Communication skills.

1. Dr. Dalia El-Shafei
Assistant professor, Community Medicine Department, Zagazig University

2. “We are born to see, but have to train ourselves to observe”

3. What
(Definition )
Why
(Importance )
How
(Elements &
Principles)
By what
(Forms)
Why not
(Barriers )

4. WHAT IS COMMUNICATION?
 Communication is sending or receiving ideas, thoughts or
feelings from one person to one or more persons in such a way
that, the person receiving it understands it in the same way the
sender wants him/her to understand.
 The term ‘Communication’, derived from a Latin term
‘Communicare’.
 Also known as “people skills” or “soft skills”.
 Ranked in a survey as the most important requirement for
successful job performance.

5. Continuous Dynamic
Transactional Irreversible
Communication

6. SENDER MESSAGE CHANNEL RECEIVER
Context
FEEDBACK
THE COMMUNICATION PROCESS
The person
initiating the
communication, or
broadcasting the
message.
The specific set of words,
gestures and images that
the sender uses to
convey what he or she
wants to say.
The channel
through which
the message
moves.
Receivers (or the
audience for the
message) - from whom
the receiver often
expects a response.
The response from the
receiver to the sender.

8. WHY WE STUDY COMMUNICATION SKILLS?
• 60% to 80% of diagnosis.
History taking
• >50% of patients deviate from the doctors’ advice or do not follow it
at all.
Good communication provides information to the
patient
• Doctors interrupt patients very early.
• Patients do not understand what the doctor is saying.
• Advice is too difficult to follow.
Poor quality of communication leads to patient’s
dissatisfaction

9. COMMUNICATION PRINCIPLES
Listening (not HEARING)
Probing (encourage)
Observing (non- verbal)
Informing (4 Cs = Clear, Correct, Concise, Complete)

10. 1- LISTENING:
Active process (Not hearing), it involves a conscious effort to listen
to words; to the way they are said, to be aware of the feelings
shown and attempts to hide feelings.
Focus your attention; avoid barriers.
Show that you are listening (verbally & nonverbally).
Understand ideas and pick key words.
Retain information (memory, notes).
Reflect or give your feedback.

12. 2- PROBING:
- What clients think/know.
 Encourage them to talk: tell them that are really listening &
wanting to hear more.
 Ask questions.
 Keep Privacy, listen.

13. 3- OBSERVING:
Nonverbal communication through:
Facial expressions Voice tone Body language

14. 4- INFORMING
In a Clear, Correct, Concise, Complete way.
Consider: Needs, Language, Obstacles.
Summing-up briefly.
Check back with the speaker to ensure that the statement is accurate.

15. Change behavior
Get action
Ensure
understanding
Persuade
Get & give
Information
COMMUNICATION
GOALS

16. Environmental
• Loud sounds
• Activities of
nearby people
• Interruptions
from others
• Physical
discomfort
Physiological
• Deafness
• Blindness
• Learning
disabilities
• Illness.
Language
• Different
language
• Specific
terminology
Personal
• Socioeconomic
conditions
• Values & beliefs
• Previous
experience
• Not valuing
themselves, not
believing that
their health is
important.
Psychological
• Stress
Frustration
• Anger, tiredness,
distracted,
preoccupied.
Barriers to the Communication

17. SENDER MESSAGE CHANNEL RECEIVER
Context
FEEDBACK
THE COMMUNICATION PROCESS OR ELEMENTS
Knowledge
Formulation
Language
Tone
Personality
Ambiguity
Interest
Clearness
Confusion
Objectivity
Noise
Accessibility
Adaptation
Decoding
Physiology
Personality
Preparation
Time
Selection bias
Formulation

18. Body
Language
55%
Words
7%
Tone of
Voice
38%

19. MEANS OF COMMUNICATION
Verbal
Oral
Written
Non-verbal
Body movement
Posture
Gesture
Facial expressions
Eye contact
Space
Touch
Time
Personal appearance
Paralanguage

21. NON-VERBAL COMMUNICATION

22. Non-verbal communication can Reinforces,
Complements, Contradicts, Regulates, or
Replaces a verbal message.

23. CATEGORIES OF NONVERBAL COMMUNICATION
Body movement: Way
of walking
Posture: Way of sitting,
standing
Gesture: Movements of
hands, legs, arms & feet
Facial expressions &
eye contact
Space: Place of sitting,
distance
Touch: Shake hands,
patting on the back
Time
Personal appearance:
Clothes, hair, jeweler
Paralanguage: Vocal
characteristics (pitch,
volume, rate & quality),
vocal interferences
(umm, uhh)

24. Smiling Eye contact How you look Shaking hands
+ve Non-Verbal Communications

25. > 360 cm
120 – 360 cm
45 – 120 cm
15 – 45 cm

26. WHEN YOU INVADE MY SPACE
 Reactions to an invasion of your space
 Feel troubled
 Get defensive
 Become aggressive

30. COUNSELLING
Counselling is a process that uses communication skills to help
client/patient to reach an informed decision/choice
Counselling will provide customized, client-oriented information
and negotiate available alternatives to help take a decision based
on clear information.
Helping a person or a group to develop
self-help & self-care abilities.

31. CONSULTATION & COUNSELING
Consultation
• Process of a dialogue that
leads to a decision
Counseling
• Helping a person or a
group of people to
develop self help

32. CONSULTATION
After each consultation session 5 things must be established
Discover the reasons of patient attendance
Define clinical problem (HPT, DM)
Address the patient’s problem (details)
Explain the problem to the patient
Make effective use of the consultation

33. PRINCIPLES FOR GOOD COUNSELLING
Treat each client
well
Interact actively
Give the right
amount of
information
Tailor &
personalize the
information
Use & provide
memory aids
Provide the
services that
satisfy the client’s
expectations.
Help clients
remember
instructions.
Confidentiality

34. COUNSELING
Preparing a counseling session
Physical setting
Timing
Interpersonal space

35. 1. Physical setting
Privacy: in a quiet, calm & no interruption
Proper lightening & temperature.
2. Timing
45-60 minutes

36. 3. Interpersonal space
4-9 feet
D
D
P D P P
(√) (√) (×)

37. COUNSELING,
CONSULTATION, COMMUNICATION PROCESS
Initiating the session
Gathering Information
Building Relationship
Explanation & Planning
Closing the sessions

38. THE ELEMENTS OF COUNSELLING
G A T H E R
Greet
Ask
Tell
Help
Explain
Return visit

39. GREET
 Give the clients your full attention as soon as you meet them.
 Be polite, friendly and respectful.
 Introduce your self and offer them seats.
 Ask how you can help?
 Explain what will happen during the visit.
 Conduct counselling privately

40. ASK ABOUT
 Reasons for coming.
 Their experience with the health matter that concerns them.
 Any information needed to complete client records.
 Ask Clients about themselves & their families as appropriate.

41. TELL CLIENT
-To decide what choices and decisions.
-To express their feelings, needs, wants, & any doubts, concerns or
questions.
 Keep questions open, simple and brief.
 Look at your client as you speak.
 Listen actively to what the client says.
 Show your interest and understanding all the time.
 Tell the clients about their condition or Choices
 Help clients understand their possible condition
 Information should be: Simple, correct and relevant

42. HELP CLIENT TO UNDERSTAND
 Help the clients think about the results of each possible choice.
 Ask if the client wants anything made clearer, repeat and
rephrase information as needed.
 Check whether the client has made a clear understanding .
“What have You understood?”
“What have you decided to do?”
 Wait for the client to answer.

43. EXPLAIN WHAT TO DO
 Give supplies, if appropriate.
 If the service cannot be given at once, tell the client how,
when & where it could be provided.
 Describe possible side effects & what to do if they occur.
 Ask the client to repeat instructions.
 Make sure the client remembers & understands.
 If possible give the client printed materials to take home.
 Explain when to come back & why.

44. RETURN VISIT
 Check if the client is using the Treatment correctly.
 Ask if the client has any Question or anything to discuss.
Consider all concerns seriously.
 Ask if the client is Satisfied, has there been any problems
since last visit???
 Help the client handle any Problems.
 Refer client who need specialized care.