guessing
    at a term

77
Communicating With Other Facilities
  • Maintain patient confidentiality
  • Observe legal requirements
  • Use caution with fax, e-mail
  • Provide only the facts
  • Be objective
  • Confirm receipt
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