3 ATCOM 21st Sept Communication Skills -3

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Communication Skills Cases in AT-COM Module:

Communication Skills Cases in AT-COM Module Prof. R. K. Dixit Pharmacology and Therapeutics K. G. M. U. Lucknow dixitkumarrakesh@gmail.com

Objectives:-:

Objectives:- To familiarize with communication To sensitize modules of communication for undergraduate

What is Communication?:

Ways of communication? B arriers in communication? Components of effective communication. S ituations which requires special communication skill. Is there any need for teaching communication W ays we can teach communication skills to our students. Any experience encountered related to miscommunication leading to mishap. What is Communication? Five Minutes Group Discussion

What is Communication?:

A process which allows us to share ideas with other. Poor communication leads to misunderstandings and mishaps. Effective communication plays core role in the medical field Doctors and medical students have to deal with people from different cultural background and different needs. There are certain situations which requires special communication skill like while breaking bad news, eliciting sexual history, resolving conflicts etc. Need for Changes in medical curriculum to introduce and evaluate communication skills among medical students . AT-COM What is Communication?

Slide 5:

Communication skills relate to physician responsibilities, including communication with patients, families, colleagues, and other health professionals . The curriculum must prepare students for their role in addressing the medical consequences of common problems, for example, providing instruction in the diagnosis, prevention, appropriate reporting, and treatment of violence and abuse.

Components of Communication:

Components of Communication

Learning Modules Related to Communication Skills (26-30-46-50-56):

Learning Modules Related to Communication Skills (26-30-46-50-56) Professional Year Name of Module Background Competencies addressed and Hours Ethics/Communication and Assessment Page Number 1 st What does it mean to be a doctor New entrants should know the holistic view of their profession K H (6+2 Hours) Ethics (Formative Assessment) 19 1 st What does it mean to be a patient A balanced apporach to the patient care experience requires an understanding of patient. Showing Emathy KH, SH Ethics (written, Viva) 21 1 st The doctor patient relationship Fundamental basis of doctor patient contract, its roles, boundaries and duties. KH, SH(6+2) Communication. SAQ 23 1 st Foundation s of Communication - 1 Communication is a fundamental prerequisite of medical profession and bedside clinical skills SH (5+2) Communication 26 1 st The Cadaver as our first Teacher Respect for the cadaver with emphasis on humanizing SH (2+2) Ethics 28

Learning Modules Related to Communication Skills:

Learning Modules Related to Communication Skills Professional Year Name of Module Background Competencies addressed and Hours Ethics/Communication and Assessment Page Number 2 nd Foundation of Communication- To ensure professional success for doctor the communication plays fundamental role SH (5) Communication 30 2 nd Foundation of Bioethics To provide an overview of fundamentals of bioethics KH (2) Ethics 32 2 nd Health Care as a right Role of doctorss as key players in helath care system KH (2) Ethics 33 2 nd Working in a health Care system To observe the work of different member s of health care system. SH (4hours Tag along +2) Ethics 34 2 nd Bioethics Patient Autonomy and Decision Making Patients autonomy 35 2 nd What does it means to be familty member of patient Role of doctor, exploration of empatthy 2 Ethics 44

Learning Modules Related to Communication Skills:

Learning Modules Related to Communication Skills Professional Year Name of Module Background Competencies addressed and Hours Ethics/Communication and Assessment Page Number 3 rd Foundation of Communication-3 Bside skills communication is fundamental prerequisite of medical profession SH Communication 46 3 rd Disclosrue of Medical Errors Effect of wrong medication Communication and Ethics 48 3 rd Foundation of Communication-4 To provide an emphasis on effective communication skills SH Communication 50 3 rd Confidentiality Identify, discuss and defend medico-legal, socio-cultural and ethical issues SH Communication 52 3 rd Fiduciary Duty Identify, discuss and defend medico-legal, socio-cultural and ethical issues SH Communication 54

Slide 12:

Professional Year Name of Module Background Competencies addressed and Hours Ethics/Communication and Assessment Page Number 4th Foundation of Communication-5 To provide effective communication SH Communication 56 4 th Medico-legal and ethical situations To discouss the medicolegal and ethical conflicts in adolescents SH (5) Ethics 58 4 th Case studies in medico-legal and ethical situations To discuss medicolegal socioeconomic and ethihcal issues as it pertains to organ donation. Ethics 60 4 th Empathy and Doctor Patient relationship Empathy SH (5) Ethics 62 4 th Case studies in ethics and the doctor industry relationships Way to maintain doctor industry relationship 5 Ethics 65 4 th Case studies in ethics and patient autonomy The empathy about patients 5 Communication and Ethics 69 4 th Dealing with Death Introduction of Thalantology “The branch of Science dealing with Death” 5 Communication and Ethics 71 4 th Medical Negligence Legal aspects of care including negligence and malpractivve and ways to protect 4 KH Ethics 74

Foundation of Communication -1 :

Foundation of Communication -1 Background- Introduction of doctor patient communication. Skills that will be introduced should include Listening, Verbal and non verbal communication, Creating respect in patient encounter Competency- Demonstrate ability to communicate to patients in a respectful, non threatening , nonjudgmental and empathetic manner- SH When- 1 st Professional Duration- 7 hours Learning Modules Related to Communication Skills (26-30-46-50-56)

Slide 14:

What and How - 1. Introductory large group session (lecture) on principles of communication 2. Self directed/guided learning by students on the importance and techniques of effective communication 3. Small group session on improving communication. (Videos, role play highlighting common mistakes in patient doctor communication. (Noisy condition with distracted doctor, lack of eye contact, interrupting patient and not listening etc. 4. Closure session with reflection in small group with emphasis on learning done and future directions. Assessment- Formative- based on active participation, Written critique of situations Summative – May be deferred for later phases Resources:- Makoul G. Essential elements of communication in medical encounter: The Kalamazoo consensus statement. Acad Med. 2001;76(4):390-3

Foundation of communication 2:

Foundation of communication 2 Background- Provides an emphasis on effective communication skills. Emphasis is on active listening and data gathering. Competency addressed:- Demonstrate ability to communicate to patients in respectful, non threatening nonjudgmental manner When:- Professional 2 nd Hours:- 5 (1+2+2) What and How:- Introductory small group session on the principles of communication with focus on opening the discussion listening and gathering data Focused small group session with role play or videos Skill lab session where student perform tasks on standardized or regular patients with opportunity for self critique by patient and by the facilitator Assessment- Formative Summative- Resources:- Makoul G. Essential elements of communication in medical encounter: The Kalamazoo consensus statement. Acad Med. 2001;76(4):390-3

Foundation of communication 3:

Foundation of communication 3 Background- Provides an emphasis on effective communication skills. Emphasis is building on active listening and data gathering. Introduction of skills dealing with emotion. Competency addressed:- Demonstrate ability to communicate to patients in respectful, non threatening nonjudgmental and empathetic manner When:- Professional 2 nd Hours:- 5 (1+2+2) What and How:- Introductory small group session on the principles of communication with focus on opening the discussion listening and gathering data Focused small group session with role play or videos Skill lab session where student perform tasks on standardized or regular patients with opportunity for self critique by patient and by the facilitator Assessment- Formative, Summative- Resources:- Makoul G. Essential elements of communication in medical encounter: The Kalamazoo consensus statement. Acad Med. 2001;76(4):390-3

Foundation of communication 4:

Foundation of communication 4 Background- Provides an emphasis on effective communication skills. Emphasis is on administering informed consent Competency addressed:- Demonstrate ability to communicate to patients in respectful, non threatening nonjudgmental and empathetic manner Identify, discuss and defend medico legal, socio-cultural and ethical issues as they pertain to consent for surgical procedures Administer informed consent and appropriately address patient queries to a patient undergoing a surgical procedure in a simulated environment When:- Professional 3 rd Hours:- 5 (1+2+2) What and How:- Introductory small group session on the principles of communication with focus on opening the discussion listening and gathering data Focused small group session with role play or videos Skill lab session where student perform tasks on standardized or regular patients with opportunity for self critique by patient and by the facilitator Assessment- Formative, Summative- Resources:- Makoul G. Essential elements of communication in medical encounter: The Kalamazoo consensus statement. Acad Med. 2001;76(4):390-3

Foundation of communication 5:

Foundation of communication 5 Background- Provides an emphasis on effective communication skills. Emphasis is on communicating diagnosis, prognosis and therapy effectively. Competency addressed:- Demonstrate ability to communicate to patients in respectful, non threatening nonjudgmental and empathetic manner (SH) Communicate diagnosis and therapeutic options to patient and family in a simulated environment. (SH) When:- Professional 4 th Hours:- 7 (1+2+4) What and How:- Introductory small group session on the principles of communication with focus on communication of diagnosis, prognosis and therapy Focused small group session with role play or videos where student has opportunity to observe mistakes in communications Skill lab session where student perform tasks on standardized or regular patients with opportunity for self critique by patient and by the facilitator Assessment- Formative, Summative- Resources:- Makoul G. Essential elements of communication in medical encounter: The Kalamazoo consensus statement. Acad Med. 2001;76(4):390-3

Slide 23:

Kalamazoo Consensus Statement In May 1999, 21 leaders and representatives from major medical education and professional organizations focused on essential elements in physician-patient communication to: facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education. The group identified seven essential sets of communication tasks: (1) Build the doctor-patient relationship; (2) Open the discussion; (3) Gather information; (4) Understand the patient's perspective; (5) Share information; (6) Reach agreement on problems and plans; and (7) Provide closure. Kalamazoo city in the southwest region of the U.S. state of Michigan.

Communication Skills Rating Scale Adopted from KALAMAZOO consensus statement Rating 1-3-Poor, 4-6 Satisfactory, 6-10 Superior:

Communication Skills Rating Scale Adopted from KALAMAZOO consensus statement Rating 1-3-Poor, 4-6 Satisfactory, 6-10 Superior Criteria Builds relationship Opens the discussion Gathers Information Understands the patient’s perspective Shares information Manages flow Overall rating

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