Communication Skills

for MRCPCH Exam

ELBA
BA

Miscommunication
Inside Others mind

My doctor doesnt know anything!

He or she is very careless!
He or she is very hesitant & confused!
Even you dont have time for me!
I don't like you!
I dont trust you!
I should ask to change this bad doctor!
Even I want to complain against him or her!
If my baby is yours you will not act like this!

Exam Philosophy
Do
what you Know

Show
what you Know

Know
that you Know

Build

Work

OSCE
Clinical
Part 2
Cases
Part 1
MCQs

a base of Know

"Education islearning what you didn't even know

Show what you Know

Clinical Examination
Communication Skills

20
%

Communicati
on Skills

Communication
Verbal

Nonverbal

Hearing
Phonation

First impression

Articulation

Features

Mentality

Body language

Vocabulary

Behavior

Fluency

Moral & Religion

Language

First
Impress
ion

Imprompt
u
Speakin
g

Basics three pillars of effective

communications
1. Topic information
1. Knowledge
2. Practice

2. Personal skills
1. Experience
2. Language

3. Systematic Approach
1. Skeleton
2. Training

Communication Verities

1. History taking
2. Breaking bad news
3. Information given
4. Critical incidence
5. Consent
6. Education
7. Ethical dilemma
8. Telephone Call
9. Colleague communication
10. Difficult scenarios

Child
Family
Colleague

Steps of Communication
Intro
Body
Fin

Steps of Communication

Welcoming
Who are you?
What do you want?
Setting & Context
Time
Who can attend

Intro

Steps of Communication

Prior knowledge
Information
Understanding
Repeat
Pauses
Name the problem
Help
Expectation

Body

Steps of Communication

Summarize
Any more question
Next action
Follow up
Educational Aids
Supportive group
Health professionals
Contact access
Thanks

Fin

Empathy & Sympathy

Empathy: is a technique or skills not a feeling.
Identify the emotion & its source then respond
appropriately to it.

Sympathy: is the feeling of sorrow for unfortunate

event

Information
for family

http://www.gosh.nhs.uk/gosh_families/information_sheets/index.html

Studies shown that most families will

need more or less the same amount
of information, irrespective of their
educational level
On average people remember :
20% of what they see or hear
50-80% of what they see & hear

Scenari
o Tips

Scenario tips : Breaking bad news

Name the problem or illness

Say sorry at least once
Chunk pieces information
Pauses
React & Respond
Hope
Help

Scenario tips : Critical incidence

Apologize
Current status
Action taken
Expected Sequences
Documentation
Consultant
Not happen again
Formal complaint

Scenario tips : Consent

Indication
Pain & sedation
Benefit & Risk
Expect worry
Alternative
Consultant
Sign the Form

Scenario tips : Education

Target of the session

Audiences
Significance
Scenario
Steps
Demo
Understanding
Repeat & summarize
Role player

Scenario tips : Ethical dilemma

Local ethics & bye law

Consultant
Team or group decision
Family input
The two views
Confidentiality
Religious authority
Legal authority
Time to think

Scenario tips : Colleague communication

Verbal Vs Written handover

Time & person
American Vs European system
Referring letter
Telephone call
Misbehavior of the colleague

Scenario tips : Telephone Call

Is the voice clear?

Who are you?
To whom you are talking?
What is the reason for call?
Patient identity
Patient status
Check understanding
Method of referral
Summarize
Next action
Report
Contact details

Scenario tips : Difficult Scenarios

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Colleague misbehavior
Conflict decision
Confidentiality breach
Aggressive behavior
Suspected abuse
Wrong information
Dying or dead child
Withdraw support
Angry person
Organ donation

Child safety
Child best interest
Senior
Dont blame
Keep quiet
Be honest
Be strict & direct
Competence

Tips Summary

Name, age & sex

Whom in front of you?
Review Information
Comfortable setting
No interruptions
No hurry
Child attendance
Eye contact
Voice
Body language
Empathy
Sympathy
Be serious
No jargons

Prior knowledge
Two way conversation
Pauses
Repeat
Check understanding
Sorry & apologize
Name the problem
Be focused
Be honest (I dont know)
Hope
Help
Summarize
Keep talking

Ineffective
Effective
communicat communicat
ion
ion

Exam.
Scenario
Telephone call
for Recurrent
chest
infection:
referral

Last message
Practice
Practice
& Practice

Thank
https://sites.google.com/site/mrcpch2009/