![Short Answer Questions – Paper II
1] Communication: Definition & Types
2] Process of communication
3] Barriers to communication
4] Kalamazoo statement
5] Importance of verbal & Non verbal communications](https://image.slidesharecdn.com/aetcom1-250724043840-8d3bcff3/85/AETCOM-1-4-Foundation-of-Communication-1-pdf-3-320.jpg)
![Types of Communications
Based on Number of persons involved
1] Intrapersonal
Self – Introspection
2] Interpersonal
3] Group communications
4] Mass communication – to society through …..](https://image.slidesharecdn.com/aetcom1-250724043840-8d3bcff3/85/AETCOM-1-4-Foundation-of-Communication-1-pdf-10-320.jpg)
![1] Physical barrier
Noise, distance, faulty equipment, wrong choice of medium , poor
infrastructure
2] Physiological or Biological barriers
These are related to a person’s health and fitness
These may arise due to disabilities that may affect the physical capability
of the sender or the receiver
➢ Proper functioning of the vocal cords, hands, fingers, eyes is necessary
for effective communication](https://image.slidesharecdn.com/aetcom1-250724043840-8d3bcff3/85/AETCOM-1-4-Foundation-of-Communication-1-pdf-23-320.jpg)
![3] Semantic barriers/ Language Barriers
Misinterpretation of words
Use of technical language or jargons
Vocabulary deficiency of both the sender and the receiver may cause
Multiple meaning of the words in different context
4] Cultural Barriers
Differences in traditions, values, beliefs, or norms between
communicators](https://image.slidesharecdn.com/aetcom1-250724043840-8d3bcff3/85/AETCOM-1-4-Foundation-of-Communication-1-pdf-24-320.jpg)
![5] Psychological barriers
Fear and Anxiety , Low Self-Esteem , Negative Thinking Perfectionism,
Stress and Overwhelm ,Prejudice and Stereotypes,Lack of Motivation,
Emotional Barriers
6] Organizational Barriers
Hierarchical levels, rigid rules, or poor communication channels within
institutions
7] Technological Barriers
These barriers can range from simple issues like poor internet connectivity to
more complex problems such as digital literacy gaps or platform
incompatibility](https://image.slidesharecdn.com/aetcom1-250724043840-8d3bcff3/85/AETCOM-1-4-Foundation-of-Communication-1-pdf-25-320.jpg)
![5 A’s of Behaviour Change Model
This model of communication is based on providing a
patient action plan at each level
1] Assessing the patient
2] Advising the patient
3] Agreeing with the patient
4] Assisting the patient
5] Arranging the patient](https://image.slidesharecdn.com/aetcom1-250724043840-8d3bcff3/85/AETCOM-1-4-Foundation-of-Communication-1-pdf-40-320.jpg)
AETCOM 1.4 - Foundation of Communication 1.pdf
- 1. AETCOM 1.4 - The Foundations of Communication - I Dr. Uttama Joshi Professor, Anatomy BV(DU) Medical College & Hospital, Sangli
- 2. Competency – 1.4 Demonstrate the ability to communicate to patients in patient, respectful, non- threatening, non- judgmental empathetic manner
- 3. Short Answer Questions – Paper II 1] Communication: Definition & Types 2] Process of communication 3] Barriers to communication 4] Kalamazoo statement 5] Importance of verbal & Non verbal communications
- 4. SLOs ➢ Define communication and its importance in healthcare system Identify the key components of effective communication (verbal, non-verbal, written) Describe Kalamazoo’s consensus of communication Analyze barriers to effective communication in medical practice Demonstrate basic communication skills through role-play activities Apply communication principles in simulated patient interactions Evaluate own communication strengths and areas for improvement
- 5. Think of a good/bad experience at a hospital what role did communication play?" "How many of you have witnessed miscommunication in a hospital?"
- 6. Why is Communication Important for Doctors? Builds doctor-patient trust Improves diagnosis and compliance Reduces errors and litigation Enhances professional satisfaction
- 7. Misconceptions Good speaking is good communication Talkative people communicate better than calm & silent people To be a good speaker you don’t have to be good listener Only intelligent people can listen Speaking is more important than listening Listening is an unconscious process
- 8. What is communication? •Communication can be broadly defined as the meaningful exchange of information, thoughts, or feelings between individuals or groups. ( In health care system) • It involves transmitting a message with the intent of creating a shared understanding •Requires …. ?? • Both the sender and receiver to be actively involved, whether through verbal or non-verbal means
- 9. Key Aspects – What is involved ? - Process •Sender: The individual or group initiating the communication •Receiver: The individual or group receiving the message •Message: The information, idea, or feeling being conveyed •Channel: The medium through which the message is transmitted (e.g., speech, writing, email, body language) •Feedback: The receiver's response to the message, indicating understanding or lack •Context: The circumstances or situation surrounding the communication, which can influence its interpretation
- 10. Types of Communications Based on Number of persons involved 1] Intrapersonal Self – Introspection 2] Interpersonal 3] Group communications 4] Mass communication – to society through …..
- 11. Communication based on feedback obtained Two-way communication Best form in health care setup Clear understanding Overcomes conflicts & misunderstanding May not be feasible in every circumstances One-way communication Authoritative faculties – of working environment after discussion carry out
- 12. Communications directed by the authorities Formal or Vertical Informal or Horizontal
- 14. Verbal & Non verbal Verbal - Spoken Written Written communication might be a letter, email, a report, or a message on social media. Written communication should aim to get your message across in a clear and concise manner. Non verbal - ➢ Facial expressions can intensify, diminish, or can cover up the emotions that you are feeling.
- 15. Verbal & Non verbal Non verbal - ➢ Posture The way you stand or sit at work can often display your attitude or attentiveness toward certain situations ➢ Body movements includes nonverbal cues such as postures and gestures. For example, slouched shoulders tend to communicate tiredness.
- 16. Gesture is a form of nonverbal communication or non-vocal communication in which visible bodily actions communicate particular messages, either in place of, or in conjunction with, speech. Gestures include movement of the hands, face, or other parts of the body Paralinguistics It is vocal communication - is the tone, loudness, pitch, tempo and accent of your voice when you speak ➢ Appropriate Touch Cultural diversity Proxemics the perception and use of space to communicate meaning and relational status
- 17. Importance of Verbal & Nonverbal communication Verbal Communication involves the use of words – spoken or written – to convey messages. It helps in Clearly explaining diagnoses and treatment plans Building trust through empathetic conversations Ensuring informed consent and patient understanding Non-Verbal Communication - It is vital because It reinforces or contradicts verbal messages Shows empathy, attentiveness, and respect Helps decode patient emotions and concerns
- 19. Communication can be --- What you say with your words It Can also be what you share with your postures and gestures (learned to express the right message). What you feel inside you impacts the subtle message you feel compelled to share outside you. As you can see, (1) and (2) can be learned with practice. But (3) has to be consciously built, so constantly align yourself to what you want to express.
- 22. Barriers to communications Barriers of communication are obstacles that hinder the effective exchange of ideas, messages, or information between individuals or groups. Language Cultural Barrier Stereotyping Physical Barriers due to perception of communicated information Emotional Barriers Interpersonal barriers
- 23. 1] Physical barrier Noise, distance, faulty equipment, wrong choice of medium , poor infrastructure 2] Physiological or Biological barriers These are related to a person’s health and fitness These may arise due to disabilities that may affect the physical capability of the sender or the receiver ➢ Proper functioning of the vocal cords, hands, fingers, eyes is necessary for effective communication
- 24. 3] Semantic barriers/ Language Barriers Misinterpretation of words Use of technical language or jargons Vocabulary deficiency of both the sender and the receiver may cause Multiple meaning of the words in different context 4] Cultural Barriers Differences in traditions, values, beliefs, or norms between communicators
- 25. 5] Psychological barriers Fear and Anxiety , Low Self-Esteem , Negative Thinking Perfectionism, Stress and Overwhelm ,Prejudice and Stereotypes,Lack of Motivation, Emotional Barriers 6] Organizational Barriers Hierarchical levels, rigid rules, or poor communication channels within institutions 7] Technological Barriers These barriers can range from simple issues like poor internet connectivity to more complex problems such as digital literacy gaps or platform incompatibility
- 26. Methods to overcome barriers Use of clear and simple language Be an active listener Reduction and elimination of noise levels Provide feedback and confirmation Be culturally sensitive and emotionally aware Improve the communication environment Eliminating differences in perception Maintain proper Emotional State Avoid Information Overload Proper Media Selection
- 27. Principles of communication Clarity The message should be clear, simple, and understandable Avoid jargon unless the audience is familiar with it Use appropriate language and structure Conciseness Be brief and to the point Avoid unnecessary details or repetition Keep the message focused on the objective
- 28. Completeness The communication should include all relevant information needed for understanding or action Answer all possible questions the receiver might have Consideration Be empathetic and consider the receiver's perspective—their background, level of understanding, emotions, and needs Respect cultural and personal differences Courtesy Communicate with politeness and respect Avoid harsh or offensive language Foster a positive relationship
- 29. Correctness Ensure the information is accurate, factual, and error-free Use correct grammar, spelling, and pronunciation In clinical communication, correctness includes medical accuracy Feedback Communication should be two-way Allow the receiver to ask questions, clarify, and respond Listen actively to the feedback and adjust communication if needed Timeliness Communicate at the right time and in the appropriate context Timely communication prevents misunderstandings or errors, especially in clinical settings
- 30. Active Listening Focus fully on the speaker, showing attentiveness through eye contact, gestures, and appropriate responses Avoid interrupting or judging prematurely Non-verbal Communication Pay attention to body language, facial expressions, tone of voice, and gestures Purposefulness Every communication should have a clear goal or intention—to inform, persuade, instruct, or build rapport Confidentiality (especially in healthcare) Maintain the privacy of information, particularly in doctor-patient communication, Respect ethical and legal boundaries
- 31. Kalamazoo’s Essential Elements of Communication It includes 7 core elements, - identifies 7 evidence based essential elements or tasks of effective doctor- patient communication , Skill competencies are identified for each statement. These statements are sub- categorized & assessed on Likert scale Assessment of communication skill is done with the help of check list based on these 7 elements Scale – Done well, Needs improvement, Not done
- 32. 7 elements are ❖ Building a relationship ❖ Opening the discussion ❖ Gathering information ❖ Understanding patient’s perspective ❖ Sharing information ❖ Reaching on agreement ❖ Providing a closure of the meeting
- 33. Building a relationship with patient Initiate the Session & Establish rapport with the patient Greet and introduce yourself Confirm patient identity Explain the purpose and structure of the encounter Use words that express concern about the patient throughout the interview Effective use of body language
- 34. Opening the discussion Allow patient to complete opening statement without interruption Ask-” Is there anything else?:” Explain & / Negotiate an agenda for the meeting Be non-judgmental Use verbal and non-verbal communication to foster trust Display respect, empathy, and attentiveness throughout.
- 35. Gathering information Begin with patient’ s story using open ended question like – Tell me about… Clarify details as & when required with more specific Yes/ No Give patient opportunity to add or correct the information Transit effectively to additional question Summarize the gathered information
- 36. Understanding patient’s perspective Ask about life event circumstances and other people that might affect health Elicite patients’ beliefs, Ideas, concerns and expectations (ICE) about illness and treatment Respond explicitly to patient statements about ideas feelings and values –show empathy
- 37. Sharing information Assessing the patients understanding of problem and desire for more information Use simple words to explain- that are easy for patient to understand Checking for mutual understanding of diagnostic and or treatment plans Asking whether the patient has any queries Provide accurate, relevant, and complete information Use visuals or written materials if needed
- 38. Reaching on agreement Include patient in choices and decisions what he or she desire Involve the patient in shared decision making Asking about patients ability to follow diagnostic and or treatment plans Discuss options, benefits, and risks Respect the patient’s values and choices
- 39. Providing the closure of the meeting Asking whether the patient has questions concerns or other issues Summarize the key points Clarifying follow up or contractor arrangement & next step Acknowledge the patient and close the interview with positive, respectful note
- 40. 5 A’s of Behaviour Change Model This model of communication is based on providing a patient action plan at each level 1] Assessing the patient 2] Advising the patient 3] Agreeing with the patient 4] Assisting the patient 5] Arranging the patient
- 41. References National Medical Commission (NMC), India. Attitude, Ethics and Communication (AETCOM) Competencies for the Indian Medical Graduate, Module 1.4: Foundations of Communication – 2019. Available at: https://www.nmc.org.in Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001;76(4):390–393. according to the National Institutes of Health (NIH) Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (3rd ed.). Radcliffe Publishing. Rao, K.G. (2011). Doctor-Patient Communication. Jaypee Brothers Medical Publishers. K rajgopal Shenoy, Krishna Garg, Sanjay Andrew Rajaratnam, Maria Pauline (2020) AETCOM Manual – Learning Module for Professional Year I – CBS Publishers