Communication Skills For Residents

Muhammad Saaiq, Khaleeq-Uz-Zaman,

Department of Medical Education,
PIMS, Islamabad.
Aug 31, 2013.
Overview of the presentation

Effective Communication?

Basic Concepts

Key Communication Skills for Doctors

 Communication

It is 2-way dynamic process of exchange of

information between a sender and a receiver
through a comprehensible language (verbal)
or non-verbal signals.
Effective Communication
Communication is effective only when
both the sender and the receiver
perceive it in its true sense

Message

SENDER RECEIVER
What are the most common
ways we Communicate
 Wo rd s Bod
yL
en
Spok ang
uag
e

Visual Im
e n Wo r ds ages
Writt
 The Process/ factors
involved in Communication
Medium

Barrier
SENDER RECEIVER
(encodes) (decodes)
Barrier

Feedback/Response
Why Communication Skills
are so Important
As Communication is a complex process that
involves individuals and media, errors may
occur.
 The “Process”
Flow of Communication

Downward
Upward
Crosswise/ Horizontal
Flow of Communication

Professor

Associate Professor

Assistant Professor

Senior Registrar

Resident/ House officer

 Flow of Communication
Crosswise/ Horizontal
Professor

Associate Assistant
SR/ Registrar Resident
Professor Professor
 Types of Communication

y VERBAL
y Spoken
y Written
y NON-VERBAL
y Body language
y Postures
y Movements

y SYMBOLIC
Verbal Communication
Channels
y Spoken Channels:

y Face-to-Face:
With patient—
With consultant—on ward rounds, OPD consultation,
In meetings--- class presentations, etc

y Telephonic consultation,

y Video Conferencing.
• Written Channels:

y Documented form/ File work

Case History, examination, investigation,
progress notes, OT notes, Reports,

Cyber communications

y Medical writings
 Non-verbal Communication

y All behaviors that express messages without the use of

words

60% of all communication is nonverbal

Burgoon, Buller, & Woodall,1989.
 Body language
Be mindful that you are dealing with “PEOPLE”
 Body language
Be mindful that you are dealing with “PEOPLE”

y POSTURES & GESTURES

y EYE CONTACT

y ORIENTATION
y How do you position yourself?
y PRESENTATION
y How do you deliver your message?
y LOOKS
y Are your looks, appearance, dress important?
y EXPRESSIONS OF EMOTIONS
y Are you using facial expressions to express emotion?
 Improving Body language

• Keep appropriate distance.

• Maintain eye contact.
• Take care of your appearance.
• Touch only when appropriate
• Smile genuinely
• Be aware – dishonest people may give
false cues
What are the various
Technical Communications
in our daily patient Care
y Oral Forms y Written Forms
y Face-to-face communications y Documentation/ file work
y History, examination y Applications/ Letters
y Counseling y E-mails / Faxes
y Consent y Notices
y Breaking bad news y Circulars
y Presentations y Newsletters
y Group discussions y Reports
y Interviews y Proposals
y Conferences y Research publications/ Thesis
y Video conferences y Brochures
y Voice conferences y Manuals
Key Communication Skills for Doctors

y Thoughtful Listening
y Impactful Presentation
y Meaningful Feedback
The Art of Thoughtful Listening
The 04 levels of Listening

y The non-listener
y The marginal listener
y The evaluative listener
y The active listener
 Writing
9% Speaking
30%
Reading
16%

Listening
45%

Contribution of various skills in day to day life’s

Communication
 Contribution of various skills in day to day life’s
Communication

__________________________________________
Skills Order Learned Extent Used Extent
Taught
_______________________________________
Listening First First Fourth
Speaking Second Second Third
Reading Third Third Second
Writing Fourth Fourth First
 Golden Principles
¾Actively listen rather than hearing.

¾Attentively focus on the message.

¾Comprehend and interpret the message.

¾Respond/ give your feedback.

¾Avoid ridiculing, arguing, or side tracking

him
How to sharpen listening skills

y Follow the golden principles

y Be open minded , abolish preoccupations,
y Minimize Interruptions
y Ask Questions
y Paraphrasing.
y Summarizing.
What are the barriers to Listening

Poor listening attitudes

Fallacies
Others
 Barriers to Listening
POOR LISTENING ATTITUDEs:
y Not paying attention
y False assumptions, Stereotyping
y Offering spontaneous opinions, approval or
disapproval.
y Offering false reassurance
y Defensiveness
y Listening what we expect to listen rather than what
is actually said
 Barriers to Listening

FALLACIES:
• Listening is not my problem!
• Good readers are good listeners
• Smarter people are better listeners
• Listening improves with age
• Listening skills are difficult to learn
 Barriers to Listening

Noise Lack of privacy

The Art of Impactful Presentation
 Impactful Presentation

An impactful presentation entails a

clear message which is clearly
conveyed to the audience
 Impactful Presentation

A good presenter is
‰Crisp and concise
‰Communicates clearly
‰Has control and authority on his subject
‰Prompts desired response among his audience

Preparation and Rehearsal are the Keys

 Impactful Presentation
Helpers

What do you want to present (content)?

Why do you want to present (purpose)?
Where will you be presenting (place)?
How do you want to present (spoken, interactive, or
slides)
Who is your audience?
 Impactful Presentation

Aspects in the development of a good

presentation:

¾Know your Audience

¾ Master your Content
¾ Organize your-Self
 Impactful Presentation
Audience Analysis

™What does the audience want ?

™What does the audience already know ?
™What are their needs, expectations ?
™How will the audience benefit from this presentation?
 Impactful Presentation
Content
y Structure the content in line with the audience’s needs
y What do you want to tell the audience?
y What is your objective?
y Prepare keeping in mind the time allotted
y Anticipate the questions and prepare
y Collect material from a variety of sources
y Arrange points logically and sequentially
y Prepare handouts if appropriate
 Impactful Presentation
Structuring the Content
™Sequence should be logical & understandable
™Interim summaries- Recaps
™Value of visual aids i.e. Power-points, flip charts, handouts
etc.
 Impactful Presentation
The Beginning
™Should be carefully designed
™Get attention
- shock, humour, question, story, facts & figures
- well rehearsed yet natural
™Motivate audience to listen
- listen to their needs
 Impactful Presentation
The Closing
™Last 2 to 2.5 minutes are as critical as the first five minutes
for a successful presentation
™Summarize- highlight important points
™Suggest action- what to do and when, where and how to do it
 Impactful Presentation
Timing the presentation (for 30 min)
2 -2.5 mins ----- opening/beginning
20 mins ---------- middle section
2 -3 mins ------- closing/end
5 mins --------- questions
 Impactful Presentation
Organizing oneself
Effective Delivery
™Be active/ proactive
™Be purposeful
™Be natural
™Be direct – don’t just talk in front of the audience ,
talk to them
™Variations –Body language, vocal (pitch, volume, rate)
 Impactful Presentation
Organizing oneself
Stage Fright
™Everyone has it to some degree
™Can be used constructively
™Key issue is not elimination of fear
Instead channel the energy it generates for an effective
presentation
 Impactful Presentation
Organizing oneself
AVOID
™Speaking too fast
™Using jargons
™Bad tone and poor content
™Not questioning
 Impactful Presentation
Organizing oneself
Handling Questions

™Usually the questions themselves give you a

lead to highlight your point of view
™Anticipate and keep answers ready
™Do not get confused, You are not supposed to
know everything
 Impactful Presentation
Organizing oneself
Visual Aids

™While using an over head projector face the

audience while talking
™Point with a pen
™Appropriate lighting
™Watch the colours
™Ensure clear visibility
™10 lines, 10 words per line
 DO’s and DON’Ts in using Visual Aids

DO,s: DON,Ts:
™Well prepared ™Overuse of colours
™Clear and simple ™Using it as notes
™Interesting ™Too busy slides
™Relevant to spoken words
™Ensure clear visibility
™10 lines, 10 words per line
Feedback Skills
 Feedback Skills
y Key Concepts:
y Positive vs. Negative Feedback
y Positive feedback is more readily and accurately perceived than
negative feedback
y Positive feedback fits what most people wish to listen and
already believe about themselves
y Negative feedback is most likely to be accepted when it is
supported by objective evidence
y Subjective impressions carry weight only when they come
from a person with high status and credibility
 Feedback Skills

y Keep it goal oriented

y Make it well timed
y Ensure understanding
y Keep it impersonal
y Direct feedback toward behaviour that is controllable
by the recipient
y Focus on specific behaviours
How do people judge us in life
The majority of our perceived
ability comes from how we
communicate with others.
 30% What We know

70% How We
communicate it.

Source: CGAP Direct

Thank You

Muhammad
MuhammadSaaiq,
Saaiq,Khaleeq -Uz-Zaman,
Khaleeq-Uz-Zaman,
Department
Department of
of Medical
Medical Education,
Education,
PIMS,
PIMS,Islamabad.
Islamabad.