Lecture 2-COMMUNICATION VARIABLES & COLLABORATIVE PRACTICES

JOHARI Window Model

• Developed in 1955 by Joseph Luft and Harry Ingham

• Purpose

  • Demonstrate the importance of open communication and self-disclosure

• Goal of the Model

  • is to increase the Open Self by sharing information about yourself and being receptive to feedback

• Helps To learn things about ourselves

  • To build trust with others by disclosing information about oneself

  • From feedback from others, we learn about ourselves and how to improve one’s skills, deal with issues

    • Always give constructive feedback

      • do not get personal or offensive

      • be sensitive to the individual’s feelings

The four quadrant grid of JOHARI Window Model

Known to self 

• Open Self

• Hidden Self

Not Known to self

• Blind Self

• Unknown Self

Open Self (known to self)

• Information about you that others and you know

  • (Knowledge, skills, attitude, personal or family history)

• involves self-disclosure

  • disclosing your thoughts, feelings, goals

    • without disclosing information that is personnel

• builds trust

  • The more people know about each other, the more cooperative and effective they are when working together

• People with large “Open Self” are

  • easy to talk to

  • communicate honestly and openly

  • work well as a team

• Benefits of Open self

  • helps with feedback and by being open

  • accepting feedback

    • one improves one’s skills and knowledge

Hidden Self (known to self)

• Information about yourself that you Know but others don' know

Blind Self

• Information about yourself that you did not know but others do know

• (Feelings of , unworthiness or inadequacy)

• Causes

  • one not to take feedback well

  • No improvement of skills and knowledge

Unknown Self

• Information about yourself that neither you or others know

Self Disclosure (part of open self; to increase awarness)

• Reveals information about oneself, disclosing things/events about yourself to others, who previously were not aware of this information

• Revealing information about yourself

  • when you need help

  • what you do well

  • articulating your aspirations/goals

Benefits of self disclosure

• Enhances communication and relationships

  • by being open and gaining trust

• Formalize relationships

  • - Get support/help in improving

    • technical skills or managing problems

• Gain new perspective and understanding

  • of yourself based on feedback from

    others

Disadvantage of self disclosure

• Personal risk, in competitive environments,

  • you reveal information that others can use against you

• Relationship risk

  • where personal information may result in rejection

• Professional risk,

  • where inappropriate comments about

    • management or colleagues

    • the organization

    • can result in a disciplinary letter or termination

Interaction with Others (part of open self; to increase awarness)

• Accepting feedback

• listening and incorporating the information to further develop your communication skills

• Seek Information about yourself

  • Ask for feedback for work you done or in your communication with colleague

  • Know yourself

Perceptions

• are formed based on our perspective

• shaped by own experiences, knowledge, prejudices,

  • how we see the situation or the people we interact.

• Based on how one communicates verbally, non-verbally, how one behaves, dresses and how one comes across to others.

• Art and skill of communication is to be able to understand and manage the impressions you give to others

Strategies to achieve desired impression:

• Reliable, enthusiastic, eye contact, facial expressions

• b) Credibility

  • demonstrating competence

  • education background

• Suppress or manage negative attitudes/behaviours

  • such as

    • raising one’s voice

    • blaming others

    • withdrawing from others

Empathy

• To feel what others feel

• To see the world as others see it

• enhances relationship.

• Empathy IS 

  • A two way competition

  • Encourage the speaker to express him/herself

    • do not interrupt, provide your undivided attention

  • Strive to be objective

Thinking empathetically

express an understanding of what the patient is saying or going through

Feeling Empathy

Ability to feel what others feel.

Confirmation

• Acknowledging the presence of a person who joins a

  group or who speaks or does something.

  • done by greeting a patient or a colleague,

  • asking how he/she is feeling

  • Answering the telephone

  • or responding to a page

Disconfirmation

• Ignoring someone’s presence as well as their

  communication.

• When disconfirmation happens, intentionally or not it

  • translates as

    • the person does not exist

    • what they have to say is not important or worth attention

Trust

• Cornerstone of an effective relationship between patient and health professional

• critical when one is ill or vulnerable

• highly correlated with patient satisfaction

Culture

• Beliefs, code of behaviors, traditions, values.

• transmitted from one generation to another through communication, observations or rules

• permeates all communication, messages effective in one culture may prove totally ineffective in another culture

• influences what you say, how you say it and the topics you talk about

Technology and media

• are influencing cultural changes and perhaps and are decreasing intercultural differences

Hospitals use interpreters who have multiple roles:

• Translators of language

• Culture broker

• Patient advocate to convey expectations and concerns

High-Context Culture

What Is Said and How or Where It Is Said Are Significant

• 1) Asia

  2) Latin America

  3) Middle East

• Long lasting relationships

• Importance of context

• Spoken agreements

• Insiders and outsiders are clearly distinguished

• Cultural patterns are ingrained and slow to change

Low-Context Cultures

What is Said is more Important Than How or Where It Is Said

1) USA

2) Canada

3) Germany

4) Britain

• Shorter relationships

• Less dependent on context

• Written agreements

• Insiders and outsiders are less clearly distinguished

• Cultural patterns change faster

Gender

• Depending on culture, there is a belief or understanding that boys and girls have different

  • attitudes, behaviors and values.

  • not related to biological differences.

• Today, the gender roles have changed and there is equality between men and women.

Importance of Culture

• Demographic changes

  • healthcare need to understand how different cultures

    • communicate illness/procedures

    • preventative medicine

    • medications

• Culture Diversity:

  • Communicating healthcare issues with sensitivity

Collaboration Model

• between Compete and Avoid

Commonly Used Elements

• Communication

• Openness

• Learning

• Listening

• Respect

• Trust

• Inquiry

• Negotiation

Less Frequently Used

• Assertive

• Belief

• Optimistic

• Acceptance

• Objectivity

Communication Essentials (by CMLTO)

• Most communication problems resolved around perception

  • Perception is based on a perspective which is shaped and judged by

    • our previous experience

    • prejudices

    • knowledge

    • traditions/beliefs

• Best Practice for Effective Communication

  • Check perception by asking

    • questions, summarizing or paraphrasing the information that the individual has provided

  • obtain feedback to determine one has a correct understanding of what is being communicated

Communication is broken down as follow

Words – 7% of the content

Vocal tone constitutes 38% of the message

Body Language constitutes 55% of the message