interpersonal skill.pdf

CHAPTER
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4
Interpersonal
Communication

Learning Outcomes
4.1 Identify elements and types of
communication.
4.2 Relate communication to human
behavior and needs.
4.3 Categorize positive and negative
communication.
4-2

Learning Outcomes (cont.)
4.5 Carry out therapeutic communication
skills.
4.6 Use effective communication strategies
with patients in special circumstances.
4.7 Carry out positive communication with
coworkers and management.
4-3

Introduction
• Medical assistants must
– Recognize human behaviors
– Communicate effectively
• Professionally
• Diplomatically
– Recognize obstacles that
affect communication
4-4

Elements of Communication
• Communication circle
– Message
– Source
– Receiver
4-5

Elements of Communication (cont.)
• Feedback
– Verbal or nonverbal
– Verification of understanding
• Noise
– Sounds
– Physical or emotional discomforts
4-6

4-7
Apply Your Knowledge
What are the elements of the
communication circle and what can
cause interference in the process?
ANSWER: The elements are: message,
source, and receiver. Noise can interfere with
the communication circle.

Human Behavior and Needs
• Different personality types – require different
communication styles
• Humanistic role in the healthcare process
– Attention
– respect
4-8

Developmental Stages of the Life Cycle
• Infant
– 0 to 1 year old
– Trust vs. mistrust
• Toddler
– 2 to 3 years old
– Autonomy vs.
shame and doubt
• Preschooler
– 3 to 6 years old
– Initiative vs. guilt
4-9

Developmental Stages of the Life Cycle (cont.)
• School age
– 7 to 12 year old
– Industry vs.
inferiority
• Adolescence
– 12 to18 years old
– Ego identity vs. role
confusion
4-10

Developmental Stages of the Life Cycle (cont.)
• Young adult
– 20s
– Intimacy vs. isolation
• Middle adult
– Late 20s – 50s
– Generativity vs.
stagnation • Old Adult
– 60s and older
– Integrity vs. despair
4-11

Maslow’s Hierarchy of Human Needs
1-12
Physiological
Safety
Love/Belonging
Esteem
Self-
actualization

Maslow’s Hierarchy (cont.)
• Deficiency (basic) needs
– Physiological
– Safety
– Love/belonging
– Esteem
• Self-actualization
4-13

Human Behavior and Needs
• Considering patient’s
needs
– Determine area of
deficiency
– Adjust communication
style
4-14

4-15
You can communicate with all people in the same way. Is
this statement true or false, and why?
ANSWER: The statement is false. Not all people are at
the same place on Maslow’s hierarchy of human needs.
To communicate effectively with a person, you need to
understand what he or she is deficient in. For example,
you would use different communication styles when
talking to a homeless person who may have
psychological and safety needs than when talking to an
elderly person who is lonely and depressed due to the
recent loss of his or her spouse.

4-16
Types of Communication
• Positive or negative
• Verbal or non-verbal
• Written

Positive Verbal Communication
• Communication
promotes the patient’s
comfort and well-being
• Sets the stage
• Examples
4-17

Negative Verbal Communication
• Curb negative communication habits
• Pay attention to others in
service-oriented workplaces
4-18

4-19
Nonverbal Communication
• Body language
• Facial expression
• Eye contact
• Posture

4-20
Nonverbal Communication (cont.)
• Touch
• Personal space

4-21
Mr. Garcia comes to the desk to check in and asks if he will be seen on
time. The receptionist continues with her paperwork, points to the sign-
in sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you
when he can.” Explain why this is an example of negative
communication.
ANSWER: This is an example of negative communication
because the receptionist:
• Did not stop what he or she was doing – was not friendly or
attentive
• Did not greet Mr. Garcia or make eye contact with him
• Did not give a satisfactory answer to Mr. Garcia’s question
• Did not make sure Mr. Garcia understood when he would be
seen
YEA!

Improving Your Communication Skills
• Listening skills
• Interpersonal skills
• Assertiveness skills
1-22

Listening Skills
• Passive listening
• Active listening
4-23

Improve Listening Skills
• Prepare to listen
• Relax and listen attentively
• Maintain eye contact
• Maintain personal space
• Think before you respond
• Provide feedback
4-24

Interpersonal Skills
• Warmth and friendliness
• Empathy
• Respect
4-25

Interpersonal Skills (cont.)
• Genuineness
• Openness
• Consideration and sensitivity
4-26

Assertiveness Skills (cont.)
• Assertive
– Open
– Honest
– Direct
• Aggressive
– Bossy
– Quarrelsome
– Manipulative
4-27

4-28
What is the difference between being aggressive and
being assertive?
ANSWER: Assertiveness means standing by your
principles while showing respect for others. You
trust your instincts, feelings, and opinions and act
on them. An aggressive person tries to impose his
or her own position on others or tries to manipulate
them. He or she is bossy, may be quarrelsome, and
does not consider another’s feelings, needs,
thoughts, ideas, or opinions.

4-29
Therapeutic Communication Skills
• Being silent
• Accepting
• Giving recognition
• Offering self
• Giving a broad opening

4-30
Therapeutic Communication (cont.)
• Offering general leads
• Making observations
• Encouraging communication
• Mirroring
• Reflecting

4-31
Therapeutic Communication (cont.)
• Focusing
• Exploring
• Clarifying
• Summarizing

Ineffective Therapeutic Communication
• Reassuring
• Giving approval
• Disapproving
• Agreeing/disagreeing
• Advising
1-32

Ineffective Therapeutic Communication
• Probing
• Defending
• Requesting an explanation
• Minimizing feelings
• Making stereotyped comments
4-33

Defense Mechanisms
• Adaptive
• Nonadaptive
4-34

Defense Mechanisms (cont.)
• Compensation
• Denial
• Displacement
• Dissociation
• Identification
• Introjection
• Projection
• Rationalization
• Regression
• Repression
• Substitution
4-35

Check those of the following that are therapeutic?
ANSWER:
Reassuring
Offering self
Mirroring
Being silent
Giving approval
Accepting
Probing
Defending
Making Observations
Giving a broad
opening
Disapproving
4-36
✓
✓
✓
✓
✓
✓

Communicating in Special Circumstances
• Some special circumstances inhibit
communication
– Heightened emotions
– Cultural differences
– Impairment or disability
– Terminal illnesses
4-37

The Anxious Patient
• May not listen well or pay attention to what
you are saying
• Observe for signs
• Acknowledge
• Identify source
• Use communication skills
4-38

The Angry Patient
• Reasons for anger
• Do not take personally
• Goal ~ help refocus to
solve problem
4-39

4-40
Patients of Other Cultures
• Unique beliefs, attitudes, values, use of
language and world views
• Avoid stereotyping
• Avoid generalization

4-41
• Cultural differences
• Language barriers

4-42
• Limited reading skills
• Cultural competence

The Patient Who is Mentally or Emotionally
Disturbed
• Determine what level of communication
the patient can understand
• Suggestions
– Remain calm if the patient becomes agitated
or confused
– Avoid raising your voice
– Avoid appearing impatient
4-43

Terminally Ill Patients
4-44
• Respect rights
• Treat with dignity
• Kübler-Ross’s Stages of Dying
– Denial
– Anger
– Bargaining
– Depression
– Acceptance

4-45
Patient’s Families and Friends
• Acknowledge family members and friends
• Keep them informed
about patient’s progress
• Remember to protect
patient confidentiality

4-46
The Patient With AIDS or the Patient Who is
HIV-Positive
• Stigma of disease
• Have accurate information about the
disease and the risks involved
• Provide human contact and treat with
dignity

4-47
What can you do to better communicate with the
anxious patient?
ANSWER: Identify signs of anxiety, acknowledge the
patient’s anxiety, identify possible sources of the
anxiety, ease any physical discomfort, and create a
climate of acceptance and trust. Use appropriate
communication skills: do not belittle the patient’s
thoughts and feelings, be empathetic to the patient’s
concerns. Help the patient recognize and cope with
the anxiety.

Communicating with Coworkers
• Positive communication
– Develop rapport
– Rules for the medical office
• Use proper channels
• Have a proper attitude
• Plan an appropriate time for
communication
4-48

4-49
Communicating with Management
• Keep supervisor informed
• Ask questions
• Minimize interruptions
• Show initiative

Dealing With Conflict
• Do not feed into negative attitudes
• Be personable and supportive of
coworkers
• Do not judge or stereotype others
• Do not gossip
• Do not jump to
conclusions
1-50

Setting Boundaries in the Healthcare
Environment
• Boundaries may be physical or
psychological
• Limits undesirable behavior
• Action will depend upon
who the aggressor is
4-51

4-52
ANSWER: You can use the following strategies to
avoid conflict in the workplace:
• Do not “feed into” others’ negative attitudes
• Be personable and supportive
• Refrain from passing judgments
• Do not gossip
• Do not jump to conclusions
What strategies can you use to avoid conflict in the
workplace?

4-53
In Summary
4.1 The communication circle involves a message
being sent, a source, and a receiver that
responds.
Feedback is the response to a message, and
noise is anything that may interfere with or
change the message.

4-54
In Summary
4.2 Understanding human behavior and needs,
and their correlation with professional
relationships, is necessary to practicing as a
medical assistant.
Understanding the various stages of human life
assists you in your communication skills with
patients.

4-55
In Summary (cont.)
4.3 Communication that promotes comfort and
well-being is considered positive
communication.
Negative communication can
be a turn-off. Lack of eye contact with
patients, except in specific cultures, or
speaking sharply to a patient is considered
negative communication.

4-56
In Summary (cont.)
4.4 Listening and other interpersonal skills can
be improved by becoming more involved in
the communication process by offering
feedback or asking questions of the patient.
Understand that assertive medical assistants
trust their instincts. They respect their self-
worth, while still making the patient feel
comfortable and important.
Aggressive medical assistants try to impose
their positions through manipulation
techniques.

In Summary
4.5 Therapeutic communication is the ability to
communicate with patients in terms that they
can understand and, at the same time, feel at
ease and comfortable in what you are saying.
Positive therapeutic skills can enhance
communication. Be aware of negative
therapeutic skills that can disrupt the
communication.
Recognize defense mechanisms in patients
and note whether the patient is using them to
cope or is not able to cope.
1-57

4-58
In Summary
4.6 Learning about the special needs of patients
and polishing your communication skills will
help you become an effective communicator.
This will assist you with handling diversity in
the workplace, handling anxious and annoyed
patients, and in dealing with patients who may
have language barriers.

4-59
In Summary
4.7 The quality of communication you have with
your coworkers and your supervisor greatly
influences the development of a positive or
negative work climate.
Use proper channels of communication. Be
open-minded. Keep supervisors informed of
office problems as they arise and show
initiative in your work habits.

4-60
Often during life-altering
experiences, patients and
their loved ones need a
shoulder to cry on or
someone to comfort them.
It is important for them to
know support is there.
—Lindsey D. Fisher (The Healers Art)
End of Chapter 4

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