Lecture 2 - Communication Skills for Effective Patient-Centered Care

Why is effective patient communication so important?

• improves outcomes

• increases satisfaction

• promotes self-care

• provide referral

interpersonal communication

process of exchanging information, ideas, and feelings between two or more people, using both verbal and nonverbal cues

interpersonal communication components

• clarity and conciseness

• tone and inflection

• active listening

• nonverbal communication

• empathy

• confidence and assertiveness

clarity

use plain and direct language, avoiding medical jargon

conciseness

be brief and focused, prioritizing key info and avoiding unnecessary detail

tone/inflection

warm tone and smile create positive impression, monotone can be perceived as disinterest and causes patient to disengage; vary tone and use inflection to emphasize points

verbal mirroring

match the tone and energy of the listener

appropriate tone variations

• Reassuring tone when calming a nervous patient

• Enthusiastic tone when delivering good news

• Firm tone when giving critical instructions

• Empathetic tone when discussing sensitive topics

active listening

communication technique where the listener fully focuses on, understands, and responds to the speaker, going beyond simply hearing the words; involves paying close attention to both verbal and nonverbal cues

reflective listening

communication technique where the listener actively tries to understand the speaker's message and then restates it back to them, confirming understanding and fostering a deeper connection

barriers to listening

• multi-tasking

• what to say next

• premature conclusions

• content only

• judgements

• turning out

effective active listening techniques

• Avoid making assumptions or stereotypes.

• Eliminate distractions, such as background noise or multitasking.

• Focus entirely on the speaker instead of planning your response.

• Ask clarifying questions to confirm your understanding.

• Wait until the speaker has finished before responding.

nonverbal communication components

kinesics, proxemics, physical environment

kinesics

study of body movements, gestures, and facial expressions as a form of nonverbal communication

proper kinesics for communication

open posture, maintain eye contact (usually), use gestures to emphasize key points, ensure facial expressions align wit the message, subtly mirror patients, respect personal boundaries with touch

proxemics

study of how people use and perceive physical space in communication, encompassing interpersonal distancing and orientation, as well as individual responses to proximity

examples of a physical environment in communication

• Color, lighting, use of space

• Noise and sound

• Pharmacy counter

• Overall appearance of pharmacy

• Attire and general appearance

examples of distracting nonverbal behaviors

excessive fidgeting, poor posture, lack of eye contact, distracting gestures, inattentive listening

empathy

sensitive ability and willingness to understand the client’s thoughts, feelings, and struggles from the client’s point of view…It means entering the private conceptual world of the other

why empathy is difficult

• Vulnerable

• Disagree

• Weakness

• Threatening

• Too intimate

• Fix problem

properties of empathy

• Active listening

• Acknowledging emotions

• Using reassuring language

• Following up

• Personalizing interactions

• Expressing empathy verbally

• Being inquisitive

• Using person-first languag

techniques for expressing empathy

acknowledge, imitate, summarize; name feelings, express understanding, respect the patient, support their struggles, and explore their feelings

personal barriers to empathy

• Time Pressure & Stress

• Burnout & Emotional Fatigue

• Depersonalization

• Limited Perspective

• Bias & Stereotyping

Depersonalization in empathy

feelings of detachment from oneself and one's experiences

what does confidence do in communication

• Builds trust

• Reduces miscommunication

• Improves decision making

• Encourages patient engagement

what does assertiveness do in communication

• Promotes clarity

• Supports advocacy

• Enhances teamwork

• Improves patient outcomes

barriers to effective patient communication (pharmacist side)

• Lack of self-confidence

• Cultural or language differences

• Emotional objectivity

• Attitudes and biases

• Listening skills

• Time and pressure

• Fear of conflict

• Internal dialogue

• Perceptions

barriers to effective patient communication (patient side)

• Cognitive challenges

• Perception of pharmacist knowledge

• Perceived need for consultation (Problem is insignificant, Physician counseling sufficient, Feel vulnerable)

• Cultural or language differences

• Emotional state

• Sensory impairment

• Misinformation

barriers to effective patient communication (administrative side)

• Efficiency driven policies

• Insufficient training

• Workplace culture

• Outcomes focus

open-ended questions

questions that cannot be answered with a simple "yes" or "no" and instead require a more detailed, elaborated response; encourage discussion, exploration, and deeper thinking by prompting respondents to use their own words and provide their perspectives

closed-ended questions

questions that offer a limited set of response options, typically requiring a "yes/no"; doesn’t allow for further expansion on issues and limit the listener’s answer

when to use open-ended questions

encourage patients to provide initial detailed explanations and insights

when to use closed-ended questions

to obtain further clarification or detail on duration, severity, and symptoms

formula of empathy

“You feel _________________because ________________.”

Indian Health Service Model

way to confirm correct patient information

Indian Health Service Model 3 prime questions

• What did the provider tell you the medication was for? (name strength, dosage form, route of administration)

• How did the provider tell you to take the medication? (administration schedule, duration of therapy, missed doses, refills, directions, medication storage/disposal)

• What did the provider tell you to expect? (adverse effects, when to expect improvement, drug/food interactions)

teach-back

communication strategy used in healthcare and other fields to ensure that a person understands information by asking them to explain it back in their own words

teach-back do’s

• Use lay terms and simple language

• Demonstrate empathy

• Provide a non-threatening environment