Interpersonal Skills and Human Behavior

1. Interpersonal Skills and Human Behavior Chapter 5

2. Introduction The medical assistant’s interpersonal skills help to set the tone of the office. Interpersonal skills and human relations intersect, and the successful medical assistant will work to improve both sets of skills throughout his or her career.

3. This chapter will examine: The importance of first impressions The differences between verbal and nonverbal communications Spatial separation The value of touch while communicating Elements of the transactional communication model Barriers to effective communication Defense mechanisms, listening, and dealing with conflict

4. Questions to consider… How can the medical assistant treat patients as individuals during a busy workday? How does the medical assistant communicate effectively with the patient’s family members? How will developing good listening skills make the medical assistant more effective? How do friends and family members play a role in the health of the patient?

5. The Patient’s Perception The patient’s perception of the physician’s office and the staff members is critically important. Perception may not be accurate at all times, but what the patient perceives is just as important as what is actually happening.

6. First Impressions First impressions are still lasting ones!

7. First Impressions First impressions are more than physical appearance or dress. Opinions formed in the first few moments of meeting last much longer in our thoughts than the actual time we spend with a person we have just met. The first impression includes attitude, compassion, and the smile!

8. Introductions Always introduce yourself to patients Smile Wear a name badge Show the patient around the office Introduce other staff members to the patient Put the patient at ease

9. Medical Record as Communication Must be legible Spelling and grammar must be well-used If it isn’t in the medical record, legally, it did not happen Anything that influences the patient’s mental, physical, or even spiritual health can be added to the medical record, because all affect the whole person

10. Verbal Communication Speak clearly and enunciate properly. Vary the pitch of the voice. Use appropriate volume. Speak at an audible level. Make eye contact. Speak in an animated fashion. Show concern. Do not interrupt a person who is speaking.

11. Verbal Communication Tone of voice is very important in communication. Never be sarcastic. Never be rude. Never make an inappropriate remark and follow it by saying, “I was just kidding.” Take care not to hurt anyone’s feelings with words or phrases. Verbal Communication depends on words and sounds.

12. Patients Need Tender Care Remember that patients are in the office to be cared for. They may have great concerns. They may be very apprehensive. They may be fearful.

13. Listen to Patients Allow patients to do most of the talking. Do not offer personal information about your own life and problems. Share only positive experiences, and then, only briefly. Do not burden the patient with your problems at any time!

14. Nonverbal Communication Nonverbal communications are messages that are conveyed without the use of words. Transmitted by: Body language Gestures Mannerisms Eye movement

15. Body Language Partly instinctive Partly taught Partly imitative

16. Body Language Involves: Eye contact Facial expression Hand gestures Grooming Dress Space Tone of voice Posture Touch

17. Appearance Appearance is a vital part of nonverbal communication. Appearance can present conflicting nonverbal information.

18. Appearance The successful medical assistant expresses: self-esteem confidence pleasant facial expressions caring attitudes

19. Conservative Appearance In the medical profession, patients expect professionalism, and conservative appearance is preferred to avoid blocks in communications.

20. Proxemics Proxemics is the study of the nature, degree, and effect of the spatial separation individuals naturally maintain and how this separation relates to cultural and environmental factors.

21. Spatial Boundaries Public Space: 12-25 feet Social Space: 4-12 feet Personal Space: 1½ to 4 feet Intimate Space: touching to 1½ feet

22. What Can Touch Mean? Touch, in the medical profession, can be comforting or can promote a sexual harassment lawsuit.

23. Avoid Claims of Battery Be very careful when touching a patient. Non-consensual touching can be considered battery in today’s litigious society.

24. The medical assistant should not be afraid to touch patients in an appropriate manner.

25. Posture and Positioning Can signal: Depression Anger Excitement Fear An appeal for help

26. The Process of Communication To communicate well, we must have a general understanding of the process of communication. Usually when two people interact, they both function as senders and receivers.

27. Channels Channels can be: Spoken words Written messages Body language

28. Encoding Senders encode a message, which means that they choose a specific method of expression using words and/or other channels.

29. Decoding The receiver decodes the message according to his or her understanding of what is being communicated.

30. Noise Noise contributes to the misunderstanding of messages. Noise is anything that interferes with the message being sent.

31. Feedback Verbal expression Body language Nod of understanding

32. Transactional Communication Model From Adler RB, Towne N: Looking out, looking in: interpersonal communication, San Antonio, 1996, Harcout Brace.

33. Listening Listening is paying attention to sound or hearing something with thoughtful attention. Listening is an important skill that the medical assistant can develop.

34. What Prevents Us from Listening? Our own thoughts distract us. Situations in our lives make it hard to listen. Conversation seems meaningless and unimportant. Too many messages are coming in at once. Emotions, such as anger, render us unable to listen. Exhaustion makes listening difficult. We have prejudged the speaker and feel there is no need to listen.

35. Listening to Patients Patients must know that we are listening—not only hearing the words that are being spoken, but attempting to interpret what the patient is trying to communicate.

36. Paraphrasing Paraphrasing: Listening to what the sender is communicating Analyzing the words Restating them to confirm that the receiver has understood the message as the sender intended it Clarifies speaker’s thoughts Helps to indicate that there is common understanding

37. Ask Open-Ended Questions Can you explain what the pain feels like? When did you first notice these symptoms? What are you usually doing when you have symptoms? What do you think is causing the symptoms?

38. Observing Carefully Watch for signals from patients, such as tears, sad expressions, or volatile temper.

39. Defense Mechanisms Verbal Aggression—A person attacks another without addressing the original complaint or disregards it inappropriately. Sarcasm—A biting edge added to words that a person states with the intent to cause pain or anger. Rationalization—Attributing actions to rational and credible motives without analyzing underlying methods.

40. Defense Mechanisms Compensation—Making up for one behavior by stressing another. Regression—The reversion to an earlier mental or behavioral level. Repression—Process whereby unwanted desires or impulses are excluded from the consciousness and left to operate in the unconscious.

41. Defense Mechanisms Apathy—A lack of feeling, emotion, interest, or concern. Displacement—The redirection of an emotion or impulse from its original object, such as an idea or person, to another object.

42. Defense Mechanisms Denial—A state in which confrontation with a personal problem or with reality is avoided by denying the existence of the problem or reality. Physical avoidance—Avoidance of any representation of a painful event. Projection—The attribution of one’s own ideas, feelings, or attitudes to other people or to objects.

43. Dealing with Conflict Conflict is the struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands.

44. Conflict can… Be beneficial to relationships Be constructive Allow people to learn about each other Promote stronger understanding Promote deeper levels of intimacy

45. Assertion—Stating or declaring positively, often forcefully or aggressively Nonassertion—The inability to express needs and thoughts or the refusal to express them

46. Resolving Conflict Every relationship experiences conflict First impulse is often the “fight-or-flight” syndrome Put aside thoughts of personal attack Think logically

47. Tips for Resolving Conflict Expect conflict – do not fear or dread it Realize that conflict can be healthy Accept that others have legitimate, viable opinions Listen and consider other’s opinions Never attack those with differing opinions Do not insist on being right all of the time Avoid judgment or assigning blame Deal with conflict quickly when it arises

48. Boundaries Boundaries indicate a limit or fixed extent. Setting boundaries at work helps to avoid awkward situations and misunderstandings.

49. Examples of Workplace Boundaries Calling a person by a first name or Mrs./Ms./Mr. Refusing to listen to offensive jokes Refraining from forwarding emails that are not business-related Leaving the office door open when speaking with someone of the opposite sex Dating people who work for the same facility or patients from the practice

50. Four Steps in Setting Workplace Boundaries Know how you expect to be treated and communicate that to others. Do not feel that you have to explain your boundaries to others. Be respectful, thoughtful, and responsible when setting boundaries. Respect other people’s boundaries if you want yours to be respected.