Communication Skills

 

Key Points:

  • "The single biggest problem in communication is the illusion that it has taken place." George Bernard Shaw
  • Two main communication frameworks
    • Kalamazoo Essential Elements
      • Set the stage, build the relationship, open the discussion, gather information, understand the other perspective, share information, reach agreement on problems and plans, provide closure, provide structure
    • 6 Function Model
      • Fostering the relationship, gathering information, providing information, decision making, enabling disease and treatment-related behavior, responding to emotions
  • Start with open ended question and later move to closed ended questions
  • Common problems with patient communication: failure to collect all patient concerns, asking interrogating questions too early, missing clues about other symptoms or concerns, missing or ignoring emotions, incomplete or inaccurate information, lack of shared decision-making
  • Mnemonic for handling emotions in others = "NURSE" 
    • Name the emotion, Understand the emotion, Respecting and/or praising the actions or behavior, Support and partner with the person, Explore the emotion
  • The best way to improve communication skills is to practice. 

 

Objectives:

  • Recognize that communication skills foster effective relationships
  • Utilize communication techniques to improve communication with patients and learners
  • Improve the communication skills of your learners

 

Recommended Resources: 

Brief Review

Watch

♥Effective Communication: How to stand up and speak to that people sit up and listen. CapstonePublishing. 6 minutes.
https://www.youtube.com/watch?v=m1RTWGglmik

Teaching Communication Skills to Medical Students. Indiana University. 13 minutes.
http://youtu.be/12auGnaKeVk

♥American Academy on Communication in Healthcare video collection and webinars.
http://www.aachonline.org/dnn/Resources/Videos.aspx
http://www.aachonline.org/dnn/Resources/Webinars.aspx

♥4 Leadership Tips for Better Communication. Athena Online. 5 minutes.
https://www.youtube.com/watch?v=E5KCvoz4XUk

Read

Oncotalk Teach. University of Washington. Nine pdf guides to critical communication tasks. For each topic, there is a background, "how to do it", pearls and pitfalls, and key references.  
http://depts.washington.edu/oncotalk/modules.php

Clack GB, Allen J, Cooper D, Head JO. Personality differences between doctors and their patients: implications for the teaching of communication skills. Med Educ. 2004 Feb;38(2):177-86. PubMed PMID: 14871388.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2923.2004.01752.x/abstract;jsessionid=B4004E58607BBD516A3990D24BFC7D14.f03t03

Joyce BL, Steenbergh T, Scher E. Use of the kalamazoo essential elements communication checklist (adapted) in an institutional interpersonal and communication skills curriculum. J Grad Med Educ. 2010 Jun;2(2):165-9. doi: 10.4300/JGME-D-10-00024.1. PubMed PMID: 21975614
http://www.ncbi.nlm.nih.gov/pubmed/21975614

Back AL, Arnold RM, Tulsky JA, Baile WF, Edwards K. "Could I add something?": Teaching communication by intervening in real time during a clinical encounter. Acad Med. 2010 Jun;85(6):1048-51. doi:10.1097/ACM.0b013e3181dbac6f. PubMed PMID: 20505408
http://www.ncbi.nlm.nih.gov/pubmed/20505408

Fryer-Edwards K, Arnold RM, Baile W, Tulsky JA, Petracca F, Back A. Reflective teaching practices: an approach to teaching communication skills in a small-group setting. Acad Med. 2006 Jul;81(7):638-44. PubMed PMID: 16799286
http://www.ncbi.nlm.nih.gov/pubmed/16799286

Rider EA, Hinrichs MM, Lown BA. A model for communication skills assessment across the undergraduate curriculum. Med Teach. 2006 Aug;28(5):e127-34. PubMed PMID: 16973446
http://www.ncbi.nlm.nih.gov/pubmed/16973446

Stiegler MP. A piece of my mind. What I learned about adverse events from Captain Sully: it's not what you think. JAMA. 2015 Jan 27;313(4):361-2. doi: 10.1001/jama.2014.16025. PubMed PMID: 25626033.
http://www.ncbi.nlm.nih.gov/pubmed/25626033

Melvin L, Connolly K, Pitre L, Dore KL, Wasi P. Improving medical students' written communication skills: design and evaluation of an educational curriculum. Postgrad Med J. 2015 Mar 26. pii: postgradmedj-2014-132983. doi: 10.1136/postgradmedj-2014-132983. PubMed PMID: 25814511.
http://pmj.bmj.com/content/early/2015/03/26/postgradmedj-2014-132983.long

The Case of the Terrible Teammate by Dr. Teresa Chan. ALiEM MEdIC Series case 1.06.
http://aliem.com/wp-content/uploads/Case-of-the-Terrible-Teammate1.pdf

The Case of the Difficult Consult by Dr. Teresa Chan. ALiEM MEdIC Series case 1.01.
http://aliem.com/wp-content/uploads/Case-of-the-Difficult-Consult.pdf

The Case of the Debriefing Debacle by Joanna Bostwick. ALiEM MEdIC Series case 2.02.
http://www.aliem.com/wp-content/uploads/Case-of-the-Debriefing-Debacle-2.02-.pdf

The Case of Breaking Bad News Badly by Dr. Stephen Singh, MD, CCFP. ALiEM MEdIC Series case 2.05.
http://www.aliem.com/wp-content/uploads/Case-2.05-Breaking-Bad-News-Badly.pdf

Wagner LW. Reflective Narrative for the Enhancement of Interpersonal Communication and Emotional Empathy. Poster.
https://www.mededportal.org/icollaborative/resource/3885

Do

♥Conducting Effective Team Meetings. AMA STEPSforward. Free online educational module. 0.5 hour AMA PRA Category 1 Credit™.
https://www.stepsforward.org/modules/conducting-effective-team-meetings

Principles of Medical Education: Maximizing Your Teaching Skills. Harvard Medical School. CME course given twice per year. $Fee Required 
www.cme.hms.harvard.edu/courses/foundations 

International Conference on Communication in Healthcare. American Academy on Communication in Healthcare. Annual CME Course. $Fee Required
http://www.aachonline.org/dnn/Events/InternationalConference(ICCH).aspx

Mintzer M, Chen A, Conway Copper T, Bauder Filmalter S, Markert M, Mathen T, Parekh N, Patel S, van Zuilen M. Breaking Bad News using Role Playing: A Multimedia Instructional Activity for Teaching Medical Trainees. MedEdPORTAL Publications; 2014.
https://www.mededportal.org/publication/9798

 

In-Depth Review

Watch

TEDMED Great Challenges: Improving Medical Communication. TedMed. 63 minutes.
http://youtu.be/DR5E9wY-DGo

Effective Communication Skills to Optimize the Patient-Provider Relationship. University of North Carolina Chapel Hill. 61 minutes.
http://youtu.be/sTan_C62afs

Smith’s Patient-Centered Interviewing. Endorsed by the American Academy on Communication for Healthcare. 

5 example videos: http://aachonline.org/dnn/Resources/SmithsPatientCenteredInterviewing3rdEd.aspx

Patient-Centered Interviewing: An Evidence-Based Method-DVD. $50: http://shop.msu.edu/product_p/msut-17.htm

Speak to be Heard. Stacey Hanke. 53 minutes
https://youtu.be/-rK-i7sfhBc?t=4m27s

Read

Smith’s Patient-Centered Interviewing, Third Edition. Endorsed by the American Academy on Communication for Healthcare. A comprehensive, evidence-based introduction to the principles and practices of patient communication in a clinical setting. Videos and workshops available to complement book. $52
http://aachonline.org/dnn/Resources/SmithsPatientCenteredInterviewing3rdEd.aspx

Teaching and Learning Communication Skills in Medicine, 2nd Edition by Suzanne M. Kurtz, Jonathan Silverman, and Juliet Draper. 2005. $52.75
http://www.amazon.com/Teaching-Learning-Communication-Skills-Medicine/dp/1857756584/ref=asap_bc?ie=UTF8

Allen, J., & Brock, S. A. Health care communication using personality type: Patients are different! London: Routledge. 2000.
https://www.questia.com/library/102919601/health-care-communication-using-personality-type

Do

DocCom. American Academy on Communication in Healthcare. The highly recommended DocCom has 42 online modules for communication skill development appropriate for faculty and students. Modules can be used independently or as part of a course. The modules provide feedback, quizzes, and grading. Contact Laura Cooley (This email address is being protected from spambots. You need JavaScript enabled to view it.) for free trial access. $Subscription Required
http://webcampus.drexelmed.edu/doccom/user/

Mintzer M, Chen A, Conway Copper T, Bauder Filmalter S, Markert M, Mathen T, Parekh N, Patel S, van Zuilen M. Breaking Bad News using Role Playing: A Multimedia Instructional Activity for Teaching Medical Trainees. MedEdPORTAL Publications; 2014. Multimedia module demonstrating the skills of delivering bad news. This MedEdPORTAL Publication includes large downloadable files. If you experience difficulty downloading these files, please contact This email address is being protected from spambots. You need JavaScript enabled to view it. to receive a free CD version via mail.
https://www.mededportal.org/publication/9798

Psychological First Aid. Coursera, Johns Hopkins University, Bloomberg School of Public Health.
https://www.coursera.org/course/psychfirstaid

Health Literacy and Communication for Health Professionals. Coursera, University of Nebraska Medical Center.
https://www.coursera.org/course/healthliteracy

 

Interviewing Resources

Mayo Clinic Intranet Access Required

Interview Training Resources.
http://intranet.mayo.edu/charlie/physician-scientist-recruitment/

Conducting an Employment Interview Guide.
http://mayoweb.mayo.edu/humanresources/perform/documents/pm_conduct_interview.pdf

Illegal Interview Questions Guide.
http://mayoweb.mayo.edu/humanresources/perform/documents/pm_illegal_questions.pdf

Preparing for a Job Interview.
http://mayoweb.mayo.edu/humanresources-education/qr/PreparingforaJobInterview.pdf