Interpersonal Communication

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4

• Interpersonal Communication

2
Learning Outcomes

• 4.1 Identify elements and types of
  communication.
• 4.2 Relate communication to human behavior
  and needs.
• 4.3 Categorize positive and negative
  communication.

3
Learning Outcomes (cont.)

• 4.5 Carry out therapeutic communication
  skills.
• 4.6 Use effective communication strategies
  with patients in special circumstances.
• 4.7 Carry out positive communication with
  coworkers and management.

4
Introduction

• Medical assistants must
• Recognize human behaviors
• Communicate effectively
• Professionally
• Diplomatically
• Recognize obstacles that affect communication

5
Elements of Communication

• Communication circle
• Message
• Source
• Receiver

6
Elements of Communication (cont.)

• Feedback
• Verbal or nonverbal
• Verification of understanding
• Noise
• Sounds
• Physical or emotional discomforts

7
Apply Your Knowledge
What are the elements of the communication circle
and what can cause interference in the process?
ANSWER The elements are message, source, and
receiver. Noise can interfere with the
communication circle.
Good!
8
Human Behavior and Needs

• Different personality types require different
  communication styles
• Humanistic role in the healthcare process
• Attention
• respect

9
Developmental Stages of the Life Cycle

• Infant
• 0 to 1 year old
• Trust vs. mistrust
• Toddler
• 2 to 3 years old
• Autonomy vs. shame and doubt

• Preschooler
• 3 to 6 years old
• Initiative vs. guilt

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Developmental Stages of the Life Cycle (cont.)

• School age
• 7 to 12 year old
• Industry vs. inferiority

• Adolescence
• 12 to18 years old
• Ego identity vs. role confusion

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Developmental Stages of the Life Cycle (cont.)

• Young adult
• 20s
• Intimacy vs. isolation
• Middle adult
• Late 20s 50s
• Generativity vs. stagnation

• Old Adult
• 60s and older
• Integrity vs. despair

12
Maslows Hierarchy of Human Needs
Self-actualization
Esteem
Love/Belonging
Safety
Physiological
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Maslows Hierarchy (cont.)

• Deficiency (basic) needs
• Physiological
• Safety
• Love/belonging
• Esteem
• Self-actualization

14
Human Behavior and Needs

• Considering patients needs
• Determine area of deficiency
• Adjust communication style

15
Apply Your Knowledge
You can communicate with all people in the same
way. Is this statement true or false, and why?
ANSWER The statement is false. Not all people
are at the same place on Maslows hierarchy of
human needs. To communicate effectively with a
person, you need to understand what he or she is
deficient in. For example, you would use
different communication styles when talking to a
homeless person who may have psychological and
safety needs than when talking to an elderly
person who is lonely and depressed due to the
recent loss of his or her spouse.
Good Answer!
16
Types of Communication

• Positive or negative
• Verbal or non-verbal
• Written

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Positive Verbal Communication

• Communication promotes the patients comfort and
  well-being
• Sets the stage
• Examples

18
Negative Verbal Communication

• Curb negative communication habits
• Pay attention to others in service-oriented
  workplaces

19
Nonverbal Communication

• Body language
• Facial expression
• Eye contact
• Posture

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Nonverbal Communication (cont.)

• Touch
• Personal space

21
Apply Your Knowledge
YEA!
Mr. Garcia comes to the desk to check in and asks
if he will be seen on time. The receptionist
continues with her paperwork, points to the
sign-in sheet, and tells Mr. Garcia Just sign
in. The doctor will be with you when he can.
Explain why this is an example of negative
communication.

• ANSWER This is an example of negative
  communication because the receptionist
• Did not stop what he or she was doing was not
  friendly or attentive
• Did not greet Mr. Garcia or make eye contact
  with him
• Did not give a satisfactory answer to Mr.
  Garcias question
• Did not make sure Mr. Garcia understood when he
  would be seen

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Improving Your Communication Skills

• Listening skills
• Interpersonal skills
• Assertiveness skills

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Listening Skills

• Passive listening
• Active listening

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Improve Listening Skills

• Prepare to listen
• Relax and listen attentively
• Maintain eye contact
• Maintain personal space
• Think before you respond
• Provide feedback

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Interpersonal Skills

• Warmth and friendliness
• Empathy
• Respect

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Interpersonal Skills (cont.)

• Genuineness
• Openness
• Consideration and sensitivity

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Assertiveness Skills (cont.)

• Assertive
• Open
• Honest
• Direct
• Aggressive
• Bossy
• Quarrelsome
• Manipulative

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Apply Your Knowledge
What is the difference between being aggressive
and being assertive?
ANSWER Assertiveness means standing by your
principles while showing respect for others. You
trust your instincts, feelings, and opinions and
act on them. An aggressive person tries to impose
his or her own position on others or tries to
manipulate them. He or she is bossy, may be
quarrelsome, and does not consider anothers
feelings, needs, thoughts, ideas, or opinions.
Good Answer!
29
Therapeutic Communication Skills

• Being silent
• Accepting
• Giving recognition
• Offering self
• Giving a broad opening

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Therapeutic Communication (cont.)

• Offering general leads
• Making observations
• Encouraging communication
• Mirroring
• Reflecting

31
Therapeutic Communication (cont.)

• Focusing
• Exploring
• Clarifying
• Summarizing

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Ineffective Therapeutic Communication

• Reassuring
• Giving approval
• Disapproving
• Agreeing/disagreeing
• Advising

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Ineffective Therapeutic Communication

• Probing
• Defending
• Requesting an explanation
• Minimizing feelings
• Making stereotyped comments

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Defense Mechanisms

• Adaptive
• Nonadaptive

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Defense Mechanisms (cont.)

• Compensation
• Denial
• Displacement
• Dissociation
• Identification
• Introjection

• Projection
• Rationalization
• Regression
• Repression
• Substitution

36
Apply Your Knowledge

• Check those of the following that are therapeutic?

• ANSWER
• Reassuring
• Offering self
• Mirroring
• Being silent
• Giving approval
• Accepting

• Probing
• Defending
• Making Observations
• Giving a broad opening
• Disapproving

?
?
?
?
?
?
37
Communicating in Special Circumstances

• Some special circumstances inhibit communication
• Heightened emotions
• Cultural differences
• Impairment or disability
• Terminal illnesses

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The Anxious Patient

• May not listen well or pay attention to what you
  are saying
• Observe for signs
• Acknowledge
• Identify source
• Use communication skills

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The Angry Patient

• Reasons for anger
• Do not take personally
• Goal help refocus to solve problem

40
Patients of Other Cultures

• Unique beliefs, attitudes, values, use of
  language and world views
• Avoid stereotyping
• Avoid generalization

41
Communicating in Special Circumstances

• Cultural differences
• Language barriers

42
Communicating in Special Circumstances

• Limited reading skills
• Cultural competence

43
The Patient Who is Mentally or Emotionally
Disturbed

• Determine what level of communication the patient
  can understand
• Suggestions
• Remain calm if the patient becomes agitated or
  confused
• Avoid raising your voice
• Avoid appearing impatient

44
Terminally Ill Patients

• Respect rights
• Treat with dignity
• Kübler-Rosss Stages of Dying
• Denial
• Anger
• Bargaining
• Depression
• Acceptance

45
Patients Families and Friends

• Acknowledge family members and friends
• Keep them informed about patients progress
• Remember to protect patient confidentiality

46
The Patient With AIDS or the Patient Who is
HIV-Positive

• Stigma of disease
• Have accurate information about the disease and
  the risks involved
• Provide human contact and treat with dignity

47
Apply Your Knowledge
What can you do to better communicate with the
anxious patient?
ANSWER Identify signs of anxiety, acknowledge
the patients anxiety, identify possible sources
of the anxiety, ease any physical discomfort, and
create a climate of acceptance and trust. Use
appropriate communication skills do not belittle
the patients thoughts and feelings, be
empathetic to the patients concerns. Help the
patient recognize and cope with the anxiety.
Right!
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Communicating with Coworkers

• Positive communication
• Develop rapport
• Rules for the medical office
• Use proper channels
• Have a proper attitude
• Plan an appropriate time for communication

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Communicating with Management

• Keep supervisor informed
• Ask questions
• Minimize interruptions
• Show initiative

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Dealing With Conflict

• Do not feed into negative attitudes
• Be personable and supportive of coworkers
• Do not judge or stereotype others
• Do not gossip
• Do not jump to conclusions

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Setting Boundaries in the Healthcare Environment

• Boundaries may be physical or psychological
• Limits undesirable behavior
• Action will depend uponwho the aggressor is

52
Apply Your Knowledge
What strategies can you use to avoid conflict in
the workplace?

• ANSWER You can use the following strategies to
  avoid conflict in the workplace
• Do not feed into others negative attitudes
• Be personable and supportive
• Refrain from passing judgments
• Do not gossip
• Do not jump to conclusions

Bravo!
53
In Summary

• 4.1 The communication circle involves a message
  being sent, a source, and a receiver that
  responds.
• Feedback is the response to a message, and
  noise is anything that may interfere with or
  change the message.

54
In Summary

• 4.2 Understanding human behavior and needs, and
  their correlation with professional
  relationships, is necessary to practicing as a
  medical assistant.
• Understanding the various stages of human
  life assists you in your communication skills
  with patients.

55
In Summary (cont.)

• 4.3 Communication that promotes comfort and
  well-being is considered positive
  communication.
• Negative communication can be a
  turn-off. Lack of eye contact with
  patients, except in specific cultures, or
  speaking sharply to a patient is considered
  negative communication.

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In Summary (cont.)

• 4.4 Listening and other interpersonal skills can
  be improved by becoming more involved in
  the communication process by offering
  feedback or asking questions of the patient.
• Understand that assertive medical
  assistants trust their instincts. They
  respect their self- worth, while still
  making the patient feel comfortable and
  important.
• Aggressive medical assistants try to
  impose their positions through
  manipulation techniques.

57
In Summary

• 4.5 Therapeutic communication is the ability to
  communicate with patients in terms that
  they can understand and, at the same
  time, feel at ease and comfortable in
  what you are saying.
• Positive therapeutic skills can enhance
  communication. Be aware of negative
  therapeutic skills that can disrupt the
  communication.
• Recognize defense mechanisms in patients
  and note whether the patient is using them
  to cope or is not able to cope.

58
In Summary

• 4.6 Learning about the special needs of patients
  and polishing your communication skills
  will help you become an effective
  communicator.
• This will assist you with handling
  diversity in the workplace, handling
  anxious and annoyed patients, and in
  dealing with patients who may have
  language barriers.

59
In Summary

• 4.7 The quality of communication you have with
  your coworkers and your supervisor greatly
  influences the development of a positive
  or negative work climate.
• Use proper channels of communication. Be
  open-minded. Keep supervisors informed of
  office problems as they arise and show
  initiative in your work habits.

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End of Chapter 4
Often during life-altering experiences, patients
and their loved ones need a shoulder to cry on or
someone to comfort them. It is important for them
to know support is there. Lindsey D. Fisher (The
Healers Art)