Key Links to TLM1010 Tri1 2020

Symbaloo Page: https://www.symbaloo.com/mix/tlm10102

The module Google Docs page: https://drive.google.com/drive/u/1/folders/1sSHTpj6ekjOKSEnBLAFWzhZ0QxsGlK__ 

Clinician-Patient Workshop for Year 1 Diagnostic Radiographer & Radiation Therapist SITzens

 

Increasingly clinician-patient communication is considered a vital component for effective health outcomes. Healthcare providers too now stress on patient-centered treatment for patient/customer satisfaction. For example, as education providers, we need to design our program keeping the students in mind and tailor it as per their requirements, and feedback.

Research in the last decade suggests placement of communication as the cornerstone for better healthcare delivery and outcome. Interpersonal communication between patient and provider influences “accurate diagnoses, understanding of the problem, likelihood of following treatment, and recovery process” (Duggan, 2006, p.94).  It is essential to understand that, at every stage of their journey, patients look towards providers for a variety of information, and addressing them promotes a healthy atmosphere and reduces the chances of disruption (Arora, 2003; Rose, 1990).

 

The communication process in the health landscape is far more complex than other industries, and thus assumes an even greater significance (Arora, 2003). Clinicians need to develop excellent communication strategies and tactics to deal with patients of diverse nature and various backgrounds. For example: In corporate companies, if one has a client-facing role, that person has to understand the requirements of the clients and work towards it. Businesses run on projects given by clients and hence is of utmost importance. However, the clientele of a company is homogenous to a great extent. In the healthcare industry, a group of patients might have similar symptoms, but there are various nuances involved. The communication process with patients is influenced by various factors that are heterogeneous in nature and varies from patient to patient such as their socio-economic condition, cultural beliefs, attitude towards western medicine, understanding of medical jargon, educational background etc. In short, clinicians need to be excellent communicators with a broader understanding of the various nuances that impacts a patient’s health outcome. In a multicultural society such as Singapore, clinicians should be extra cautious regarding cultural sensitivity.

 

Given the significance of communication in the healthcare setting, the ultimate goal of the workshop is to understand the need for effective communication for patient care and develop skills that are required for effective communication. Developing interpersonal communication skills and strategies is the focus of this workshop along with preparation for their vodcast assignment. The vodcast will demonstrate two scenarios: one on effective communication, and the other on ineffective communication. The content of the vodcast will be critically analyzed by the project group.

The aim of this workshop is to:

·      understand the essence of communication in a healthcare setting;

·      reflect critically on the need for effective clinician-patient communication;

·      understand the possible challenges in clinician-patient communication;

·      develop communication strategies and tactics for effective communication;

·      refine further the communication skills

·      make a video demonstrating effective and ineffective communication;

·      analyze the video critically through oral presentation.

The Nature of Clinician-Patient Communication:

 

Effective clinician-patient communication is vital for effective health delivery. It is crucial for better health outcomes, patient satisfaction, and clinician’s job satisfaction. Indeed, learning to communicate effectively is a learning journey. However, in this workshop, we will layout the broader understanding of interpersonal communication in the health landscape—the importance of such communication, potential barriers, and challenges—along with an explanation of fundamental skills to improve communication for future purposes. This workshop will provide both theoretical underpinnings of communication along with hands-on activities for a better understanding of the implementation of these concepts in our daily lives.

 

Interpersonal communication among clinicians and patient is central to the doctor-patient relationship. In the last decade, there has been growing stress on patient-centered care and the share of power with patients. Health communication scholars highlight that through shared power, patients’ needs, beliefs, and preferences surface that often facilitate the desired health outcome. For example, patients who more actively influence the content and structure of the interaction also indicate better health outcomes (Duggan, 2006).

The core communication skills for better health outcomes are information sharing, interpersonal sensitivity, and partnership building. However, it is essential to understand that the efficiency of these skills is dependent on the nature of a clinician-patient relationship. In the context of radiation therapists and diagnostic radiographers, such relationships might be long-term, hence might require much investment. For instance, even in our daily life, our interpersonal communications differ from person to person—in terms of length, quality, depth, and emotional interplay—and has a broad spectrum. It depends on how much time one has invested in cultivating a relationship; based on the nature of the relationship interpersonal communication usually continues.

                                          

Dr. Stephen Sanders, a physician, explains the importance of the clinician-patient relationship.

Medical Communication between Clinician and Patient

 

In the healthcare setting, the relationship between the clinician and the patient is complex in nature, and the communication that occurs between them is a higher-level therapeutic communication. This is because the communication is connected to the patient’s destiny intertwined with elements of uncertainty and individual instability. For instance: even for a simple visit to our dentist, as a patient, you and I hope for clarification regarding our medical condition and some level of assurance. Clarification regarding our medical condition is often complex in nature due to various factors, and lack of understanding of the subject is one of the primary reasons along with emotional factors such as fear and anxiety.

 

Complexity of Clinician-patient relationship – Power Relations

 

The process of communication exists within a setup of complex relationships where lies the interplay of power. For effective communication, one needs to be aware of the power differentials that shape the communication process. As clinicians, the students have to understand the effects of power within the healthcare structure.

 

In healthcare structure, the clinician represents a position of power and authority with a vast knowledge of medicine; the patient is the one in need of the clinician’s expertise to cure them of their illnesses (Chichirez & Purcărea, 2018).

 

The clinician is considered as an active element in this relationship with considerable power, high status, often full of energy, and sometimes viewed as the one with magical powers. On the other hand, the patient is a passive element, grappled with fear and anxiety, lack of knowledge about the illness intruding their body. For the clinician, the disease is a scientific and objective problem, whereas for the patient it is a subjective and emotional problem. Hence, the foundation of this relationship is based on an asymmetrical and consensual ground. Thus, as a clinician, while interacting with the patients, one needs to be aware of these power differentials for effective interpersonal communication. Communication does not happen in a vacuum; it largely depends on the fundamental nature of relationships (Chichirez & Purcărea, 2018).

 

Research suggests that there are primarily three situations in the doctor-patient relationship:

• activity-passivity - the doctor is active, and the patient is passive;
• managing-cooperation - the patient follows the medical advice;  
• mutual participation - the doctor guides the patients and the patient participates in understanding the medical problem (Chichirez & Purcărea, 2018).

 

For example, in activity-passivity, the patient might not follow medical advice and discontinue treatment, whereas in managing-co-operation the patient follows the doctors’ advice. Although this literature suggests these three situations in the context of the doctor-patient relationship, this can be applied in the clinician-patient setting too. Mutual participation is the ideal where both the entities decide as a team, thus ensuring maximum health output. 

Sensitivity to the cultural traditions of the patient is essential for effective communication. The clinician is the one who needs to be respectful of the patients’ cultural beliefs/attitudes and strive towards cultural competence. Greater cultural competence of physician communication leads to the empowerment of patients and fosters patient proactivity.

 

For instance, during the initial COVID-19 outbreak among the migrant workers staying in dormitories, hospitals in Singapore called the doctors of Bangladeshi origin back to work. For example, Dr. Muntasir Mannan Choudhury, whose name has become very popular among the Bengali migrant workers of Bangladesh origin, came back from overseas where he was on training after getting a call from the authorities.

 

Refer to the news article by Asia one for more details- https://www.asiaone.com/singapore/you-are-one-us-skh-doctor-comforts-migrant-workers-stuck-their-dorm

 

For mass communication, Dr. Muntasir used a loudspeaker in the dormitories to communicate in Bengali with the migrant workers. His message aimed at giving support and hope to the workers by saying that they did not have to worry and panic since the doctors were there to help them. According to the workers, this message in Bengali provided solace to many of them.

 

It is imperative to remember that positionality as a clinician provides one with a unique vantage point to shape the communication process to a great extent. Research also suggests a relational approach during interaction with patients such as paying more attention to emotional needs, nurturant discourse management, and emotional expression in interpersonal sessions (Duggan, 2006). As radiation therapists and diagnostic radiographers, the treatment involved is invasive in nature; hence, there is a greater need of creating an environment where patients can communicate openly even if communication happens for a short period of time.

References

 

Arora, N. K. (2003). Interacting with cancer patients: the significance of physicians’ communication behavior. Social science & medicine, 57(5), 791-806.

 

Chichirez, C. M., & Purcărea, V. L. (2018). Interpersonal communication in healthcare. Journal of medicine and life, 11(2), 119.

 

Makely, S. (1990). Methods for teaching effective patient communication techniques to radiography students. Radiography today, 56(638), 14-15.

 

Rose,J.H.(1990). Social support and cancer: Adult patients’ desire for support from family, friends, and health professionals. American Journal of Community Psychology,18, 439–464.