Communication and interpersonal skills (CIS)

Ability to foster the relationship: Listening attentively: postpone using records until the patient has completed their opening statement Showing interest, respect, care and concern; do not frown! Skills in gathering information: encourage the patient to tell his/her story Elicit the patients perspective: priorities, expectations, worries, how the illness affects life Ideas (beliefs): Tell me about what you think is causing it. Do you have any clues; any theories? Do you have any thoughts about why this is happening?. Concerns: Is there anything particular or specific that you were concerned about? What was the worst thing you were thinking it might be? What concerns you most about your symptoms? Expectations: What were you hoping we might be able to do for you? What do you think might be the best plan of action? What were you thinking would be the best way of tackling this? Effect of the problem on the patients life: How has your illness affected your ability to work? Your life at home? Your social activities? Skills in providing information: give information in assimilable chunks; check for understanding There are three important things that I would like to discuss. First ... The working diagnosis is. Use repetition and summarizing to reinforce information Information on the next steps Encourage questions, clarification or expression of doubts Check for the patients understanding Helping the patient make decisions: What should happen next? First elicit the patients perspective (ideas, concerns, expectations) Involve the patient by making suggestions rather than directives Assess the patients agreement and willingness Ability to support emotions: Using statements of understanding and support. The empathic response is a technique that consists of three steps: 1. identifying the emotion, 2. identifying the source of the emotion, and 3. responding in a way that shows you have made the connection between the first two steps. I want to be sure I understand. You told me (paraphrase). Is that correct? The more you tell me, the better Ill be able to help. Remember, Im here to help. This must be a _ experience for you. You seem _. Do you want to tell me why? How do you feeling today? Painful, frustrating, hard, sad, embarrassing, irritating, unpleasant, tough, difficult. Reassure the patient that you: Understand his concerns. Will you everything you can to make him feel better. Will do everything you can to find out what is wrong. Will get him the best treatment available. Will remain his doctor and will always be available to help. Emotional support: Allow patient to express his concerns. Deliver information in a caring and sensitive manner. Elicit the patients need for support.

The introduction Knock before entering the room. Greet the patient: Hello Mr. /Mrs. /Ms. ____ My name is Dr. Andrs. I will be your physician today. Offer a handshake (except when patient is in emotional or physical distress) Drape the patient I have a drape for you. May I cover your legs? Here you go. Asking the first question: I see you have ______. Please tell me about it. Uh-huh, continue, go on, I see, what happened next? The closing or summary Transition: Let me tell you what Im thinking. Give knowledge: I think you may have Im thinking of two possibilities. Explain next steps Counseling: counselor and/or social worker Say goodbye, make appointment