Transcript Development of competencies for doctor-patient

Development of competencies for
doctor-patient communication
Dr Gediminas Raila, MD, PhD
Kaunas University of Medicine, Kaunas, Lithuania
Patient consultation
Good communication between people, whether
it happens in the context of a consultation with
the patient, a conversation with a colleague or a
request to the manager, is key for successful
health promotion.
Patient consultation.
Questions to think about:
• What is your basic attitude towards the people
you work with?
• Do you accept them on their own terms or do
you judge them by your own standards?
• Do you encourage people to be independent,
make their own decisions, solve their problems
without interfering?
Consultation problems
1. Partnership or one-way process. Accepting
and judging, autonomy and dependency.
2. The doctor-centred or patient-centred
consultation approach.
3. Communication barriers: verbal and non-verbal
barriers that affect communication.
4. Patient motivation and resistance.
Small group tasks:
1. Planning a group meeting
2. Identifying non-verbal communication that
affects interpersonal communication
3. Helping people to talk
4. Improving patient motivation
Topics to think about
Planning a group meeting
• Identify the health problem you are going to
change.
• Think about the best place, time and physical
features of the meeting room.
• Think about the lecturer aims for the first
meeting.
• List the objectives for group members for the
first meeting.
Planning a group meeting
Make a plan for what you will do:
1. As people start to arrive.
2. To get people to get to know one another.
3. For the main part of the group meeting.
4. To round off the meeting at the end.
5. To evaluate whether you have achieved your
objectives.
Non-verbal communication
Describe the main categories of non-verbal
communication according to the following list:
1. Bodily contact
2. Proximity
3. Orientation
4. Level
5. Posture
6. Physical appearance
7. Facial expression
8. Hand and head movements
9. Eye contact
10. Non-verbal aspects of speech
Non-verbal communication
Think about which physician’s non-verbal
behaviour was associated with better
patient satisfaction and better
communication.
Non-verbal communication
Describe your feelings as a patient when:
1. The doctor frequently touches your hand.
2. The doctor is standing and talking to you from
too far away.
3. You are having a conversation while one of
you is sitting and the other is standing.
4. You are holding a conversation with a doctor
but neither of you are looking at one another.
Helping people talk
• Please describe the physician’s verbal
behaviours promoting positive interpersonal
relations.
• Think about the physician’s verbal behaviours
that enhance information exchange.
• Describe the consultation techniques that
encourage people to talk.
Improving patient motivation
• Describe the factors that influence the patient’s
behaviour. Think about predisposing, enabling
and reinforcing factors.
• Focus on the practical and circumstantial factors
that might inhibit motivation (e.g. patients’
understanding of the health issues, their belief in
their ability to change, cultural and gender
differences).