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32 Cards in this Set
- Front
- Back
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WHAT IS INTERSUBJECTIVITY
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Striving to understand others
Being understood |
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WHAT IS IMPACT
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Extent to which a message brings about change in thoughts, feelings or behaviour
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what are 5 of the many purposes of communication
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Maguire (1989)
Patients were interviewed by medical students. Patients preferred interviewers who; |
Were warm and sympathetic
Were easy to talk to Introduced themselves Appeared self-confident Listened to the patients and responded to their verbal cues Asked questions that were easily understood and were precise Did not repeat themselves |
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4 reasons why good communication is important
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To make an accurate, comprehensive diagnosis
Detect emotional distress in patients and respond appropriately Increase patient satisfaction with care provided To increase compliance with advice and instructions |
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when beginning a consulation
what puts patients at ease |
A comfortable setting
Being greeted my name and a handshake Being shown where to sit The interviewers introducing themselves and explaining the procedure An easy first question The interviewer appearing interested in your remarks |
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65% of all social interactions are made up of
non verbal communication of the clinician can do what as clincians what do we pick up on |
65% of all social interactions are made up of non-verbal communication
The non-verbal communication of the clinician can affect the patient’s ability to cope with dental experiences As clinician’s we can pick up on our patient’s non-verbal cues |
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what specific factors in non verbal communication may affect the patients perception of us
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Level/ Position
Proximity Posture Eye contact Non-verbal reinforcers of speech tone, pitch, speed, ’ahs’, ‘uhms’ |
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what body movements give signals to our patients
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Hands and arms
Facilitate the transmission of messages from one person to another Self-directed gestures – often a sign of tension e.g. ring twisting, hand-wringing Head and shoulders Head nods – different meanings Legs and feet Movements tend to display signs of unease Social leakages – individual subconsciously displays evidence of tension or nervousness |
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what can facial expressions do
how many movements identified |
Communicates emotional states (46 separate facial movements identified – Ekman, Friesen 1982)
Examples; wink, lip corner puller, inner brow raiser |
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what is actually said in verbal communication to the patient
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What is actually said
Questioning Listening Explaining |
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2 types of questions asked
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open
closed |
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pro's and cons of open questions
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Advantages of open questions
More relevant information can be obtained in a given time The patient feels more involved in the interview The patient can express all the concerns and anxieties about their problem Disadvantages of open questions Interview may take longer, difficult to control Some of the interview may not be relevant |
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features of closed questions
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The information obtained is restricted to the questions asked
The interview is controlled by the interviewer The interviewee has little opportunity to express their concerns and feelings. |
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what do probing questions allow us to do
and give examples of 3 |
Clarify; What do you mean by that?
Justify; What makes you think that? Check accuracy; You definitely took three tablets a day? |
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state one of the main core skills of good communications
and tips to help with this core skill include |
Listening is one of the core skills of good communication
Tips Allow patients to talk without interruption Effective listening means concentrating on what the patient says and trying to understand their feelings as they speak Be alert to verbal and non-verbal cues To demonstrate your attention, use appropriate body language and facilitate comments Allow pauses and silences |
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what does facilitating involve
give examples |
Aims to help and encourage the patient to talk as fully as possible about their problems
Verbal “Please go on and tell me more” “Yes, I understand – please continue” Non-verbal Appropriate posture – e.g. lean slightly forward towards the patient, maintain eye contact and nod at appropriate times |
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what is signposting
give an examples |
Structuring the consultation into easily understandable sections that are communicated to the patient
e.g. We’ve talked about your main problem, can I now go on to ask you some questions about your general health? |
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main functions of explanations
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Provide information
Simplify complexities Correct mistaken beliefs Give advice Aid patient compliance Highlight the important elements of any procedure Offer reassurance and reduce uncertainty Justify one’s actions and recommendations Increase patient satisfaction Ensure patient understanding |
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top tips for explaining information to the patients
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Be realistic in the objectives you set
Advice and instructions should be given early in the session, the most important information should be given first Use short words and sentences Avoid jargon Give information in a structured way – in a set of ‘chunks’ Use visual aids, leaflets, posters Check that your patient understands your message and allow them to ask for clarification Be friendly, not officious – sufficient to establish rappo |
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when dealing with lots of information what should we do
and why |
one thing at a time
Generally people can retain about seven pieces of information at any one time Don’t ‘overload’ your patient with information Give the most important information first |
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what type of information should we avoid
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jargon
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examples of illustration and its benefits to a clinician
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‘One picture is worth 1000 words’
Audiovisual aids Diagrams Drawings Pictures Useful for explaining complex procedures Extremely useful in dentistry to explain procedures e.g. root canal treatment, crowns, bridges |
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benefits of asking patients to repeat what was just said to them
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Asking patients to repeat in their own words what they understand of the information they have just been given increases their retention of that information by 30% (Bertakis 1977)
Patient recall is increased by signposting, summarising, repetition, clarity and use of diagrams (Ley 1988) |
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when ending an interview what must be done
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Allow sufficient time to end the interview properly.
Essential Features; Summarise what the patient has told you Ask them to check the accuracy of what you have said Ask them to repeat in their own words what advice or information they have been given Enquire if they would like to add anything End by thanking the patient. |
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HOW TO CALL YOUR PATIENT
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Call your patient from the waiting room
Say who you are Escort your patient onto the clinic Show your patient where to sit Position yourself in front of your patient Explain what you are going to do today Say who your tutor is Small talk |
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how must we initiate the history and examination
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‘Because I haven’t seen you before I need to ask you some questions and have a look at your teeth and gums. This will help me and my tutor to put together a plan for your treatment’
Can I start by asking you…… |
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what must i do in clinic at ldi when taking medical history
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Use the inside of the yellow patient notes card
Medication – write out a list, if unsure ask Use of follow-up probing questions Ask your tutor to check what you have written before doing your examination |
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what type of social history questions should i be asking
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Occupation
Smoking status Alcohol intake non-judgemental approach |
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how to question on the patients oral hygiene
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What do you do to keep your teeth clean?
Follow-up/ Probing/ Facilitating type questions How often do you use floss? Which type of mouthwash do you use? |
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how should oral hygiene instruction be given
issues with oral hygiene instruction |
Advise patient to bring their own toothbrush
Demonstrate by brushing the patient’s teeth Tailor advice to the individual patient One thing at a time Repetition and reinforcement Use of charting sheets – targets Issues Embarrassment Feeling patronised |
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when ending the appointment at the LDI what should be done
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Summarise what you have done
Does the patient have any questions? Escort the patient to the reception area to make arrangements for another appointment |
