1. Communication Skills MBBS Semester I Lab 2 Dr. Mahmood Y. Hachim Dr Abubakr H Mossa 2012

2. Outline Steps of patient management Patient-centered communication Personal appearance Timing Setting Getting started –Greeting & naming –Demeanor (behavior) –Attitude –Questioning –Stay on topic –Eye contact –Note taking

3. Patient management History taking Physical examination Investigation Treatment and follow up

4. Personal appearance-Dress Extreme tastes in fashion to be avoided Men wear (shirt and tie) Women wear (skirt or trouser with shirt) The belly and shoulders ( to be covered) Hair conservatively styled, no hair over the face, wear long hair tied up.

5. Personal appearance- Accessories Name badge to be visible Stethoscopes in coat pocket Try not to tuck items in your belt Shoes shine and clean Clean surgical scrubs may be worn if appropriate. Personal appearance and accessories

6. TimingAvoid an allocated quiet time Avoid mealtimes Avoid when the patient's long-lost relative visit. Inform other when you take the patient from bed

7. SettingPrivacy Quite Comfortable No intervening furniture Seating Setting of the room

8. Greeting & NamingShaking hands Standing Remember the name Title them Title you

9. DemeanorGive the patient your full attention. Appear encouraging with a warm, friendly manner. Use appropriate facial expressions don't look bored! Define your role Avoid medical jargon Demeanour (behavior)

10. AttitudesConfident Friendly Competent Trustworthy. Be aware of a person's cultural background Personal attitude

11. Style of questioningPrepare Your Clients for Questions Open questions versus closed questions Multiple choice questions Clarifying questions Difficult questions with courtesy ? Questioning ?

12. Open questions versus closed questions Open questions are those where any answer is possible What's the problem? How does it feel? These allow the patient to give you the true answer in their own words. Be careful not to lead them with closed questions. Compare How much does it hurt? to Does it hurt a lot?. The former allows the patient to tell you how the pain feels on a wide spectrum of severity, the latter leaves the patient only two options and will not give a true reflection of the severity

13. Multiple choice questions Often, patients have difficulty with an open question if they are not quite sure what you mean. What sort of pain is it, What does it feel like, exactly?. Give them a few examples but leave the list open-ended for them to add their own words. You must be very careful not to give the answer that you are expecting from them. For example, in a patient who you suspect has angina ( crushing pain), you could ask: What sort of a pain is it burning, stabbing, aching, for example?

14. Clarifying questions Use clarifying questions to get the full details: When you say dizzy, what exactly do you mean? Difficult questions Apologize for potentially offensive or embarrassing questions: I'm sorry to have to ask you this but

15. Staying on topicInterruptions Reflective comments Eye-contact Adjusting your manner Don't take offence or get annoyed

16. Eye-contact Make eye-contact and look at the patient when they are speaking. In the medical situation, whilst the patient is speaking, you may be tempted to make notes, read the referral letter, look at a test result, or similar you should resist and stick to the normal rules of eye- contact.

17. Adjusting your manner You should try to adjust you manner and speech according to the patient's educational level. This is can be extremely difficult you should not make assumptions on intellect or understanding solely on educational history. A safe approach is to start in a relatively neutral way and then adjust your manner and speech based on what you see and hear in the first minute or two of the interaction but be alert to whether this is effective and make changes accordingly.

18. Interruptions Apologize to the patient if you are interrupted. Don't take offence or get annoyed As well as being directly aggressive or offensive, people may be thoughtless in their speech or manner and cause offence when they don't mean to. As a professional, you should rise above this. Reflective comments Use reflective comments to encourage the patient to go on and reassure them that you are following the story: Yes, I see that.

19. Note TakingNot to interfere with interview Explain the purpose of note taking or not to take notes. Never hide or cover your notes Never write anything that you do not want them to read. Stick to the facts TAKING NOTES

22. Thanks