By

Assistant professor Family Medicine

Qassim Medical College
1429 -1430
 Session Objectives
By the end of the session, the participant will be able to:

How to enhance communication

Identify verbal and non-verbal communication

Describe reasons that communication fails

Practical learning sessions

To know what is counseling

 Communication Skills

Definition of communication :
• Human communication is the process of creating
meaning between two or more people .

• It is the transferring of a thought or a message to

another party, so it can be understood and acted
upon
Elements of the communication process

There are six elements in the communication process :

1 . Source - The speaker; the originator of the
communication .
2 . Message - The meaning the speaker wishes to
transfer.
3 . Channel - The verbal or non-verbal method by
which the messages transmitted .
4 . Receiver - The person or group for which the
message is intended .
5 . Feedback - The receiver's verbal and non-verbal
response to the source of communication.
6 . Interference- Any factor that could interfere with
transmission of the message.
What Can We Communicate ?

ti o n Ideas
a
Inform

e s Norm
t i t ud s
At
All communication methods are important in
training
But
Our emphasis will be upon the spoken word...
70 % or all our communication efforts are:

- Misunderstood - Misinterpreted
- Rejected - Disliked
- Distorted - Not heard

In the same language, same culture!

 Physicians requires frequent and high
quality communication with his patients

A skilled Physician
must be a
!successful communicator
:The Goals of Training Communications

To change behavior

To get and give

To get action
Information

To persuade To ensure understanding

Communication is the process of sending
and receiving information among people…

Feedback

receiver sender

SENDER RECEIVER
 :Effective communication

When the stimulus as it was initiated and

intended by the sender or source
corresponds closely with the stimulus as it is
perceived and responded to by the receiver:

R (receiver's meaning)
S (sender's meaning)
All messages do not reach the receiver due to
”“distortion

Feedback

Sender Receiver

Distortion
 ‫عمر بن الخطاب‪” :‬نعم المسكن بيت‬
‫المقدس‪ ،‬القائم فيه كالمجاهد في سبيل‬
‫ن يقول احدهم ليتني لبنة‬
‫ال‪ ،‬وليأتين زما ٌ‬
‫في بيت المقدس“‬
‫المكان الذي يهدم وتنهب آثاره‬

‫أماكن‬
‫مقترحة‬
‫للهيكل‬
What causes distortion or the barriers
to understanding/listening?

• Perceptions • Environment – noise

• Language • Preconceived /expectations
• Personal Interests • Attention span
• Emotions • Physical hearing problem
• Speed of thought
 Preparing the Message
The following steps represent the process
you should follow in preparing the message:
1 . Select topic : knowledgeable and interested for you and
patient (audience).
2 . Formulate a specific purpose : that clearly states the
objective of the message.
3 . Analyze the audience and setting : age, sex, social
class, occupation, culture, beliefs/religion.
4 . Organize the information : arrange the message so that
it will be easily received by the audience.
5 . Rehearse the speech: You should rehearse the
message a sufficient number of times.
 Language
Language is a primary channel of communication, and how
you use it will greatly affect the outcome of your message .
Four guidelines can assist you in using language effectively :
1 . Be clear: Clarity means using language the audience will
immediately understand, think of your­self as a translator.
2 . Be specific: Means limiting the meaning of your
language; reduces the possible range of assumptions of
the audience .
3. Be concrete: Give your language life, action gives vitality
to your language.
4. Be appropriate: Avoid certain types of language such as
slang, informal language, jargon (language characteristics
of a group).
 Listening…the other side of
communication
Too many people see communication as merely speaking.

Messages must be received as well as sent.

A good question to ask yourself is, are you really
listening or simply waiting for your turn to talk.
If you are thinking about your reply before the other
person has finished, then you are not listening!
How can to improve your listening skills

Delay evaluation Pay attention

Use spare Develop a desire

time wisely to listen

Build good
Listen for ideas.
listening habits
and content
 !Effective Listening…try it out
Listen to support the speaker
understand the message

Give constructive feedback Listen

Try out these summarizing phrases:

“If I understand you correctly, your main concerns are…”

“These seem to be the key ideas you have expressed…”

 Other helpful techniques to foster
communication (non-verbal)…

Gestures;
Nod Your Head Facial expression

Maintain eye Appearance

contact

Keep an open Movement

body position
 Verbal aspects of non-verbal
communication
Voice affects message regardless of the words .
Three important aspects
you should know :
1. Rate: Rate is the speed at which you speak, the
normal rate is 125 to 150 words per minute .
2. Pitch: Pitch refers to how high or low your voice
sounds
3. Loudness: Volume should be always sufficient
to be heard comfortably by even the farthest
member of the audience .
 Outcome improved with better
communication
• Symptom resolution
• Psychological distress reduced
• Health and functional status improved
• Blood pressure control improved
• Pain control improved
• Patient anxiety reduced

From Slewart U (1995). Effective physician-patient communication and patient

outcomes: a review. Canadian Medical Association Journal 152: 1423-1433.
 )Factors in communication which improve (compliance

• Clinician understands the patient

• Clinician's tone of voice
• Clinician elicits all the patient's health concerns
• Patient is comfortable asking questions
• Patient perceives that sufficient time is spent with
the clinician

Stewart Metal. (1999) Evidence on patient communication. Cancer Prewnffon and

Control 300: 35-30 .
 Factors Against Clinician
complaining patients as the cause of 76%
:their complaint against their clinician
• Feeling deserted
• Feeling devalued
• Information poorly delivered
• Lack of understanding.

Stewan M et al. (2DOO) The iinpact or patient­centred care on outcomes. Journal of

.Family Practice 4ffi 796­804
 …Ask Yourself

How to Improve
Your Communication
Skills?

The Answer Is:

Practice it !
 ?What is Counseling
• Helping the persons to help themselves “
to choose !! ”.

• “relationship through which a person who

needs help is enabled to change in ways
that the person finds helpful”
 ?How
• In group

• One-to-one( mostly)
 ?How
)stages ( Egan 1982 3

Stage I - Exploration
Stage II - Understanding

Stage III - Taking action

 Stage I - Exploration
Aims:
• Establish rapport
• Enable client to explore feeling

Skills:
• Attending & good listening
• Active listening (reflecting, paraphrasing &
summarizing)
• Open questions
• Concreteness/ probing
• Respect/ empathy
 Stage II - Understanding
Aims:
• Piece together data from stage I to see the
“bigger picture”
• Develop new & more objective perspectives
and better self-understanding
TO SEE THE NEED FOR CHANGE AND THE DIRECTION

Skills:
• Integrating information
• Challenging (information sharing, advanced
empathy, confrontation, self-disclosure &
immediacy)
 Stage III - Taking action

Aims:
• Defining realistic goals.
• Implement effective change.

Skills:
• Goals & strategy setting.
• Facilitating action( immediate preparation, challenge
and support )
• Evaluation ( of participation, of goals, of strategies)
• Closure of the session.
 Credibility
It means being believable in the eyes of the audience .
Three important qualities of personal credibility:
1 . Integrity ­The speaker's honesty and truthfulness.
2 . Intelligence ­The speaker's knowledge and wisdom
3 . Goodwill ­The speaker's sincerity, interest in
and concern for others .