1. Unit 1 Developing Effective Communication in Health and Social Care
BTEC level 3
Unit 1
Developing Effective Communication in Health and Social Care

2. Unit 1 Assignment 2
In this next Assignment you will be focusing on the BARRIERS to communication and interpersonal interactions, and how to overcome these.

3. Unit 1 BTEC level 3 Section 2
Argyle’s stages of the communication cycle
( ideas occur, message coded, message sent, message received, message decoded, message understood)
Tuckman’s stages of group interaction (forming, storming, norming and performing)
Barriers to communication
Barriers. E.g. types of communication ( difficult, complex, understood) Language needs/preferences, sensory impairment, disability, personality, self-esteem, anxiety, depression, aggression, submissiveness, assumptions, value and belief systems, jargon and cultural variations, use of power, effects of alcohol/drugs.
Theories of communication
Understand factors that influence communication and interpersonal interaction in HSC environments
Factors in the Environment
Factors: (e.g. physical, emotional, social, communication skills, individual needs)

4. Glossary Additions ……
Environmental factors -
Barriers -

5. Factors and Barriers to communication
Communication can also be stopped dead in the water. This is what barriers do, stop things, just like a road barrier stopping you driving down a road. An example of a barrier to communication is the person being in another room. A strategy to get over this is to text or call them.
Activity 1:
In pairs look at the examples and list the factors and barriers to communication.
Scenario 1: Jess arranges to meet her friend in a popular and overcrowded night club.
Scenario 2: Mark and James are in a three hour lesson.
Scenario 3: Angie is driving to work and spots, notices that a fellow motorist has excessive smoke coming out of the car.

6. Environmental Factors influencing communication
An example of a factor is:
When you are trying to communicate with someone there are a number of things (factors) which can make communication better or worse. Such as:
1) The room being too hot so you get sleepy.
2) Music being on too loud so you can’t hear the other person
The factors we are looking at are ?
Physical
Emotional
Social
Communication skills
Individual needs
Activity 2!
In pairs Identify how each factor could improve and decrease communication. Write your comments on the A3 table you will be given. Step by Step – see the following slides

7. Factor Examples Way it improves Way it decreases
Environmental factors that affect Communication
Note: all should relate to a HSC setting
Factor
Examples
Way it improves
Way it decreases
 Physical Environment 
Emotional Factors    
Social Factors  
Communication Skills  
 Individual Needs

8. Factor Environmental factors that affect Communication
Note: all should relate to a HSC setting
Factor
 Physical Environment 
Emotional Factors    
Social Factors  
Communication Skills  
 Individual Needs

9. Effect of drugs/alcohol
Environmental factors that affect Communication
Factor
Examples
 Physical Environment 
Lighting
Warmth / Cold
Noisy
Emotional Factors 
Depression
Aggressive
Submissive
Low self-esteem
Self-confident   
Social Factors  
Values
Beliefs / Religion
Culture
Intellectual ability
Effect of drugs/alcohol
Prejudice
Communication Skills  
Complex
Simple
Good understanding
Good listening skills
 Individual Needs

10. The person is very outgoing which makes them very talkative.
Environmental factors that affect Communication
Note: all should relate to a HSC setting
Factor
Examples
Way it improves
 Physical Environment 
Lighting
Warmth / Cold
Noisy
Emotional Factors 
The person is very outgoing which makes them very talkative.   
Social Factors  
Communication Skills  
 Individual Needs

11. The person is very outgoing which makes them very talkative.
Environmental factors that affect Communication
Note: all should relate to a HSC setting
Factor
Examples
Way it improves
Way it decreases
 Physical Environment 
Lighting
Warmth / Cold
Noisy
Emotional Factors 
The person is very outgoing which makes them very talkative.
The person is very shy and not confident at joining in, or starting, conversations.   
Social Factors  
Communication Skills  
 Individual Needs

12. Factor Examples Way it improves Way it decreases Physical Environment
 Physical Environment 
Lighting
Warmth / Cold
Noisy
Seating
Space
Time
Quiet environment, in a room which is not too hot with seating around a small table – this allows all parties to be heard and listened too effectively 
Noisy, crowded environment – some of the conversation may be missed and / or misinterpreted, meaning the right care may not be implemented
Emotional Factors 
Depression
Aggressive
Submissive
Low self-esteem
Self-confident
The person is very outgoing which makes them very talkative.
The person is very shy and not confident at joining in, or starting, conversations.
OR they are very aggressive and dominant and don’t allow a conversation   
Social Factors  
Values
Beliefs / Religion
Culture
Intellectual ability
Effect of drugs/alcohol
Prejudice
If person X comes into the hospital under the influence of drugs or alcohol, time needs to be given for this to wear off, or family can be contacted to aid as an advocate, to ensure the service user gives consent for any requirements needed
Person X may have particular beliefs etc or preferences that cant be discussed whilst they are under the influence. If this is not ascertained then the wrong care may be given. 
Communication Skills  
Active listening
Checking understanding
Invasion of personal space
Inappropriate non-verbal behaviour
Use of jargon 
 Individual Needs
Sensory impairment (deaf or blind)
Disability (mentally or physically)
Spoken language
If a deaf person is able to sign to an interpreter a meaningful conversation can take place
If a blind person can read their care plan in braille, then they will be able to understand what is going to happen 
If the deaf person is just spoken very loudly to in the hope they can lip read. 
If a blind person is just told the situation and has to remember what the care plan is, they may forget and then have no way of finding out.

13. Activity 3:
Let’s see what you have learned and relate it to real life too.
Read the case study below and identify and explain the following: (hint: use your command word sheets to ensure you answer this correctly)
Identify what physical factors influenced this communication?
What other factors can you identify? Name them and explain whether they have made this a successful or unsuccessful discussion.
You are observing a multi-disciplinary team (MDT) meeting where Mrs Singh is due to be discharged home following major bowel surgery. Present at the meeting are Mrs Singh and her husband, the ward nurse, the district nurse, the social worker, the doctor, a physiotherapist, a dietician and an occupational therapist. The meeting is to organise a discharge package for Mrs Singh and is held in the ward day room at lunchtime. The MDT are all seated around the table on high chairs whilst Mrs Singh and her husband are sitting in lower ‘patient’ chairs. Mrs Singh and her husband speak minimal English. There is a lot of background noise from the ward and the light in the day room is flickering. The ward nurse begins the meeting and has to raise her voice to be heard over the environmental noise. She appears rather aggressive. The MDT begin to discuss Mrs Singh and use a lot of medical terminology. The conversation speeds up as time is limited and the doctor needs to leave imminently and does not appear interested. You notice that Mrs Singh and her husband look slightly bewildered and are nodding their heads intermittently.
Eventually the MDT agree on the care package that they deem to be appropriate and ask Mrs Singh and her husband to agree to it. They thank the MDT and leave looking extremely confused.

14. Activity 3:
Let’s see what you have learned and relate it to real life too.
Read the case study below and identify and explain the following: (hint: use your command word sheets to ensure you answer this correctly)
Identify what physical factors influenced this communication?
What other factors can you identify? Name them and explain whether they have made this a successful or unsuccessful discussion.
You are observing a multi-disciplinary team (MDT) meeting where Mrs Singh is due to be discharged home following major bowel surgery. Present at the meeting are Mrs Singh and her husband, the ward nurse, the district nurse, the social worker, the doctor, a physiotherapist, a dietician and an occupational therapist. The meeting is to organise a discharge package for Mrs Singh and is held in the ward day room at lunchtime. The MDT are all seated around the table on high chairs whilst Mrs Singh and her husband are sitting in lower ‘patient’ chairs. Mrs Singh and her husband speak minimal English. There is a lot of background noise from the ward and the light in the day room is flickering. The ward nurse begins the meeting and has to raise her voice to be heard over the environmental noise. She appears rather aggressive. The MDT begin to discuss Mrs Singh and use a lot of medical terminology. The conversation speeds up as time is limited and the doctor needs to leave imminently and does not appear interested. You notice that Mrs Singh and her husband look slightly bewildered and are nodding their heads intermittently.
Eventually the MDT agree on the care package that they deem to be appropriate and ask Mrs Singh and her husband to agree to it. They thank the MDT and leave looking extremely confused.

15. Remember what are the barriers to communication ……..
Types of communication ( difficult, complex, understood)
Language needs/preferences,
Sensory impairment,
Disability,
Personality
Self-esteem
Anxiety
Depression
Aggression
Submissiveness
Assumptions
Value and belief systems
Jargon
Cultural variations
Use of power
Effects of alcohol/drugs.

16. Identifying barriers to effective communication – Activity 4
Watch this hypothetical video clip
1. On whiteboards what are the barriers in each situation?
Now watch this scenario
1. Individually identify the factors and barriers to communication.
2. What do you think is the outcome of this situation
3. Compare these with your partner
4. With your partner - think of a situation in the Health Care profession where this same situation could happen

17. Clip 1 – Breaking it down ….
A) Bobby is being seen by the doctor
Barrier  Doctor doesn’t listen to the service users problem, he just prescribes medication (jargon / assumption / use of power)
B) Bobby is speaking to the receptionist
Barrier  Bobby is submissive / anxious and just accepts his insurance company can’t pay the bill
C) Bobby is now seriously ill and back with the doctor
Barrier  none – the doctor is now having to deal with a more serious case and is asking questions to establish why the situation has worsened. He is now listening to the service user.

18. Clip 2 – Factors and Barriers involved in breaking down this communication
* Physical
* Emotional
* Social
* Individual needs
Barriers
* Noise – train and tannoy
* Niqab – can’t lip read
* Aggression
* Culture and beliefs
* Technology failure
* Language needs due to being deaf
Outcome
Frustration
Anger
Not making any further effort to communicate
Unhappy

19. Looking at Assignment 2 – Task A
You have been asked to deliver a training session to the new recruits the title of which is “Explain factors that may influence communication and interpersonal interactions in health and social care settings”. 
In order to support the delivery of the training session, you must produce a PowerPoint presentation and a handout to give out to the recruits.  
In your presentation, ensure you explain:  
- Factors in the environment 
- Barriers to communication 
Explain the full range of factors and barriers that may help or hinder effective communication and interpersonal interactions in health and social care situations. (4 of each, MUST be in detail with a link to a case study)

20. Unit 1 BTEC level 3 Section 3
Possible strategies to overcome barriers , e.g. staff training, assessment of need, using preferred method, promoting rights, confidentiality, defusing aggression, assertiveness, appropriate verbal/non verbal communication, building relationships, appropriate environment, attitude, confidence.
Human :- advocates, interpreters, translators, mentors, befrienders, technological aids (hearing aids, text phones, Mincom, voice activated software, relay systems, loop systems)
Communication and interpersonal interaction
Aids to communication
Understand ways to overcome barriers in a HSC environment

21. Ways of overcoming barriers to communication – write these into your notes
● Staff training
● Assessment of need and using preferred methods of communicating
● Promoting rights
● Maintaining confidentiality
● Being assertive
● Diffusing aggression
● Building relationships
● Appropriate environment
● Meeting self-esteem needs by maintaining an appropriate attitude.

22. Some extra scenarios to consider …….
Activity 6 In Pairs
For each of the barriers given identify possible strategies health care professionals would use to overcome these
Some extra scenarios to consider …….
Type of barrier
Possible strategies (overcoming barriers)
Service user suffers from a sensory impairment, e.g. deaf.
The service user has low self-esteem and is depressed.
The individual is stressed (anxiety attacks)
The service user is being aggression to yourself.
They assume that you are useless because of your gender.
A doctors tried to explain a problem but they are using too much jargon.
Your boss is abusing their power and making you do jobs which you are not meant to do.
The service user is under the influence of alcohol or drugs

23. Some extra scenarios to consider …….
Activity 6 In Pairs
For each of the barriers given identify possible strategies health care professionals would use to overcome these. Use your notes
Some extra scenarios to consider …….
Type of barrier
Possible strategies (overcoming barriers)
Service user suffers from a sensory impairment, e.g. deaf.
Assessment of need and using preferred methods of communicating
The service user has low self-esteem and is depressed.
Meeting self-esteem needs by maintaining an appropriate attitude
The individual is stressed (anxiety attacks)
Building relationships
The service user is being aggression to yourself.
Diffusing aggression
They assume that you are useless because of your gender.
Promoting rights
A doctors tried to explain a problem but they are using too much jargon.
Staff training
Your boss is abusing their power and making you do jobs which you are not meant to do.
Being assertive
The service user is under the influence of alcohol or drugs
Appropriate environment to detox

24. Explain how would you overcome the barriers you identified previously?
Activity 7: Relook at this case study, but this time ……….
Explain how would you overcome the barriers you identified previously?
You are observing a multi-disciplinary team (MDT) meeting where Mrs Singh is due to be discharged home following major bowel surgery. Present at the meeting are Mrs Singh and her husband, the ward nurse, the district nurse, the social worker, the doctor, a physiotherapist, a dietician and an occupational therapist. The meeting is to organise a discharge package for Mrs Singh and is held in the ward day room at lunchtime – A quiet private room should be used for this multi disciplinary meeting. The MDT are all seated around the table on high chairs whilst Mrs Singh and her husband are sitting in lower ‘patient’ chairs – there should be no difference in height of chairs as they give an impression of power and that the service user should be submissive, they should be trying to empower the service user. Mrs Singh and her husband speak minimal English – a translator should be amongst the multidisciplinary team. There is a lot of background noise – a quiet private room would negate this from the ward and the light in the day room is flickering – this should be reported and dealt with by premises staff as it is a distraction. The ward nurse begins the meeting and has to raise her voice – this may appear aggressive towards the SU, in a private room this would not have happened to be heard over the environmental noise. She appears rather aggressive. The MDT begin to discuss Mrs Singh and use a lot of medical terminology – the team should use language the SU can understand, not jargon. The conversation speeds up as time is limited and the doctor needs to leave imminently and does not appear interested. - staff training in skilled listening You notice that Mrs Singh and her husband look slightly bewildered and are nodding their heads intermittently.
Eventually the MDT agree on the care package that they deem to be appropriate and ask Mrs Singh and her husband to agree to it. They thank the MDT and leave looking extremely confused.

25. Overcoming the barriers to effective communication
Watch this hypothetical video clip again
1. What was the barrier in each situation
2. How could the barrier be overcome?
Now watch this scenario again
1. How could these barriers you have identified be overcome?
2. What could either of the girls do to make the outcome better?

26. Break it down further …. A) Bobby is being seen by the doctor
Barrier  Doctor doesn’t listen to the service users problem, he just prescribes medication (jargon / assumption / use of power)
Solution  Doctor could have explained to patient what the seriousness of his condition was and ensure that he could afford the medication
B) Bobby is speaking to the receptionist
Barrier  Bobby is submissive / anxious and just accepts his insurance company can’t pay the bill
Solution  Bobby could be more proactive and assertive, and pursue the situation. The receptionist could try to find an alternative solution by speaking to the doctor, that way she would realise the seriousness of Bobby’s situation and could help him sort it with his insurance company.
C) Bobby is now seriously ill and back with the doctor
Barrier  none – the doctor is now having to deal with a more serious case and is asking questions to establish why the situation has worsened. He is now listening to the service user.

27. Factors that influence effective communication in different service-user groups
Select a service-user group (for example, children, elderly people or those with learning difficulties)
and consider communication barriers that are specific to that group. Complete the table below.
Barriers to communication and interpersonal interaction
How can this barrier affect your service- user group?
What can be done to reduce the negative influence of this barrier? (Overcoming Barriers)
Using your chosen service-user group, give an example to explain your points
Environmental factors (setting, noise, time, lighting, space)
Type of communication (difficult, complex, sensitive)
Language needs and preferences
Cultural variations
Disability or impairment (learning, hearing, visual)
Emotional barriers (poor self-esteem, depression, anxiety)
Abuse (physical, mental, financial, neglect)

28. Overcoming Barriers - Staff training
This is a vital part of any job within HSC professionals and should be ongoing.
Staff are given initial induction courses on starting with an organisation.
Staff are then often given further training on specific factors around the individuals they will be supporting.
Often staff are given specific training on individuals who have specific communication types.

29. Overcoming Barriers - Assessment of need and preferred method of communication
The needs of people
Professionals will need to make an assessment of the persons individual needs and ensure that all other professionals are aware of these needs.
This also allows there preferred method of communication to be used.

30. Overcoming barriers - Promoting rights
The Human Rights Act (1998) is designed to support all individuals .
All services that are involved in the Health social care and early years also promote the rights of the individual through their codes of practice and policies these rights cover
Confidentiality
To be treated as an individual
To be treated in a dignified way
To be protected from danger or harm
To be cared for in a way that meets their needs and takes account of choices
To be respected
A service user’s rights
To be given privacy
To be able to communicate using their preferred method
To be allowed access to information about themselves
To be treated equally and not discriminated against

31. Aid Overcoming barriers: Advocate Interpreter Translator Mentor
Human or technological aid
Function
Type of service user who might benefit from this aid
The advantages of using this aid
The possible disadvantages of using this aid
Advocate
Interpreter
Translator
Mentor
Befriender
Hearing aid
Voice activated
Software
Minicom

32. Assertiveness
1. Write a short summary of each of the following behaviours.
Aggressive:
Assertive:
Submissive:
2. Read the following scenarios and decide on responses that would be aggressive, assertive and submissive.
Scenario 1
A colleague rings you up while you are talking to a new client. Your colleague wants to talk about a meeting set up for next week about another client and is quite insistent.
Aggressive response:
Assertive response:
Submissive response:
Scenario 2
Your boss has criticised your communication skills, stating that a number of clients have complained that you have been rude to them. You disagree with this and believe your boss is being unfair.

33. Answers …..
Scenario 1
Aggressive response: ‘Why do you always ring me up when I’m in the middle of speaking to a client? You are so rude.’
Assertive response: ‘I’m in the middle of something at the moment. Can I ring you back later?’
Submissive response: ‘I’m talking to a client at the moment but I will stop to talk to you.’
Scenario 2:
Aggressive response: ‘That’s not true! They’re the ones who are rude and you just want an excuse to pick on me.’
Assertive response: ‘Well, I disagree with you. Perhaps you could give me an example of when I have been rude.’
Submissive response: ‘Okay, you’re right. I’m not very good at this job

35. Looking at Assignment 2 – Task B
To supplement your presentation, you have been asked to include a report:
 “Explaining strategies that are used in health and social care environments to overcome barriers to effective communication and interpersonal interactions”.  
In your report you must ensure you explain: 
Possible communication and interpersonal interaction strategies  
Aids to communication: human and technological aids 

36. Glossary Terms Aggressive: Angry insistence on being right
Assertive: Being able to negotiate a solution to a problem
Submissive: Frightened and accepting you will lose or be put down.
Group values: Group members share a common system of beliefs or values in order for the group to communicate and perform effectively
Reflective listening: Reflecting back to the person what you think they said in order to check your understanding
Assertiveness: Being able to negotiate a solution to a problem
Self-esteem: How you value or feel about yourself
Caring presence: Being open to the experience of another through a ‘two-way’ encounter with that person
Stereotyping: A fixed way of thinking involving generalisations and expectations about an issue or group.