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TRANSCRIPT
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
Verbal and Nonverbal Communication
• Verbal Communication
• 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.
Verbal and Nonverbal Communication
• Verbal Communication
• 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.
Verbal and Nonverbal Communication
• Nonverbal Communication
• Facial expressions
• Gestures
• Body language
• Eye contact
• Grooming
• Mannerisms
Verbal and Nonverbal Communication
• Communication Messages Conveying Impatience
• Interrupting people when they are speaking
• Answering telephone calls curtly
• Finishing another person's sentence
• Rushing the patient
Verbal and Nonverbal Communication
• 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
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
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
Communication in Special Circumstances
• The Angry Patient
• Remain calm
• Use positive communication and professional techniques
• Try to defuse patient's anger
• Take patient into a private office
Communication in Special Circumstances
• The Angry Patient
• Listen carefully, without judging, to assist in solving the problem
• Use a quiet, calm voice that projects concern
Communication in Special Circumstances
• The Anxious Patient
• White coat syndrome
• Anxiety patient feels when encountering medical staff
Communication in Special Circumstances
• The Anxious Patient
• Signs of anxiety
• Trembling
• Flushing
• Perspiring
• Fidgeting
• Talking excessively
• Remaining unusually quiet
Communication in Special Circumstances
• 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
Patients with Sensory Impairment
• 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
Patients with Sensory Impairment
• 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
Patients with Sensory Impairment
• 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
Communication and Patients' Rights
• Human dignity of each patient preserved regardless of patient's:
• Socioeconomic background
• Race
• Age
• Nationality
• Sexual orientation
• Gender
Communication and Patients' Rights
• 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