PHA 361 - Pharmacy Communication Skills L2

Communication Barriers

Anything that interferes with effective communication between the pharmacist and patient.

Internal/Personal Barriers

Barriers that come from within a person, such as beliefs, past experiences, body language, hierarchy, lack of trust, or use of medical jargon.

External Barriers

Barriers from the surroundings, such as noise, distractions, technology issues, lack of privacy, language differences, or the pharmacy counter.

Examples of Internal Barriers

Medical jargon, incongruent thoughts, beliefs, past experiences, poor listening, negative body language, lack of trust.

Examples of External Barriers

Background noise, ringing phones, drive-through distractions, technology problems, language barriers, patient being in a hurry.

Trust in Communication

Involves credibility, listening, and empathetic responses.

How to Overcome Internal Communication Barriers

Use plain language, practice empathy, build trust, avoid assumptions, and improve listening skills.

How to Overcome External Communication Barriers

Reduce distractions, decrease noise, improve privacy, resolve technology issues, and use interpreters when needed.

Example of an Internal Barrier

A pharmacist using medical jargon the patient does not understand.

Example of an External Barrier

A loud pharmacy environment preventing the patient from hearing instructions.

Open-Ended Questions

Questions that require more than a yes/no response and encourage detailed information.

Examples of Open-Ended Questions

What medications do you take? How have you been feeling? Describe your symptoms.

Words Commonly Used in Open-Ended Questions

Who, what, when, where, how, describe, explain, discuss, elaborate.

Closed Questions

Questions that can be answered with yes or no.

Example of a Closed Question

Do you take medications?

Nonverbal Communication

Communication expressed without words through posture, gestures, facial expressions, and body movements.

Open Nonverbal Communication

Positive body language such as uncrossed arms, visible palms, leaning forward, and open posture.

Closed Nonverbal Communication

Negative or defensive body language such as crossed arms, clenched fists, hidden palms, or turning away.

Examples of Open Movements

Uncrossed arms, palms visible, leaning toward the patient, maintaining eye contact.

Examples of Closed Movements

Crossed arms, clenched fists, hands in pockets, turning body away.

Example of Open Nonverbal Communication

Leaning toward the patient with uncrossed arms and visible palms.

Example of Closed Nonverbal Communication

Crossed arms, avoiding eye contact, and turning away from the patient.

Most Telling Sign of Open or Closed Communication

The palms.

Tips for Reading Nonverbal Cues

Look at multiple gestures and the entire nonverbal message rather than one isolated gesture.

Positive Nonverbal Cues

Leaning in, face-to-face interaction, nodding, open posture.

Negative Nonverbal Cues

Leaning away, backing up, turning away from the patient.

Signs of Disagreement

Rubbing nose, rubbing ear, rubbing eyes while leaning away.

Signs of Evaluation or Thoughtfulness

Head tilt, stroking chin, resting face on hand.

Signs a Patient Wants to Pause or Think

Pinching bridge of nose, cleaning glasses repeatedly, placing glasses arm in mouth.

Signs a Patient is Ready to Leave

Hands on hips, leaning forward with hand on thigh.

Signs of Frustration

Clenched hands with interlocked fingers, wringing hands.

Signs of Anger or Irritation

Clenched fists, hand behind neck, fingers pulling collar.

Signs of Nervousness or Lying

Covering mouth with hands.

Signs a Patient Wants to Speak

Flicking hand upward, tugging ear, placing finger on lips.

Professional Nonverbal Communication for Pharmacists

Maintain eye contact, appropriate touch, proper tone, professional dress, welcoming environment.

Power Differential in Healthcare

Patients may feel inferior or intimidated by pharmacists because pharmacists are viewed as authority figures.

How to Reduce Power Differences

Sit or kneel to patient level, avoid standing over patients, create a collaborative environment.

Health-Related Nonverbal Considerations

Gait, tremors, poor hygiene, or inappropriate clothing may indicate underlying health issues.

Listening

The process of fully hearing and understanding the patient before responding.

Nonverbal Signs of Listening

Facing the patient, open arms, visible palms, nodding, subtle smiling.

Verbal Signs of Listening

Summarizing, repeating, paraphrasing, empathetic responses.

How to Demonstrate Active Listening

Face the patient, maintain eye contact, nod occasionally, avoid interrupting, summarize and paraphrase responses.

Summarizing

Communicating the main points of what the patient said in a shorter form.

Repeating

Repeating the patient’s exact words back to them.

Paraphrasing

Restating the patient’s message in your own words while keeping the same meaning.

Example of Summarizing

“So your headaches began last week and worsen at night.”

Example of Repeating

Patient: “I feel dizzy every morning.” Pharmacist: “Dizzy every morning?”

Example of Paraphrasing

“So you’re saying the medication makes you too tired to work.”

Empathy

Understanding and acknowledging another person’s feelings from their perspective.

Sympathy

Feeling pity for someone without truly understanding their feelings.

Purpose of Empathy

Helps patients feel heard, safe, and less alone.

Empathetic Response

A response that acknowledges both the patient’s feelings and the reason for those feelings.

Two Parts of an Empathetic Response

Describe the emotion + summarize why the patient feels that way.

Example of Empathy

You seem frustrated because your medication cost increased.

Example of an Empathetic Response

“You seem overwhelmed because managing all these medications has become stressful.”

Empathy Best Practices

Avoid “I” statements, do not offer advice immediately, do not interrupt, do not make promises you cannot keep.

“There is no I in empathy”

Empathy should focus on the patient, not the healthcare provider.

Literacy

The ability to read, write, speak, compute, and solve problems needed to function in society.

Illiterate

Completely unable to read and write.

Functionally Illiterate

Reads at or below a 5th grade level.

Moderately Illiterate (Low Literacy)

Reads at a 5th to 8th grade level.

Average Adult Reading Level in the U.S.

7th to 8th grade level.

Numeracy

The ability to understand and use mathematical information.

Health Literacy

The ability to obtain, process, and understand health information needed to make appropriate health decisions.

Impact of Low Health Literacy

Increased hospitalizations, higher healthcare costs, decreased health status, poor medication understanding.

Examples of Health Literacy Limitations

Difficulty reading labels, measuring medications, understanding instructions, refilling prescriptions.

Signs a Patient May Have Low Health Literacy

Saying they forgot glasses, avoiding reading, taking long to read materials, relying on family members.

Techniques to Assess Health Literacy

Use teach-back method, ask open-ended questions, observe reading behaviors, and assess understanding of instructions.

How Pharmacists Can Help Patients with Low Health Literacy

Use plain language, avoid jargon, use visual aids, employ teach-back method, use empathy.

Strategies to Help Patients with Low Health Literacy

Use pictures, simplify instructions, avoid medical jargon, speak slowly, and provide demonstrations.

Teach-Back Method

Asking patients to explain information back in their own words to confirm understanding.

Cultural Competency

The attitudes, knowledge, skills, and values needed to work effectively in cross-cultural situations.

Linguistic Competency

The ability to communicate effectively with diverse populations, including those with low literacy or limited English proficiency.

Traditional Medicine

Practices and beliefs indigenous to specific cultures used to treat illness.

Western Medicine

Conventional evidence-based therapies regulated by the FDA.

Alternative Therapy

Therapy used instead of conventional medicine.

Complementary and Alternative Medicine (CAM)

Therapies used alongside conventional medicine.

Integrative Medicine

A combination of evidence-based conventional medicine and CAM therapies.

Acculturation

Adopting beliefs and behaviors of another culture while still maintaining aspects of one’s original culture.

Assimilation

Completely adopting another culture’s customs and potentially losing original cultural identity.

Characteristics of a Culturally Competent Pharmacist

Aware of disparities, sensitive to cultural influences, recognizes biases, advocates for patients.

How Providers Can Reduce Health Disparities

Recognize biases, advocate for patients, reduce barriers to care, use evidence-based medicine.

LEARN Model

A communication framework used to overcome cultural and communication barriers.

Purpose of the LEARN Model

To improve communication and cultural competency between healthcare providers and patients.

L in LEARN

Listen with empathy and understanding to the patient’s perception of the problem.

E in LEARN

Explain your perception of the illness and treatment plan.

A in LEARN

Acknowledge similarities and differences between perspectives.

R in LEARN

Recommend a plan of care that fits the patient’s beliefs and situation.

N in LEARN

Negotiate and agree on a plan of care with the patient.

Special Populations in Pharmacy

Pediatric, geriatric, pregnant/lactating, and patients with chronic medical conditions.

Pediatric Patients

Not miniature adults; altered pharmacokinetics and limited safety data.

Geriatric Patients

Reduced renal/hepatic function, increased medication sensitivity, multiple disease states.

Pregnant/Lactating Patients

Treatment must balance maternal benefit with fetal/infant risk.

Patients with Chronic Conditions

Often experience medication burden, drug interactions, and disease management challenges.

What is a common HIPAA violation?

Lack of employee training

What is a common HIPAA violation?

Medical record mishandling

What is a common HIPAA violation?

Using insecure technology

What is a common HIPAA violation?

Hacking and malware

What is a common HIPAA violation?

Authorization and patient signature violations

What is a common HIPAA violation?

Disclosing the wrong patient's information