Development of competencies for doctor-patient communication

1. Development of competencies for doctor-patient communication DrGediminas Raila, MD, PhD Kaunas University of Medicine, Kaunas, Lithuania

2. 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.

3. 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?

4. Consultation problems • Partnership or one-way process. Accepting and judging, autonomy and dependency. • The doctor-centred or patient-centred consultation approach. • Communication barriers: verbal and non-verbal barriers that affect communication. • Patient motivation and resistance.

5. Small group tasks: • Planning a group meeting • Identifying non-verbal communication that affects interpersonal communication • Helping people to talk • Improving patient motivation

6. Topics to think about

7. 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.

8. Planning a group meeting • Make a plan for what you will do: • As people start to arrive. • To get people to get to know one another. • For the main part of the group meeting. • To round off the meeting at the end. • To evaluate whether you have achieved your objectives.

9. Non-verbal communication • Describe the main categories of non-verbal • communication according to the following list: • Bodily contact • Proximity • Orientation • Level • Posture • Physical appearance • Facial expression • Hand and head movements • Eye contact • Non-verbal aspects of speech

10. Non-verbal communication Think about which physician’s non-verbal behaviour was associated with better patient satisfaction and better communication.

11. Non-verbal communication • Describe your feelings as a patient when: • The doctor frequently touches your hand. • The doctor is standing and talking to you from too far away. • You are having a conversation while one of you is sitting and the other is standing. • You are holding a conversation with a doctor but neither of you are looking at one another.

12. 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.

13. 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).