Interfacing Strategies by drsaiful

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									Personal and Professional
Development Program
DPST Workshop Series


Module 3:
Interfacing Strategies




                                               Muhama
                                               Ahmad F




                            Majmin Sheikh Hamzah
                            Mohamad Najib Mat Pa
                            Shima Sepehr0

                                               Muham
                                               Ahmad F
Contents

INTRODUCTION                                  6
THE ‘DISCOVERING POTENTIAL FOR SUSTAINABLE
TRANSFORMATION’ (DPST) WORKSHOP SERIES        8
OBJECTIVES                                   10
DEFINITIONS                                  11
METHODS OF COMMUNICATION                     12
IMPORTANCE                                   12
PURPOSE                                      12
THE REASONS FOR TEACHING/LEARNING
COMMUNICATION IN GENERAL & IN MEDICINE       13
THE COMMUNICATION PROCESS                    14
MODELS OF COMMUNICATION                      16
BASICS OF COMMUNICATION SKILLS               16
WHAT PROMOTES EFFECTIVE COMMUNICATION?       16
WHAT ARE THE FIVE COMPONENTS?                17
EXTERNAL FACTORS AND INTERNAL FACTORS        18
WHAT ARE THE FACTORS?                        18
BARRIERS TO EFFECTIVE COMMUNICATION          19
POINTS TO REMEMBER IN AN ENCOUNTER WITH AN
INDIVIDUAL/PATIENT                         20
INTERFACING STRATEGIES TO EFFECTIVE
COMMUNICATION                                21
COMMUNICATION TIPS                           26
THE SEVEN (7) TASKS OF CONSULTATION          27

                                              1
HOW TO CLOSE A CONVERSATION / CONSULTATION 27
HOW TO GIVE FEEDBACK                      28
SCENARIO & ROLE – PLAY                    29
SESSION OUTLINE                           30
REFERENCES                                32




                                           2
 First Publication: July 2010

© Dr Majmin Sheikh Hamzah

  © All rights reserved. No
 part of this publication may
  be reproduced stored in a
      retrieval system, or
 transmitted, in any form or
  by any means, electronic,
 mechanical, photocopying,
   recording, or otherwise,
 without prior permission of
    author/s or publisher.

  ISBN: 978-967-5547-13-3

          Edited by

Dr Majmin Sheikh Hamzah
Dr Mohamad Najib Mat Pa
     Shima Sepehr

        Published by:

   KKMED Publications
Medical Education Department,
 School of Medical Sciences,
   USM, Kubang Kerian,
     16150 Kota Bharu
     Kelantan, Malaysia

   Published in Malaysia

                                3
Acknowledgment



I would like to express my gratitude to my former
lecturer and mentor, Associate Professor Dr Robert
Chen who is currently attached to the Faculty of
Medicine and Health Sciences, University Tunku Abdul
Rahman. Without his support and guidance during the
early stage of my teaching career in University
Kebangsaan Malaysia as well as his willingness to share
his knowledge, experience and teaching materials in
communication which is his field of interest, the
completion of this module will not be possible.

Last but not least, I would also like to express my
gratitude to Program Pembangunan Insaniah Pelajar
(PPIP) and Medical Education Department, School of
Medical Sciences, Universiti Sains Malaysia for giving
opportunity to me as the main author for this module.




Dr Majmin Sheikh Hamzah
Main author
Faculty of Medicine
Universiti Kebangsaan Malaysia




                                                     4
Contributor

Dr Rosniza Abd Aziz
Medical Education Department
School of Medical Sciences
Universiti Sains Malaysia

Dr Nor Azwany Yaacob
Community Medicine Department
School of Medical Sciences
Universiti Sains Malaysia

Dr Ahmad Fuad Abd Rahim
Medical Education Department
School of Medical Sciences
Universiti Sains Malaysia

Dr Muhamad Saiful Bahri Yusoff
Medical Education Department
School of Medical Sciences
Universiti Sains Malaysia




                                 5
Personal and Professional Development Program
School of Medical Sciences
Universiti Sains Malaysia Health Campus

Introduction
The School of Medical Sciences (SMS), Universiti Sains Malaysia
practices an integrated, problem-based and community-oriented
medical curriculum. This five year programme is divided into three
phases. Phase I (year 1) is the fundamental year focusing on organ-
based systems, Phase II (year 2 and 3) continues the system-based
approach and introduces the basics of clinical clerkship. Phase III
(year 4 and 5) is the clinical phase whereby the students are
rotated through all the clinical disciplines. The school adopts the
SPICES approach in the implementation of its curriculum, i.e.
Student oriented, Problem based, Integrated, Community oriented,
Electives and Self learning and Systematic.
Ethical issues, communication and soft skills were realized as
important elements in the curriculum since the inception of the
school. Relevant inputs were imparted to students at various
places in the time table. This practice was improved and
consolidated from time to time. In the mid-nineties a ‘Student
Motivation Unit’ was established to assist students who needed
counseling and was soon followed by a more formal Student

                                                                 6
Development Unit. In 1996 this unit was combined with another
parallel component of the school's curriculum, the Bioethics and
Communication Skills Programme and was renamed as the Student
Personal and Professional Development Programme (PPDP). In line
with the Malaysian Ministry of Higher Education directive to all
institutions of higher learning to emphasize soft skills in all
university curriculums, SMS once again renamed the PPDP to
Student Soft Skills and Development Programme (Program
Pembangunan Insaniah Pelajar - PPIP) in 2007. This programme
facilitates and coordinates soft-skills development activities in the
curriculum to foster the development of good personal attitude
and professional behavior in the undergraduate. It also helps the
undergraduates to adapt to challenges in the learning process.




                                                                   7
The ‘Discovering Potential for Sustainable Transformation’
(DPST) workshop series

The Discovering Potential for Sustainable Transformation (DPST)
workshop series was introduced and developed to enhance and
promote positive personal qualities, soft skills and professional
development among undergraduate medical students. The
programme is run through a series of five one-day workshops. The
topics of workshops are:

         Maximizing Personality.
         Leading to Lead.
         Interfacing Strategies.
         Taming Your Enemy.
         Response to Change.

The importance of promoting and nurturing positive personal
qualities, soft skills and professional development among future
medical doctors are becoming more apparent within healthcare.
Research evidence showed that they have effects on the quality of
care provided. This programme might affect personal qualities, soft
skills and professional development in different ways, including the
effect that they might have on the wellbeing of themselves and
their staff which, in turn, are related to the quality of care provided.
Healthy and competent healthcare providers affect the quality of
healthcare system and indirectly reflect the quality of Universiti
Sains Malaysia (USM) undergraduate medical programme.
Therefore it reflects the APEX status and puts the USM
undergraduate medical programme in the eyes of the world. It is
noteworthy that a sustainable transformation of undergraduate
medical students’ potential is a must.

The Discovering Potential for Sustainable Transformation (DPST)
was introduced because of three simple reasons:

To increase awareness of the impact and importance of positive
personal qualities, soft skills and professionalism to students as
well as future medical doctors.



                                                                     8
To encourage the development of positive personal qualities, soft
skills and professionalism among undergraduate medical students
as future medical doctors.

To help USM undergraduate medical students to develop their own
self-improvement strategies to improve and maximize their
potential therefore they will be a better and more competence
either as medical doctors or as persons.

Last but not least, we really hope that the DPST programme will be
a precursor towards sustainable transformation of future medical
doctors’ positive personal qualities, soft skills and professional
development.




                                                                9
Module 3
Interfacing Strategies




Objectives
General Objectives
     1. To expose and familiarise year 1 medical students to the
         art of effective communication and its importance.
     2. To be able to apply their appropriate knowledge, skills
         and attitude on effective communication in their clinical
         practise later.
Specific Objectives:
         Exploring different communication skills and styles
         Identifying individual communication styles and its
          relevance to different personalities.
         Understanding the importance of effective
          communication.
         Describing some barriers to effective communication.
         Giving feedback.
         Managing time
         Closing a conversation in a positive manner
         Applying effective communication styles to daily life and
          to clinical practice in the future.




                                                                 10
Definitions
What is meant by ‘interfacing strategies?’
It is the combination of the words ‘Interface’: connection /
boundaries / medium in between two objects, two things;
meanwhile ‘Strategies’ means ‘Plans’.
The word ‘communication’ originated from a Latin word which
means ‘to impart or to share’.
Communication is a “social interaction through messages” as
defined by Fiske (1990).
In simple language it is about:

‘How to stay connected in a conversation through a
medium’
Communication Skills definition
It is a set of skills that enables a person to convey information so
that it is received and understood. It is also an ability to use
language (receptive) & express (expressive) information.
Communication skills involves both science and art:
         - Science: Communication theories – Theories of how to
           communicate with people
         - Art: Personal qualities of the person, conveying messages
           in different situations and selecting appropriate
           communication styles




                                                                   11
Methods of
Communication
    Verbal
    Non-verbal
    Written
    Visual

Importance
“Communication is not only a basic
part of our everyday lives, but an
essential one, in the sense that we
cannot not communicate” described
by Thompson in 2003.


Purpose
Multipurpose:
-   Information dissemination
-   Express ideas & emotions
-   Education (imparting
    knowledge – oral
    presentation)
-   Building relationship
-   Entertainment
-   Decision making
-   Feedback




                                12
The Reasons for teaching/learning
communication in general & in medicine
      Correct training in communication skills can help in
       making an individual or students see other individuals or
       persons or patients as people, rather than as cases.
      Communication is one of the core clinical skills.
       Developing it to a professional level of competence is as
       important as developing competence regarding cognitive
       knowledge, physical examination skills, other clinical
       skills components and problem solving.
      Effective clinician-patient communication results in
       numerous significant benefits in areas such as patient’s
       understanding and recall during clinical consultation,
       compliance, symptoms resolution and psychological
       outcomes, patient and physician satisfaction, and
       malpractice claims.
      Experience alone can be a poor teacher of
       communication skills. Without proper guidance and
       reflection, experience tends to reinforce communication
       styles and habits regardless of whether they are good or
       bad.
      Communication is a series of learned skills which can be
       taught. It is not just a single global ability or a personality
       trait.
      Changes resulting from communication training can be
       retained.




                                                                  13
The Communication Process
Effective communication is all about conveying your messages to
other people clearly and unambiguous.
Effective communication is also all about receiving information
that others are sending to you, with as little distortion as possible.
To be an effective communicator and to get your point across
without misunderstanding and confusion, your goal should be to
lessen the frequency of problems at each level of this process;
with clear, concise, accurate, and well planned-communication
The situation in which your message is delivered is the context.
This may include the surrounding environment or broader culture
(corporate culture, international cultures, and so on).
As the source of message, we need to be clear about why you are
communicating and what you want to communicate.
We also need to be confident that the information we are
communicating is useful and accurate.
Encoding is the process of transferring the information you want to
communicate into a form that can be sent and correctly decoded
by others.
Success in encoding depends partly on our ability to convey
information clearly and simply, but also on our ability to
anticipate and eliminate sources of confusion (e.g. cultural issues,
mistaken assumptions). We need to know our audience well.
Messages are conveyed through channels, with verbal channels
including face-to-face meetings, telephone and video conferencing;
and written channels including letters, emails, memos and reports.
Different channels have different strengths and weaknesses.
Choosing right channel is important.
Just as successful encoding is a skill, so is successful decoding
(involving, for example, taking the time to read a message carefully,
or listen actively to it.) Just as confusion can arise from errors in
encoding, it can also arise from decoding errors. This is particularly
the case if the decoder doesn't have enough knowledge to
understand the message.



                                                                  14
Your message is delivered to individual members of your audience.
No doubt, you have in mind the actions or reactions you hope your
message will get from this audience. Keep in mind, though, that
each of these individuals enters into the communication process
with ideas and feelings that will undoubtedly influence their
understanding of your message, and their response. To be a
successful communicator, you should consider these before
delivering your message, and act appropriately.
Your audience will provide you with feedback, as verbal and
nonverbal reactions to your communicated message. Pay close
attention to this feedback, as it is the only thing that can give you
confidence that your audience has understood your message. If
you find that there has been a misunderstanding, at least you have
the opportunity to send the message a second time.




                                feedback




                                                                 15
Models of
Communication
Transmission model
The communication process is
complete when a message
has been transmitted from
the sender to the receiver.

Interactional model
The communication process is
ONLY complete when the
sender receives feedback that
the message has been
received as intended. These
may involve a number of
interactions.


Basics of
communication
skills
Communication is a TWO-
WAY process.
What the sender said is not
necessarily what the receiver
hears or perceive.


What promotes
effective
communication?
Fiske in 1994 also described
that:
“…communication is often
taken for granted when it
should be taken to pieces”.
It involves five different
components or elements to
ensure effective
communication.



                          16
What are the five components?
Verbal communication
What do you want to communicate?
(The message is the information that you want to communicate)
Clear, Concise, Useful, Accurate; language appropriateness


Voice management
How is the information being said?
It can add extra meaning to what is being said (positive or negative
impression). E.g.: appear friendly, irritable, bored, angry or
agitated


Active listening
Determine the accuracy of information obtained and effectiveness
of conversation/clinical consultation


Non-verbal
Bickley in 2003 described that:
“......just as the host / doctor is observing the guest / the patient,
the guest / the patient will also be watching the host / doctor”.
Besides words (verbal component), gestures, eye contact and
postures are able to send messages too.


Culture awareness
Scollon and Scollon in 2001 defined culture as. “...customs, world
view, language, kinship system, social organization or other taken-
for-granted day-to-day practices of a people which that set that
group apart as a distinctive group.”
Lack of cultural awareness leads to misunderstanding and conflicts




                                                                     17
External factors and internal factors (Within
the Sender and Receiver)

What are the factors?


External Factors:
Physical set-up & Environmental set-up
       Seat arrangements
       Proximity (distance between the sender and receiver)
       Conducive and comfortable surroundings (ensure privacy
        and confidentiality)
Personal appearance and manners


Internal factors: (within the Sender or Receiver)
       Psychological factors
       Personality
       Communication styles




                                                               18
Barriers to effective communication
   1.   Speaking using ‘big/bombastic’ words or medical jargon.
   2.   Asking only closed questions  Interrogation.
   3.   Authoritative attitude (usually on the side of the
        mentor/medical/health professional.)
   4.   Closed body posture.
   5.   Lack of or no eye contact.
   6.   Distancing, i.e.: sitting too far apart that the patient feels
        removed.
   7.   Appearing too busy & too rushed.
   8.   Not listening & constantly interrupting patient.
   9.   Lack of respect  attitude, aloofness, ignoring, brushing
        off, etc.
   10. Perceived lack of confidentiality, e.g. discussing patient’s
       problem in hearing distance from other patients.
   11. Doctor visually looking unprofessional, e.g.: poor dress
       code, too high-status appearing.
   12. Writing too soon after opening the interview, before
       listening to patient.
   13. Environmental interference, e.g. lack of privacy, people
       coming in and out of room, too hot/cold, too noisy,
       children interfering.
   14. Lack of time management skills = lack of respect for
       patient’s time.



                                                                   19
Points to remember in an encounter with an
individual/patient
These points should be considered when you meet and individual
or patient, both in a formal or informal (consultation /
conversation) situation.
When receiving them, put yourself in their shoes. Establish initial
contact by attending to things such as the physical set-up,
proximity, environmental set-up, psychological setting, being
respectful to other people’s culture and beliefs, etc. Convey
warmth.
Greet them and put them at ease. Obtain their preferred form of
address.
Introduce yourself and explain your roles. Ask the opening
question and pay attention to the use of appropriate open versus
closed questions.
Set the agenda for the interview.
Encourage the guest/patient to express themselves in their own
words. Look for verbal & non-verbal cues.
In your interview, the use of three skills is critical for you to
understand the story fully: Facilitation, Repetition and Clarification.
     1.   Facilitation
          In facilitation you encourage the guest/patient to say
          more, but not specifying the topic. It can be done
          through posture, actions or words.
     2.   Clarification
          It is indicating that you have been listening to the guest /
          patient and pinpointing what you know and don’t know.
     3.   Repetition
          Echoing the guest / patient’s words encourages him / her
          to give more details. It is helpful and useful for eliciting
          both facts and emotions.
After you feel you have enough information, it is useful to piece it
all together in a summary. Give feedback where appropriate and
close the conversation /consultation.


                                                                   20
Interfacing strategies to effective
communication
1.   Your personal appearance & manners
     a.   As a student / intern (especially during your clinical
          training in the future) it is expected that you dress
          professionally and appropriately. Do not ‘under dress’
          e.g. wearing slippers, nor ‘overdress’, e.g. by wearing too
          many expensive jewellery or strong perfume.
     b.   Personal grooming and clothing, e.g. too heavy make-up
          for the girls, dyed hair (bright colours) among the boys..
     c.   Please wear your white coat and name tag during all
          potential patient encounters during your clinical postings
          in the future.
     d.   Watch your social manners, and what you say, especially
          when patients are around during your clinical postings in
          the future.
     e.   Watch your use of slang language in public.
     f.   Watch your use of medical jargon in public, e.g. SOB
          (Shortness of Breath) can be taken as a swear word!




                                                                  21
2.   Physical setting
     a.   Placement of table & chairs. If possible, avoid having
          things placed between you and your guest or patient
          during your clinical consultation in the future e.g. pile of
          charts, books, etc.
     b.   Proximity. Distance between the sender and the receiver
     c.   Verbal privacy & Confidentiality: Outsiders should not
          be able to listen to the conversation through open doors
          or windows.
     d.   Phone Interruptions. The desk phone and your hand-
          phone should be off or in silent mode, to avoid
          interruption.
     e.   People interruptions. Avoid other individual
          interruptions unless it is necessary.
     f.   Physical privacy. The interview room should ideally be
          private
     g.   Visual privacy. Outsiders should not be able to see what
          happened in the consultation room.




                                                                    22
3.   Psychological setting
     a.   You are the host.
            i.   When a guest /patient comes to see you in the
                 office/clinic, he/she is coming as a guest/outsider.
                 You are the host/insider. It is your duty to make
                 your guest / patient comfortable, physically and
                 psychologically.
           ii.   You have to make the first initiative to greet your
                 guest.
          iii.   You have to make the initiative to offer the guest a
                 chair.
          iv.    This will also keep the guest informed that you are
                 ‘in-control’ of the time together.
     b.   Be organized.
            i.   Have your tools on-hand.
                 1.   Have your pen/pencil, stethoscope, etc. with
                      you.
                 2.   Know where the usual locations of charts,
                      forms, other tools, such as BP cuff, tongue
                      depressors, spare battery for flash light, patient
                      gowns and lap sheet, etc.
           ii.   Know where the locations of the common services,
                 such as patient’s washroom, lab, pharmacy, nursing
                 station, etc.
          iii.   Know the names of the ‘important’ people, medical
                 assistants, such as your nurse and registration desk
                 staff. It is embarrassing to call for help from your
                 nurse, by calling her/ him “Hey you, . . . ”
          iv.    Know the system on how your institution is
                 operated upon etc.




                                                                       23
     c.   Appear interested in the guest / patient.
            i.   Sit at your guest / patient’s physical level /eye-level.
                 This is especially important when interviewing those
                 who are handicapped or small children and elderly.
           ii.   Eye contact
          iii.   Give non-verbal feedback, e.g.: nodding your head,
                 saying “hum…” “ha…” (non-sense words), etc.
     d.   Appear unhurried.
            i.   You look hurried if you repeatedly or constantly look
                 at your watch or the wall clock, keep reaching for
                 the phone to make calls unrelated to your guest /
                 patient, remain standing, or you keep moving to the
                 door.
     e.   Allow the patient to finish his/her sentences without
          interruption
4.   Be respectful of other people’s culture and believes.
     a.   Malaysia is a multi-cultural country. A respectful
          physician will learn as much as he/she can about other
          people’s customs, religious practices, etc.
     b.   Malaysia is also a major tourist destination from people
          all over the world, including Saudi Arabia, Australia,
          Europe and North America.
     c.   As a medical professional, you will encounter any of
          those people. Even if you don’t have direct contact with
          them, others may talk about you and that will reflect on
          not only your professionalism, but also the
          professionalism of the whole medical/health system of
          your country.




                                                                      24
5.   Verbal component
     a.   Open questions versus closed ended
          questions
     b.   Use of appropriate words and phrases
     c.   What to say?
     d.   How you say it?
     e.   When you say it?
     f.   Where do you say it?
6.   Non-verbal component
     a.   Eye contact
     b.   Facial expression
     c.   Gestures
     d.   Postures
     e.   Proximity
     f.   Clothing and accessories




                                               25
Communication Tips
Communication is a two way process.
1.     Start with Open-questions, e.g.: “How do you feel?” (Open
       answers) then narrow down using Closed-questions, e.g.: “Do
       you have any fever?” (Yes or No or one-word answers)
2.     Check if what was said is what you understood. You can do
       this by various techniques:
       i.   Rephrasing, e.g.: “Let me say it as I understand it…”
      ii.   Further Questioning, e.g.: “How is that pain?”
     iii.   Asking for clarification, e.g.: “Do you mean to say that…’
     iv.    Asking for elaboration, e.g.: “Can you tell me a bit more
            about it?”
3.     Ask for agreement with the guest / patient:
       i.   Your assessment of the problem
      ii.   Your management plan
     iii.   Patient’s willingness to adhere to the plan
     iv.    Follow-up schedule, if indicated.
      v.    How to contact you if additional or new problems appear.




                                                                        26
The Seven (7) Tasks of Consultation
The purpose of the medical interview:
     1.   Define the reason for patient’s attendance.
     2.   Consider other problems.
     3.   With the patient, choose an appropriate action for each
          problem.
     4.   Achieve a shared understanding of the problems with the
          patient.
     5.   Involve the patient in the management & encourage
          patient to accept appropriate responsibility.
     6.   Use time and resources appropriately.
     7.   Establish and maintain a relationship which helps achieve
          other tasks.

How to close a conversation / consultation
If the session is finished, make sure the guest / patient is also
aware of it. It can be done in a non-verbal manner, e.g. closing the
patient’s chart, capping your pen, pushing yourself away from the
table, etc.
Try to end with a positive note. Don’t destroy the guest’s /
patient’s hope no matter how hopeless the situation may look to
you.
Ask the guest / patient if he/she has anymore that they want to
discuss.
If you have no more time, use ‘How to manage time’ techniques.
Close the interview in a positive manner and with a ‘Management
Plan’, i.e.:
          a    When is next follow-up visit?
          b    What is the guest / patient supposed to do,
          c    What will you have to do before his next
               appointment
          d    Thank the guest /patient for coming.


                                                                  27
How to give feedback
      1.   Focus on the good points first
      2.    Later on the negative aspects and offer options or
           suggestions to improve.
      3.   Communicate your observations on the person’s
           work /performance.
      4.   Never on the personality or being judgemental
           towards the person.
      5.   Avoid using the word “you” when you offer
           suggestions.
      6.   Do it in a tactful manner.




                                                            28
Scenario & Role – play
Divide yourself in two groups, Group 1 and Group 2.

Instructions:
Group 1
You have to observe ‘Role play 1’ and give feedback to your friends
involved in the role-play. Please refer to the “COMMUNICATION
CHECKLIST” provided (Appendix 1).

Group 2
You have to observe “Role play 2i and Role Play 2ii” and give
feedbacks to your friends involved in the role-play. Please refer to
the “COMMUNICATION CHECKLIST” provided (Appendix 2).

1 (Role play by group 1 and observed by group 2)

Picture yourself as a student who has some underlying
psychosocial problems leading you being absent from a lot of
classes (lectures and small group discussions).
You are called by your mentor for an explanation about your
absence.
Instructions:
How would you inform your mentor about your difficulties?

2i – 2ii (Role play by group 2 and observed by group 1)

Your friends voiced out that they are not happy with one of the
team members during their community placement.
The student involved is always absent –‘missing in action’ and it
disrupts the flow of their community project and the group
dynamics.
You notice that most of the group members have been ignoring
the particular student.
Instructions:
As an appointed team leader,
    i.    how would you communicate with the student about the
          problem?

   ii.    how would you communicate to other team members
          not to ignore the student?
                                                                    29
     Session Outline

     Following is a suggested session outline. The facilitator is free to
     modify the outline as is relevant.

                                                       Size of
             Objectives                Activity                    Materials     Time
                                                       Group

     Information Delivery 1

     Introduction of session       Lecture           Whole       Computer and    10
     Ice-breaking                                    group       LCD OR white    mins
                                                                 board
     Highlight relevance of
     knowing communication –
     to maximize strengths and
     potential, to improve
     weaknesses
     Explanation of objectives
     of session

     Information Delivery 2

     Identify the different        Video session     Whole       Computer and    15
     communication skills and                        group       LCD             mins
     styles


     Group activity 1

     At the end session,            Working in       Sub group   Mahjong paper   60
     participants should be able    small groups                 Marker pens     mins
     to:                            Role-plays
1.   Identify one’s own             1. Scenario 1
     communication styles and
     relate them to their own       2. Scenario 2
     personalities.                 (i & ii)

2.   Justify the importance of      Break
     effective communication        participants
     in their daily life and        into 3 groups
     future clinical practice.      Discuss how to
3.   Identify the barriers to       role play the
     effective communication.       scenario

4.   Develop ways how to            After 10
     overcome those                 minutes, each
     communication barriers.        group presents
                                    for 5 minutes
5.   Apply effective
     communication styles that
     suit themselves in
     becoming future doctors



                                                                                  30
Evaluation and debriefing

To make sure that            Discussion         Sub group    PPT file:       10
participants know why        Check                           objectives      mins
they have been asked to      responses
do the things required of    against list
them

To review what has been      Discussion         Whole        PPT file: key   15
learnt                       Individuals        class        points          mins
                             asked to
                             contribute

To obtain feedback from      Fill in feedback   Each         Feedback form   10
participants regarding the   form*              person                       mins
session

                                                Total time   2 hours




                                                                              31
References

  1.   Marrie MC and Ros C (2008). Good practice
       communication skills in English for the medical
       practitioner, Student‟s book. UK: Cambridge
       University Croos.
  2.   http://www. skillscade.com
  3.   http://www. skillscade.com/books/books.html
  4.   Owen DWH (2004). The handbook of
       communication skills. USA: Rontledge.
  5.   Jonathan S, Suzanne K, Juliet D (2004). Teaching
                                         nd
       and learning skills in Medicine. 2 edn. Radcliffe
       Medical Press.
  6.   Suzanne K, Jonathan S and Juliet D (2003).
       Marrying content and process in clinical method
       teaching: Enhancing the Calgary Cambridge guides,
       Acad Med, 78:802-809.




                                                         32
         Appendix 1

                                  Communication Skills Check-list


                      Role play 1

                      Tick ( / )where appropriate.

         Items                  Observed         Not observed          Not sure         Remarks

Receiving a person

   The student was able
    to greet the mentor
    appropriately.
   The student
    introduced
    him/herself.
   The student offered
    himself a seat before
    being invited to sit by
    the mentor.

   The mentor was able
    to make the student
    feel relaxed and
    comfortable.
   The mentor was able
    to use an appropriate
    welcoming tone of
    voice.
   The mentor was able
    to greet the student
    appropriately.
   The mentor invited
    the student to sit
    down.
   Addressing the
    student by name.

                              Mentor   Student   Mentor   Student   Mentor   Student
Verbal component
    Using words or
     phrases that were
     easily understood
    Using
     “big/bombastic”
     words or phrases.
    Used of “open”
                                                                                       33
      questions.
     Used of “closed”
      questions
     Controlling the
      conversation
     “ Warming-up” the
      conversation
     Using courtesy
      words and phrases
     Clarification
      techniques
     Facilitation
      techniques
     Repetition
      techniques
     Summarizing
      techniques.
     Polite closing
      comment

          Items                   Observed         Not observed          Not sure         Remarks
                               Mentor    Student   Mentor   Student   Mentor   Student
Non - Verbal component

     Eye contact
     Facial expression
      (Eg: smile, frown)
     Posture ( Eg:
      nodding the head,
      leaning forward,
      crossing arms over
      the chest)
     Body Gestures


      Answer “Yes” or “No” and state your reasons.


1.   The physical set-up was appropriate.

2.   The environment was appropriate.

3.   In your opinion, was the student‟s clothing
     and accessories appropriate?

4.   The mentor showed his „empathy” towards
     the student.

5.   Is the mentor actively listening during the
     conversation?
                                                                                         34
6.   Is the student actively listening during the
     conversation?

7.   Any feedbacks been offered?

8.   In your opinion, was the feedback technique
     appropriate?

9.   Did the communication follow the
     transmission model?

10. Did the conversation follow the interactional
    model?




                                                    35
    Appendix 2
                         Communication Skills Check-list


            Role-play 2

            Tick (/) where appropriate.

          Items                 Observed         Not observed          Not sure         Remarks

Receiving a person
   The team leader was
    able to greet the
    student appropriately.
   The team leader
    introduced him /
    herself and explain
    his roles.
   The team leader
    position him/herself
    at eye – level with the
    student before
    starting the
    conversation.
   The team leader was
    able to make the
    student feel relaxed
    and comfortable.
   The team leader was
    able to use an
    appropriate
    welcoming tone of
    voice.
   The team leader
    addressed the
    student by name.

                               Team    Student    Team    Student    Team    Student
                              leader             leader             leader
Verbal component
    Using words or
     phrases that were
     easily understood
    Using
     “big/bombastic”
     words or phrases.
    Used of “open”
     questions.
    Used of “closed”

                                                                                       36
        questions
       Controlling the
        conversation
       “ Warming-up” the
        conversation
       Using courtesy
        words and phrases
       Clarification
        techniques
       Facilitation
        techniques
       Repetition
        techniques
       Summarizing
        techniques
       Polite closing
        comment

Items                           Observed           Not observed       Not sure             Remarks
                                Mentor   Student   Mentor   Student   Mentor     Student
Non - Verbal component

       Eye contact
       Facial expression
        (Eg: smile, frown)
       Posture ( Eg:
        nodding the head,
        leaning forward,
        crossing arms over
        the chest)
       Body Gestures


        Answer “Yes” or “No” and state your reasons.


     1.    The physical set-up was
           appropriate.

     2.    The environment was appropriate.


     3.    The team leader showed his/her
           “empathy” towards the student.

     4.    Is the team leader actively
           listening during the conversation?

     5.    Is the student actively listening
           during the conversation?

                                                                                           37
6.   Any feedbacks been offered?

7.   In your opinion, is the feedback
     technique appropriate?

8.   Did the communication follow the
     transmission model?

9.   Did the conversation follow the
     interactional model?




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