1. INTRODUCTION TO CLINICAL
COMMUNICATION SKILLS
Dr RM Abraham
Clinical skills
NRMSM UKZN

2. CLINICAL COMMUNICATION SKILLS(CCS)
AIM:
 To promote the practice of effective communication
within healthcare with patients, carers, collegues
and other professionals.

3. EFFECTIVE
COMMUNICATION/GOOD CONSULTATION
involves:  Sharing information with
 Understanding the the patients with regards
patients problems from to:
his/her perspective by
allowing the patients to a)Explaining procedures
narrate their story in their that would be necessary
words and at the same to help make a diagnosis.
time demonstrating
b)Discussing the various
interest, empathy, respect
treatment options and
and attending to their
their effects.
comfort at all times.

4. GOOD DOCTOR
 Remember that the success of a good doctor
depends not only on his/her medical knowledge but
also the way he/she communicates with his/her
patients e.g the way he explains the problems,
diagnosis and treatment to his patients.
 Since Medicine is a subject that is learnt from the
interaction with patients, it is therefore essential that
medical students develop their communicating
capacity at the undergraduate level.
 We would therefore be teaching and providing you
with the building blocks that are necessary to create
a Good consultation.

5. CCS-OBJECTIVES
 To explore the basics of what makes a good doctor.
 Importance of a medical interview in clinical
practice from the point of view of
a)The doctor
b)The patient

6. A-WHAT MAKES A GOOD DOCTOR?
 Think of a previous 4)Why does a good doctor-
medical encounter you patient relationship
had with a doctor matter?
5)What did the doctor do to
1)How did the consultation make the interview go
go? well?
2)How was the Doctor- 6)What could the doctor do
patient relationship and to make the interview go
what do you perceive better?
should be a good doctor- 7)What message about
patient relationship? being a good doctor did
3)What do you really value you take away from the
and need in a good experience?
doctor?

7. GOOD DOCTOR-PATIENT RELATIONSHIP
 Achieved by:
1)Establishing a good rapport with the patient:
 Greet the patient
 Obtain patients name
 Intrd yourself, clarify your role and the nature of the interview
 Obtain consent
2)At all times demonstrating interest,empathy,respect and
attending to the patients physical comfort.
3)Good communication with patient:
 Gives the patient the chance to tell you what is wrong with
them in their words.
 They will tend to open up as they have the impression that
you are honest with them and hence they trust you and feel
more confident to tell you what is exactly going on in their
mind

8. GOOD COMMUNICATION
Skills:  Non-verbal skills-gives the pt a
1)Encouraging the patient to tell clue of your level of interest
his/her story of the problem from E.g. body posture,eye contact,
when it started to the present in gesture,facial expression,touch
their words using a more open  Picking up pts verbal and non-
questioning technique. verbal cues and responding to
2)Listening attentively without them-often pts ideas,concern
interrupting by: and expectations are provided in
 Wait time-give pt adequate time
these cues.
to respond 3)Use of appropriate language.
 Facilitative response-encourage 4)Clarifying statements that appear
pt to say more using phrases vague.
"uh-huh", "go-on","I see","yes" 5)Summarizing periodically to verify
your understanding and also
gives pt the feeling that you are
listening to them attentively.

9. B-IMPORTANCE OF A MEDICAL INTERVIEW
AIM: TO OBTAIN FACTUAL ACCOUNT OF PATIENTS ILLNESS AS WELL AS THE
PATIENTS PERSPECTIVE OF THE ILLNESS B4 SUGGESTING AND AGREEING TO
A PLAN OF MANAGEMENT
Doctors agenda: Patients agenda:
a)Develop a good To discuss
relationship with the pt. a)Ideas and thoughts of the
b)Make a diagnosis- illness.
 by obtaining the b)Concerns about the
sequence of events and illness.
analyzing the symptoms c)Expectations from the
etc(History taking) consultation.
 Examination of pt. d)Feelings about the
 Investigating pt. illness.
c)Manage the pt.- e)Effects the illness is
 Pharmacological having on their life.
 Non-pharmacological

10. ANALYZING A CONSULTATION
 Watch a DVD clipping of a medical consultation to
help explore the
a) Purpose
b) Difficulties
c) Strengths and
d) Weaknesses
From both the doctor's and patient's view point

11. THANK YOU