INTERPERSONAL COMMUNICATION

BLOCK 1; MEDICAL FACULTY

SRIWIJAYA UNIVERSITY

CHAPTER 1
INTRODUCTION
A. Background
Communication is one of the basic needs of human being. Human as a social beings
always needs a relationship with others. Doctor is one of the professions who always
interacts with other people. Communication between doctor and patient is one of the
competence that needs to be mastered by any doctor in performing their daily profession.
Communication competence is very important in which it determines the success especially
in helping to solvehealth problem of the patient. All this time, communication competence
was neglected both in education and practice of the doctor/dentistry. Some doctors think that
they dont have enough time to communicate with the patient, while patient in general will
feel at the lower position in front of doctor (superior-inferior), so they are afraid to ask and
tell something to the doctor and they just answer based on what the doctor asks them.
Those things make the doctors dont get enough information to establish a diagnosis and
further follow-up plan.
A trust relationship between doctor and patient based on openness, honesty and
understanding of needs, expectations, also interests of each is necessary to built. Thus, the
patient will give a true and complete information so it can help doctor in making diagnosis
and further management plan properly.
A good communication and takes place in a equivalent position (not in super-inferior
position) is needed so the patient wants/will tell about his illness/chief complaint that he feels
honestly and clearly. Effective communication skill become basic for the formation of doctor
patient communication. Effective communication can influence patients emotion in making a
decision about next action plan.
Based on that explanation, so the effective communication becomes one of nine
competences that needed to be mastered by medical graduates in Indonesia that has been

established by Indonesia Medical Council. In order to achieve the target of competence, it

needs communication learning which is done step by step. Basic communication skill
modules are needed as a references in that learning process, one of them is about basic
interpersonal communication skills module, which will underlie doctor-patient communication
skill in the next module.
B. Competence
The competences in this module are:
1. The use of good, right, and easy to understand language
2. Interpersonal communication principle: effective oral communication, a method to give
comfortable and conducive situation in effective communication, method to encourage
the other person to give the information voluntarily, method to identify the purpose of
others in communicate.
3. Some of effective communication elements: interpersonal communication, manner in
communicate, body language, eye contact, the way in speaking, tempo in speaking,
voices tone, words that are used/avoided, present in the conversation, active listening
skills, empathy.
C. Importance
This module is need to teach so that students will be able to implement the principle of
interpersonal communication clearly and with full of empathy.
D. Students characteristic
Students participating in learning interpersonal communication skill are those whom just
entered medical faculty without any prior knowledge regarding communication skills and
clinical situation.
E. Learning objectives
After finishing this module, the students are expected:
1. To be able to start and get used to do communication independently with good, right and
easy to understand language.
2. To be able to create a comfortable and conducive situation in effective communication
3. To be able to push other to give information voluntarily
4. To be able to identify the purpose of others in communicate
5. To be able to practice verbal and non verbal communication precisely and effectively
6. To be able to attend and get involved in the conversation
7. To be able to practice active listening

8. To be able to practice empathy

CHAPTER II
LITERATURE
Interpersonal Communication
Based on types of interaction in communication, communication is divided into
intrapersonal communication, interpersonal communication, small group communication and
public communication. Through intrapersonal communication, we are talking with ourselves,
knowing and evaluate ourselves, considering all decisions that will be made and prepare the
messages that will be delivered to others. While in

Sedangkan dalam komunikasi

interpersonal communication we interact with others, knowing them and ourselves, and
reveal ourselves to others. Small group communication and public communication interact
with more people, usually > 3 persons.
In interpersonal communication, the communication happens between persons face to
face, that enables every participant to catch others reaction directly, verbally or non verbally.
Interpersonal communication which involves only two persons such as in the husband and
wife, two colleagues, best friend, teacher-student, etc.
Purpose of Interpersonal Communication
Interpersonal communication has several purposes. Those purposes such as:
a. Finding Yourself
One of the interpersonal communications purposes is to find personality of someone. If
we get involved in interpersonal meeting with others, we will learn so many things about
ourselves and also about others.
Interpersonal communication gives chance to us to talk about what we like, or about
ourselves. It is so interesting and fun if we discuss about our own feeling, thought, and
behaviour. By talking about ourselves to others, we give an incredible feedback to our
feeling, thought, and behaviour.
b. Finding Outside World
There are so many information that we know come from interpersonal communication,
eventhough there are many information that came to us from that mass media, those things
often discussed and finally learned or explored by interpersonal interaction.

c. Forming and Maintaining Meaningful Relationship

One of the greatest desire from a man is to form and maintain a relationship with others.
Most of the time we use in interpersonal communication is immortalized to form and
maintain social relationship with others.
d. Change an Attitude and Behaviour
There are so many times we use to change attitude and behaviour of others by
interpersonal meeting. We may want them to choose a specific way, such as trying a new
diet, buying a specific object, watching movies, writting and reading a book, entering a
certain area and believe that the thing is right or wrong. We are using many times to get
involved in interpersonal position.
e. To Play and Pleasure
Playing covers all the activity that has a primary purpose which is to look for a leasure.
Talking with a friend about our activities at the end of the holiday, discuss sports, telling
stories and jokes.

By doing that kind of interpersonal communication, it can give an

important balance in mind that needs to relax from all the seriousness in our environment.
f. To Help
Psychiatric experts, clinical psychologist and therapeutic uses the interpersonal
communication in their professional activity to direct their clients. We all also serves to help
others in our interpersonal interactions daily. We consulted with a friend who break up of
love, in consultation with the students about the courses that should be taken and so forth.
Interpersonal Communication Effectiveness
The effectiveness of interpersonal communication starts with five general qualities, that
is openness, empathy, supportiveness, positiveness, and equality.
1. Openness
The quality of openness refers to at least three aspects of interpersonal communication.
First, an effective interpersonal communicator should be open to the person whom he asked
to interact with. It doesnt mean that the person should open about all of his history. It looks
interesting, but it usually doesnt do any help in communication. On the other way, there

must be a willingness to open himself to tell information that is usually hidden, as long as the
disclosure is worth it.
The second openness aspect refers to the willingness of communicator to react honestly
towards the upcoming stimulus. A person who are silent, not critical, and not responsive, in
general belongs to the boring person. We want people to react honestly to what we said.
And we have the right to expect this. There is nothing worse than ignorance, even
disagreement is more fun. We show the openness by react spontaneously to others.
The third aspect is about ownership of the feeling and thought. Openness in this term
means to admit that feeling and thought given is trully belong to you and you have the
responsibility on it. The best way to tell about this responsibility is by message using I (first
person singular pronoun).
2. Empathy
Henry Backrack (1976) defined empathy as the ability of someone to know what is
happening to someone else at a certain time, from the perspective of the other person,
through the eyes of someone else's." Sympathize, on the other hand is a feeling for others
or feel the sadness of others. While empathy is to feel something like a person who
experienced it, be in the same boat and feel the same feelings in the same way.
An empathic person can understand motivation and experience of others, feeling and
their attitude, also their expectation and desire for future.
We can communicate empathy in verbal and non verbal way. In a non verbal way, we
can communicate empathy by showing (1) active involvement with a person through face
expression and appropriate gesture; (2) centralized concentration through eye contact, full
attention gesture, and physical closeness; also (3) an appropriate touch or caress
3. Supportiveness
An effective interpersonal relationship is a relationship in which there is a supportiveness
attitude. A consept that is formulated by Jack Gibbs work. An open and empathic
communication can not be done in unsupportive circumstances. We show the supportive
attitude by (1) descriptive, and not evaluative, (2) spontaneous, not strategic, and (3)
provisional, not very sure.

4. Positiveness
We communicate the positive attitude in interpersonal communication with at least 2
ways: (1) states the positive attitude and (2) positively encourage the person who become
our friends in every interaction we made. Positive attitude refers to at least two aspects of
interpersonal communication. First, interpersonal communication will be built up if someone
has a positive attitude towards themselves.
Second, positive feeling in communication situation is very important for an effective
interaction.

Kedua, perasaan positif untuk situasi komunikasi pada umumnya sangat

penting untuk interaksi yang efektif. There is nothing more fun than to communicate with
people who do not enjoy the interaction or do not react favorably to the situation or
interactions atmosphere.
5. Equality
In every situation, perhaps there is an inequality occurring . One may be smarter than
other. Richer, more handsome or beautiful, or more athletic than others. There was never
any two people who truly equal in all aspects. Apart from this inequality, interpersonal
communication will be more effective if the atmosphere is equal. It means that there should
be a tacit acknowledgment that both sides are equally valued and valuable, and that each
side has something important to give. In an interpersonal relationship characterized by
equality, disagreement and conflict can be viewed as an effort to understand the differences
that surely exist rather than as an opportunity to drop others. Equality does not require that
we accept and approve all the verbal and nonverbal behavior of others. Equality means that
we accept the other side, or in the words of Carl Rogers, equality asks us to give "
unconditional positive appreciation " to others .

1. Effective communication
Given the limited time and resources in communicating, so building the effective
communication

is

indispensable.

Effective

communication

becomes

form

of

communication that is capable of directing the communication to be more accurate, effective

and efficient. Effective communication does not stop when the speaker finish his point.
However, communication is said to be complete when the recipient is able to understand the
message given as expected. Content / material in effective communication competence in
interpersonal communication includes the following aspects:

Verbal and non verbal communication

Active listening skill

Communication with empathy attitude

Here are some techniques in order to get an effective communication:

a) Make sure of what will be communicated and how to communicate (with regard to the
clarity of the message)
b) Use clear and understandable language to the communicant
c) Use the appropriate and adequate communication media if necessary
d) Create a good and right atmosphere of communication (calm atmosphere, not noisy,
comfortable)
e) Listen attentively to what is being expressed by communicant because what is said by
communicant is feedback to the message given by communicator
f)

Avoid unintentional communication. Each communication process should has clear

objectives and done with planning.

g) Remember that communication is a two way processes, in which there should be a

feedback between the communicator and the communicant.
h) Assure that the actions taken are not in contradiction with what was said. In other words,
verbal expression must be in accordance with the non-verbal expression.

2. Communication with empathy (emphatic communication)

Empathy is an ability to feel the feeling of messanger based on messangers perspective
or putting himself in the thought and feeling of others (internal frame of reference), as if he

can feel and understand the emotion condition of others. Empathy also can be described as
an overall acceptance of others. This form of acceptance can be seen in the interaction that
happened. The forms of acceptance are listening to the feeling, looking for any discomfort,
appreciate any concern, also entering to the core of the concern of his clients.
In order for communication with empaty can run well, the communicator should
understand communicants feeling that comes from their signs, in verbal or non verbal sign.
By understand feelings, the communicant feels that he is well accepted and in the end he
will be more open in express his problem. This communication with acceptance and
openness basics will later on be very helpfull in creating smooth communication.
The ability to show empathy in the process of communication involves several
components such as:

Cognitive : understanding and knowing from communicants perspective

Affective: feels the feeling of communicant

Psychomotor : able to describe the feeling from communicants perspective

Comes from any concerns and compassion which are expressed verbally and non
verbally.

Helps communicant to grow positive feeling to himself

Make the communicant feels not threatened and not afraid to express himself and his
emotions.

Ask and tell communicant to share his feelings.

Use verbal and non verbal communication as a form of understanding of what is felt by
communicant

Express verbally what is felt by communicant

Here are some examples to communicate with empathy:

I can understand the worried that you feel right now.

I can understand if you are so confusing, mr Budi....

It looks like mr Adi is so sad...

It looks like you are very worry....

You are so upset maamif there is someone who can...

I can feel that you are very confuse now

If I were you... I also will feel sad confuse angry for what has happened..

Attitude in Communication with empathy

There are five attitudes or ways to present himself physically to fasilitate empathy
communication:
a) Face to face. The meaning og this position is I am ready for you.
b) Maintaining eye contact. Eye contact in the same level means respect communicant and
expressed our desire to keep in communicating.
c) Bending towards communicant. This position shows that we want to hear or listen to
something.
d) Maintaining an open attitude, no legs or arms folded will show openness to
communicate.
e) Stay relax. Still be able to control the balance between tension and relaxation in giving
response to communicant.
Requirements of empathy communication is:
1. Present and involved in conversation
Presents in conversation means the receiver shows seriousness in observing what is
said by communicant who has problem. The presence in conversation is evidenced by the
involvement physical aspect, mental and intellectual of individual. The existance of physical
aspect can be seen in the open posture, eye contact to the other, also a close physical
distance. The existance of mental aspect can be seen in the interest to other so the individu
can concentrate to whom he spoke. If this mental aspect doesnt exist, then it can be seen
from the soaring toughts of the receiver to something else, that is outside of the
conversation purpose. For example he is thinking about the tasks that have not done,
dreaming of something, or developing plans outside conversation. The existance of
intelectual aspect proved by the presence of any understanding focus in the conversation so
the negative commentary to the messanger can be vanished.
2. Actively Listening

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Active listening is the ability to keep in touch with others. It is different with passive
listening (hear), actively listening shows a situation full of warmth and togetherness. Pasive
listening just uses ears, while active listening involves feeling and heart. It is not only words
that are being heard but also their feeling.
Skill to Observe
Give attention physically
Look and open yourself using body language
Keep up the eye contact
Shows face expression and other sign to indicate the interest in what others are
saying

Following Talk Skill

Do not interrupt or deflect conversation
Asking a relevant question so that the answer will not only be Yes or No
Do not take over the role and asking too many questions
Keep silent but paying full attention

The disclosure is to say with other words what is being told by the speaker, to check if

you heard it correctly. You do not judge to the content of what they are saying.
To disclosure something, you may use sentences such as:
So you are saying-- So you are thinking-- Looks like you are saying-- etc
Perform reflection:
Telling others what are you thinking about their feeling
Such as: you look angry?

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 Seems that you are disappointed?

Paraphrasing :
Say it with other words with the same meaning to what have been told to you to get an
exact understanding.
Such as: if I am not mistaken?
So are you saying that?

Focusing:
Talking about the main problem
Such as: from all of your saying, which one is the most important?

Example of uneffective communication

Rivet on his own thought about what would he say he doesnt pay attention to what
others saying
Cut off the conversation and then ecpress his own opinion
Selectively listening to what he wants to hear.
Cut off others talk and deflect the statement according to his will

3. Barrier in Communication
Barrier in communication may become a big problem because it complicates and maybe
frustrating for people to communicate each other in understanding the meaning of each.
Some barriers in interpersonal communication such as:
a. Physical barriers : distance, room with a closed door.
b. Perception : every person has their own perception, understanding and thought

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c. Emotion : an emotional person tends to not thinking clearly, a person who is

easily suspicious, and over distrust
d. Culture : determine someones behaviour
e. Language : the differences in language will hamper the understanding in
communication
f.

Gender : related to logic and emotion

4. Steps of Communication
1.

Greetings

2.

Introducing yourself

3.

Asking for talking/discussing

5.

Communications Competence

The competence of communication refers to your ability to communicate effectively. This

competence include things like knowledge about environments role (context) influence the
content and form of the communication message (such as, the knowledge that a topic
maybe suitable to be communicated to certain listener in a certain environment, but maybe it
may not suitable for other listener and environment). The knowledge about procedure of
nonverbal behaviours (such as propriety of touch, loud voice, also physical closeness) are
also a part of communication competence.
By increasing your competence, you will get many option to behave. The more you know
about communication (means the higher your competency), the more options you may have
to communicate in a daily life. This process is similar to the process of learning vocabulary:
the more words you know (means, the more your vocabulary competence), the more ways
you may have to express yourself.
SKILL LAB MECHANISM
a. Pretest.
b. Briefing and checklist-reading.
c. Roleplay in a mini-group; every group of 5-6 people are facilitated with one
co-assistant as a mentor. Two students play as communicator, and the
others and the co-assistant acts as observers that hold the checklist.

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d. Documenting discussions result

e. Reflection and feedback.
Scenarios:
-

First month experience in FK Unsri.

Discussion about co-assistant life.

Goals:
-

Each group documents their results in a written paper.

Every person in a group is able to talk about their groupmates and co-assistant
mentor and give at least three unique fun-facts about them.

Every person in a group is able to talk about their their co-assistants story
throughout their life as a medical student.

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CHECKLIST
Interpersonal Communication Checklist

Important things in interpersonal communication:

Communicator and communicant meet up face to face
The communication takes place between 2 persons
Verbal and non-verbal communication also emphaty
Using language which is relevant and comfortable with each other.
No
.

Interpersonal
Communication
Skills

I. Ice breaking
1. Greeting
2
4.
6.
7.
II.
8.
9.
10.
11.
12.
13.
14.

III
15.
16.
17.

Parameter

Score
0123

Assalamu`alaikum wr wb; good morning

Asking news
how are you mr/ms?
Creating a
comfortable
circumstance
Asking open-ended how do you experience in getting medical school?
question
Asking feedback
I feel nervous since this is my first skill lab, how
and response
about you?
Non-verbal Communication
Eye contact
Keep eye contact, comfortable and natural look
Face expression
Relax face
Show some interest and attention;
Mouth
Relax and smile
Body language
Relax, natural, comfortable & open body posture;
Facing the patient/client with 45 degree angle
Hands and feet
Relax, natural, comfortable and open body posture
movement
Appearance
Clean and neat clothes
Speech
Clear articulation, appropriate tone, not too loud or
too soft
Appropriate use of word and phrase
Communication with empathy
Present at the
Show seriousness in listening the conversation from
conversation
mental and physical aspect
Actively listening Showed by reflecting steps below
Reflecting Skills
Reflection skills showed that there is an empathy
Reflecting content Paraphrasing (Restate what the communicant has
said with other words without changing the meaning
of the statement)

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Perception Checking (Asking question about things

that are still unclear from what the communicant has
said, and not a new information)
18. Reflecting Feeling Asking/reflecting the feeling that might be feel by
communicant eventhough might not be feel
explicitly.
You look sad/angry/disappointed/happy about.....
19. Reflecting
Asking/reflecting experiences/behaviour
Experience
communicant in discussion process.
I saw that you always crumpled your hand/looking
out the window, could you tell me what was behind
it? What did it mean?....
TOTAL
SCORE = 42
0 = never done 1 =done but not well 2 = well done 3 = perfectly done

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