1. بسم الله الرحمن الرحيم Communication Skills

2. Mass communication Small-group communication Large-group communication Interpersonal communication Type of Communication

3. Is process in which messages are generated and transmitted by one person and subsequently received and translated by another. Interpersonal communication

4. It is include: Sender. Receiver. Message. Feed-back. Barriers. Interpersonal communication

5. The sender: person with something to say (i.e. message). Interpersonal communication

6. The message: is the element that is transmitted from one person to another. Messages can be thoughts, ideas, emotions, information, or other. Message can be transmitted by both verbal and non verbal. Interpersonal communication

7. The receiver: the person receiving massage from the sender. “decode” the message and assign a particular meaning to it. Conceder both the verbal and nonverbal components of message. Interpersonal communication

8. Feedback: process by which the receivers communicate back to senders about their understanding of the senders’ message. By using verbal and non verbal communication, the receiver feeds back information to the sender about how the message was translated. Interpersonal communication

9. The feedback message is directed in the opposite direction of the original message. Feedback can be Simple: nodding your head. Complex: repeating a set of complicated instructions to make sure that you interpreted them correctly. Interpersonal communication

10. Barriers and interferences: any thing affect the message and feedback. Noise – glass partition – defective hearing …… Interpersonal communication

11. As a sender: You are responsible for ensuring that the message is transmitted in the clearest form, in terminology understood by the other person, and in an environment encouraging to clear transmission. Check whether the message was received as intended, you need to ask for feedback from the receiver and clarify any misunderstandings. Personal responsibilities in the communication model

12. As receiver: You have the responsibility of listening to what is being transmitted by the sender. Provide feedback to the sender by describing what you understood the message to be. Personal responsibilities in the communication model

13. Types of Interpersonal Communication Skills

14. 1.Verbal communication. 2.Nonverbal communication. Types of Interpersonal Communication Skills

15. Types of Interpersonal Communication Skills

16. 1. Verbal Communication

17. Verbal Communication 1. Face-to-face meetings: are information-rich, since they allow for emotions; immediate feedback to take place (instructions for patient, workforce, etc) 2. Written communication: is more appropriate for describing details, especially of a technical nature as in the example of monitory a patient’s complex medical condition (prescription, instructions for patients, etc) 3. Computer aided communication: E-mail is a preferred channel for coordinating work and schedules.

18. 2. Nonverbal Communication

19. Nonverbal Communication Wards are not the only way by which pharmacists communicate. Words normally express ideas. nonverbal expression convey attitudes and emotions.

20. Nonverbal communication involves a complete mix of behaviors, psychological responses and environmental interactions through which we consciously or unconsciously relate to another person. Nonverbal Communication

21. Nonverbal Versus Verbal Communication It differs from verbal communication in that the medium of exchange is neither vocalized language nor the written word.

22. Important Elements of Nonverbal Communication 1.Kinesics ( body movement ). 2.Proxemics ( distance between person trying to communicate ). 3.Physical environment. 4.Distracting factors.

23. Important Elements of Nonverbal Communication 1. Kinesics The manner in which you use your arms,legs, hands, head, face,and torso may have a dramatic impact on the messages that you send. As a health care professional, you need to generate a feeling of empathy and communicate to the helping of others.

24. Important Elements of Nonverbal Communication There are two posture of Kinesics will influence the nonverbal communication : An open posture. A closed posture.

25. Important Elements of Nonverbal Communication An open posture A closed posture

26. Important Elements of Nonverbal Communication An open posture Is standing ( or sitting) with a full frontal appearance to the other person. As an open communicator, you should also have your legs and arms comfortably apart ( not crossed ), and a facial expression that expresses interest and a desire to listen as well as speak.

27. A closed posture Occurs when you have your arms folded in front of your chest, legs crossed at the knees, head facing downward, and eyes looking away from the patient. Communication from a closed posture may shorten or half further productive interactions. Sometimes it is appropriate to use a closed posture, for example, when you want to limit the interaction with an overly talkative person. Important Elements of Nonverbal Communication

28. Key components of kinesics : Varied eye contact ( consistent, but a stare ). Relaxed posture. Appropriate comfortable gestures. Frontal appearance ( shoulders square to other person ). Slight lean toward the other person. Erect body position ( head up, shoulders back ). Important Elements of Nonverbal Communication

29. 2. Proxemics The distance between two interacting persons plays an important role in nonverbal communication. It is the structure and use of space, is a powerful nonverbal tool. Important Elements of Nonverbal Communication

30. 2. Proxemics Most people in united states tend to be more comfortable when a distance of 18 inches to 48 inches is maintained between other individuals. at this distance, causal personal conversations normally take place. Interpersonal distance of more than 4 to 6 feet are generally reserved for public rather than private communication. Important Elements of Nonverbal Communication

31. 2. Proxemics Patients usually indicate nonverbally whether they feel comfortable with the distance by either stepping backward or leaning forward. The type of instructions that you need to give to the patient will also affect the distance. for sensitive issues, such as explaining the use of a rectal or vaginal medication, you may need to enter the patient's private zone, especially if others are around. Important Elements of Nonverbal Communication

32. 3. Environmental nonverbal factors A number of environmental factors play important roles in communicating nonverbal messages to patients. for example, the colors used in the pharmacy's décor, the lighting, and the uses of space all have been documented as important nonverbal communication factors. Important Elements of Nonverbal Communication

33. 3. Environmental nonverbal factors The general appearance within the pharmacy setting conveys nonverbal messages to patients. Dirt, clutter carry negative nonverbal messages. Important Elements of Nonverbal Communication

34. 3. Environmental nonverbal factors Within the community practice setting, the use of the prescription counter is an important environmental factor. The counter and related shelving serve to keep the prescription dispensing process from the public's view. However, they can also serve as communication barriers if they inhibit your interaction with your patients. Important Elements of Nonverbal Communication

35. 3. Environmental nonverbal factors Professional staff should dress appropriately. you want to convey a friendly appearance, but you also want to convey professional competence. Your appearance and the appearance of your fellow employees can enhance or distract from the sense of professionalism within your practice site. Important Elements of Nonverbal Communication

36. 4. Distracting nonverbal communication 1)lack of eye contact. 2)facial expression. 3)body position. 4)tone of voice. Important Elements of Nonverbal Communication

37. Important Elements of Nonverbal Communication 4. Distracting nonverbal communication 1) lack of eye contact is one of the most distracting nonverbal elements. It is Limit your ability to receive feedback from the patient about the messages that you are giving. Using good eye contact dose not mean that you continually stare at patient, because that may make them feel uncomfortable as well.

38. Important Elements of Nonverbal Communication 4. Distracting nonverbal communication 2) facial expression An inadvertent facial expression may send a message that you did not intend to transmit. For example, If you roll your eyes as a patient explain something to you,you may be communicating a feeling of disinterest or lack of concern toward the patient.

39. 4. Distracting nonverbal communication 3) body position Most patient will judge your willingness to talk to them based on their perception of your body position. For example, closed posture. Important Elements of Nonverbal Communication

40. Important Elements of Nonverbal Communication 4. Distracting nonverbal communication 4) tone of voice For example, a comment in a sarcastic or threatening tone of voice will produce a different effect than the same phrase spoken with an empathic tone. In addition, conveying a message in a dull, monotone voice may convey a lack of interest on your part.

41. Detecting Nonverbal Cues in Others : Assessing the meaning behind the nonverbal messages of others is difficult, because we tend to interpret nonverbal cues based on our own personal background and experience. We “filter” these message based on our personal orientation and experiences. Important Elements of Nonverbal Communication

42. Important Elements of Nonverbal Communication Detecting Nonverbal Cues in Others : The meaning of the nonverbal messages that we receive may or may not be the meaning intended by the sender. For example, we may sense a hint of anger in a patient’s voice when in actuality they are using their normal voice and they are not angry at all.

43. Important Elements of Nonverbal Communication Dealing with Sensitive Issues: A wide variety of embarrassing issues could exist within practice, including incontinence, sexual dysfunction, depression, menopause, hemorrhoid, contraception, and breast or prostatic cancer.

44. Important Elements of Nonverbal Communication Dealing with Sensitive Issues: As a pharmacist, You should be prepared to recognize situations that may be sensitive areas for patients. You should be comfortable discussing such matters in a nonthreatening way and in a nonverbal environment that conveys confidentiality and privacy.

45. Important Elements of Nonverbal Communication Dealing with Sensitive Issues: Some tips and tactics to help with sensitive situations: 1.Watch your patients. 2.Discuss sensitive issues with clarity and avoid potentially frightening scenarios. 3.Be recognizant of the potential for non adherence.

46. Important Elements of Nonverbal Communication Overcoming Distracting Nonverbal Factors: First: recognize distracting nonverbal elements. Second: finding strategies to overcome these distracting nonverbal elements.

47. Communication barrier

48. Communication barriers can be identified as following: 1-environmental barriers. 2-personal barriers. 3-time barriers.

49. 1-environmental barriers That include: A.physical barriers B.noise. C.lack of privacy. D.busy.

50. A.Physical barriers in some situations, patient can not see pharmacy personal behind these counters it’s difficult for patient to talk with individuals they can not see and inhibit the communication. this type may give patient the impression that the pharmacy dose not want to talk to them.

51. B.Noise These noises interfere with ability to communicate with patient. noise also interferes with ability to use the phone effectively when trying to communicate with physicions,patients and other.

52. C.lack of privacy some pharmacies have counseling room or areas but many may not have. can be enhanced by moving to the end of the prescription counter and lowering voice to achieve amore private environment.

53. D.Busy pharmacy this may create the impression that there appears to be little time to discuss personal matters with patient. it’s important that pharmacists organize their work patterns to minimize this impression.

54. 2-personal barriers 1- pharmacist-related personal barriers: shyness and lack of confidence avoid interpersonal communication. dysfunctional internal monologue limit ability to listen effectively.

55. 2-personal barriers 2- patient-related personal barriers: -patient belief that the health care providers are not concerned about them as individual but rather as cases or disease. -patient perceptions of their medical conditions may also inhibit communication.

56. 3-time barriers the timing of interaction is critical, choosing an inappropriate time this may lead to communication failure.

57. Techniques to improve patient understanding

58. The following strategies for clear communication and improved patient understanding : 1- Emphasize key points Underline, highlight or circle key points.

59. 2- Give reasons for key advice : example: antibiotic prescription.

60. 3- Give definite, concrete and explicit instructions Any information that patients can mentally pictures is more easily remembered,Use : 1-visual aids 2- photographs,or 3- demonstrations

61. Automatic Pill Dispenser

62. 4- provide key information at the beginning and end of the interaction.

63. 5- End the encounter by giving patients the opportunity to provide feedback about what they learned.

64. Do not ask a patient, “Do you understand?” Instead, ask patients to explain or demonstrate how they will undertake a recommended treatment or intervention. If the patient does not explain correctly, assume that you have not provided adequate teaching. Reteach the information using alternate approaches. The teach-back technique

65. 6- Slow down. Communication can be improved by speaking slowly. 7- Use lay language instead of medical terminology. 8- Supplementing oral instructions with written information is an essential part of patient counseling.,Before using written material assess the level of literacy to read and understand the information.

66. When patients are beginning a new regimen of medications …….. How we can help them ……….? Techniques to establish new behaviors

67. 1. Help patients identify ways to integrate new behaviors with current habits. This strategy is known as “ tailoring “ of regimens. Linking new behaviors ( taking a medication ) to habitual behaviors, such as brushing teeth before going to bed. Techniques to establish new behaviors

68. 2. Provide appropriate compliance aids. Individualized medication packaging for daily or weekly doses seems to work for some patients. Techniques to establish new behaviors

69. Digital timepieces installed in special vial caps can cue patients to take medications and help them monitor when medications have been taken. Techniques to establish new behaviors

70. Programs in the smart phone ……… Techniques to establish new behaviors

71. 3. Suggest ways to self-monitor. How ………. ? By use a medication diary or calendar on which to record medication. This will be help two problems: 1. forgetting to take medication. 2. forgetting whether a dose has been taken. Techniques to establish new behaviors

74. Also, patients can monitor their response to treatment, such as by taking their own blood pressure or testing their blood glucose levels. Techniques to establish new behaviors

75. 4. Monitor medication use. With chronic care medications, we should monitor adherence frequently and assess patient perception of effectiveness and problems encountered. Techniques to establish new behaviors

76. We should review prescription records for potential problems, such as patterns of late refills. Techniques to establish new behaviors

77. Many pharmacists also call patients to see how they are taking the medication and responding to therapy after they start on new prescription. Techniques to establish new behaviors

78. Reference: Lippincott; Communication skills in pharmacy practice.

79. Done by :  Hana AL-Thobaiti Pharma. D