Importance of good clinical communication skills

1. INTRODUCTION TO CLINICAL
COMMUNICATION SKILLS
Dr RM Abraham
Clinical skills
NRMSM UKZN

2. CLINICAL COMMUNICATION
SKILLS(CCS)
AIM:
 To promote the practice of effective
communication within the healthcare settings
with patients, carers, collegues and other
professionals.

3. EFFECTIVE
COMMUNICATION/GOOD
CONSULTATION
involves:
 Understanding the patients problems from
his/her perspective by allowing the patients to
narrate their story in their words and at the
same time demonstrating interest, empathy,
respect and attending to their comfort at all
times.
 Sharing information with the patients with
regards to:
a)Explaining procedures that would be necessary
to help make a diagnosis.
b)Discussing the various treatment options and
their effects.

4. GOOD DOCTOR
 Remember that the success of a good doctor
depends not only on his/her medical knowledge
but also the way he/she communicates with
his/her patients e.g the way he explains the
problems, diagnosis and treatment to his
patients.
 Since Medicine is a subject that is learnt from
the interaction with patients, it is therefore
essential that medical students develop their
communicating capacity at the undergraduate
level.
 We would therefore be teaching and providing
you with the building blocks that are necessary
to create a Good consultation.

5. CCS-OBJECTIVES
 To explore the basics of what makes a good
doctor.
 Importance of a medical interview in clinical
practice from the point of view of :
a)The doctor
b)The patient

6. A-WHAT MAKES A GOOD DOCTOR?
 Think of a previous medical encounter you had with a
doctor
-How did the consultation go?
-How was the Doctor-patient relationship and what do
you perceive should be a good doctor-patient
relationship?
-What do you really value and need in a good doctor?
-Why does a good doctor-patient relationship matter?
-What did the doctor do to make the interview go well?
-What could the doctor do to make the interview go
better?
-What message about being a good doctor did you take
away from the experience?

7. GOOD DOCTOR-PATIENT
RELATIONSHIP
 Achieved by:
1)Establishing a good rapport with the patient:
 Greet the patient
 Obtain patients name
 Intrd yourself, clarify your role and the nature of the
interview
 Obtain consent
2)At all times demonstrating interest,empathy,respect and
attending to the patients physical comfort.
3)Good communication with patient:
 Gives the patient the chance to tell you what is wrong with
them in their words.
 They will tend to open up as they have the impression that
you are honest with them and hence they trust you and
feel more confident to tell you what is exactly going on in
their mind

8. GOOD COMMUNICATION
Skills:
-Encouraging the patient to tell his/her story of the problem from when
it started to the present in their words using a more open questioning
technique.
-Listening attentively without interrupting by:
 Wait time-give pt adequate time to respond
 Facilitative response-encourage pt to say more using phrases "uh-
huh", "go-on","I see", "yes"
 Non-verbal skills-gives the pt a clue of your level of interest
E.g. body posture, eye contact, gesture, facial expression, touch
 Picking up pts verbal and non-verbal cues and responding to them-
often pts ideas, concern and expectations are provided in these cues.
-Use of appropriate language (avoid using medical jargon or explain the
jargon).
-Clarifying statements that appear vague.
-Summarizing periodically to verify your understanding and also gives
pt the feeling that you are listening to them attentively.

9. AIM: TO OBTAIN FACTUAL ACCOUNT OF PATIENTS ILLNESS
AS WELL AS THE PATIENTS PERSPECTIVE OF THE ILLNESS
B4 SUGGESTING AND AGREEING TO A PLAN OF
MANAGEMENT
Doctors agenda:
a)Develop a good
relationship with the pt.
b)Make a diagnosis-
 by obtaining the
sequence of events and
analyzing the symptoms
etc(History taking)
 Examination of pt.
 Investigating pt.
c)Manage the pt.-
 Pharmacological
 Non-pharmacological
Patients agenda:
To discuss
a)Ideas and thoughts of
the illness.
b)Concerns about the
illness.
c)Expectations from the
consultation.
d)Feelings about the
illness.
e)Effects the illness is
having on their life.

10. ANALYZING A CONSULTATION
 Watch the DVD clippings of medical
consultations on the facebook page(
www.facebook/clinicalskillsukzn) to help explore
their
a) Purpose
b) Difficulties
c) Strengths and
d) Weaknesses
From both the doctor's and patient's view point

11. THANK YOU