Created in Canva
SKILLS COMMUNICATION2026 - 2027 P r e p a r e d b y : C L I N I F Y P L U S C L I N I F Y
communication skillsسﺮﻬﻔﻟا Content Page Chapter 1 [ Effective Communication skills ] 1 Chapter 2 [ Types of communication ] 8 Chapter 3 [ Rapport with children ] 17 Clinify plus
communication skillsClinify plus page 1 1st chapter (Effective Communication skills ) Definition of communication skills: In General: It is a process of sharing information (one person gives to or receive from another person certain information ) In dealing with the patient: Effective communication skills provide kind, natural, friendly and comfortable manner in dealing with the patient for successful patient care and good doctor patient relationship. Definition of Rapport: “effective communication in harmony with the patient” .Rapport is most easily established during the patient's first visit, and achieving rapport enhances the likelihood that the patient will comply with the treatment plan. The element of the communication: sender message receiver channel feedback
communication skillsClinify plus page 2 The element of the communication Importance of effective communication skills : 1. Enhances the patient’s compliance with the treatment plan. 2. The patients are more likely to forgive a less than perfect experience or an unexpected poor clinical outcome. 3. Increases the patient's satisfaction 4. Decease the complaints against physicians which occurs as result from a breakdown of the caring aspect of the doctor-patient relationship more than from the technical quality of treatment. 5. Establish important issue in human dealing as respect and dignity in general and maintain confidentiality and dealing with compassion for patient in specific
B- Opening the session Before entering Help Great your patient Hand shakingcommunication skills Clinify plus page 3 Principles of Communication skills: 1. A good first impression 2. Dealing with patient 3. Achieving rapport A- Doctor appearance White coat Smile of the doctor Sitting posture Environment Introduce yourself Maintain eye contact Give him sense of interest New patient A) Patient education B) Summarization or Paraphrasing C) Concluding the history D) Confidentiality E) Confrontation when needed 1) Respect 2) Active listing to your patient 3) Develop rapport with the patient
communication skillsClinify plus page 4 1. A good first impression: N.B Remember: You do not get a second chance to create a first impression. A- Doctor appearance : White coat gives positive attitude from the patient to the physician. Keep it clean Smile of the doctor helps in quick establishing friendly atmosphere and break down barriers Sitting posture should be erect with head up to appear alert. B- Opening the session Before entering the examining room or hospital room to see a patient, review the record briefly and become familiar with the patient's name and its proper pronunciation. Pronouncing the patient name in right way, you should review the patient file before starting with him to be familiar with his name. Help in opening the door and assisting patients, if unable to walk (especially elderly patients) shows a consideration that aids in establishing and maintaining rapport. Great your patient and call him with his name with considering age variations, Ask your patient how he or she prefers to be addressed, and adding a title to his or her name, if preferred, will indicate your interest in the patient and show that you care (Miss, Misses , Mr., Dr., Engineer , ................)
communication skillsClinify plus page 4 Hand shaking : Help in breaking ice , with preservation of cultural background Environment: Avoid barriers between you and your patient as a desk or a examination tool or your bag. Introduce yourself : ( name and position ) / insure confidentiality / Ask for permission to continue with the interview in the presence of others. For example, you may say, “Miss. Sara. Is it okay for me to speak to you in presence of your family / friend in the room or would you prefer to be alone while we talk?” Even ask for permission to your senior colleague even if you will discuss the patient case . Maintain eye contact with your patient as lack of eye contact may be interpreted as a lack of concern Give him sense of interest by revision of his pervious visit. New patient: When meeting a new patient, the method used to address the patient during the introduction can help establish rapport by conveying an atmosphere of mutual respect. Greet the patient warmly with a handshake and a smile while maintaining eye contact. Use the patient's name during the introduction, during the interview, and on leaving. An appropriate introduction would be, “Good morning, Mrs. ..........., I'm Dr........., and I'll be taking your medical history and examining you today.” It is also better to show concern for the patient with an opening statement such as “How can I help you?” rather than “What brings you here today?”
N.Bcommunication skills Clinify plus page 1 2) Dealing with patient : Respect your patient as a human , with no consideration to position or stander of living 1/ Respect with Patient : Physician should takes patient complain seriously (even if emotional or psychosomatic The physician should listen to the patient's fears and comments. Answer patient questions and deals with his fear about his disease . Patients should believe that their comments are being listened to and taken seriously. They must believe that the physician values their comments and opinions before trusting him or her with personal information. If the physician has negative feelings toward a patient, an extra effort can be made to avoid showing signs of anger 2/ Respect with colleagues : Respect your colleagues and other stuff (nurse , workers and technicians) who are working with you : Patients find it difficult to respect a physician who is making negative statements about other people or other physicians. Any comments that can be interpreted as “building yourself up by tearing someone else down” leads to a reverse effect 1) Respect:
Active Listening Hearing Active Listening is (hearing , understanding, remembering, interpreting , evaluating , and responding) Hearing (receiving sounds through air without efforts ) as one of special senses doesn’t mean listening . Listening needs to make sense of what’s heard and the actual meaning is oriented.communication skills Clinify plus page 1 2) Dealing with patient : 2) Active listing to your patient : A good physician must be a good listener. The ability to listen well is the most important part of communication with the patient The skilled physician can spend 10 minutes with a patient, but the patient feels it was 20. This is far better than the physician who spends 20 minutes but leaves patients feeling that the physician was in a hurry and that they were encroaching on the physician's precious time every minute of the visit. The skilled physician : N.B Importance of active listening: Respect and trust Improve rapport with the patient Reduce negative impression Increases confidence
communication skillsClinify plus page 1 Barriers to effective listening: Selection what do you want to know and ignore other words (Biased listening) Interruptions as phone calls , loud noise Time pressure , clock watching Talker not speaking loudly enough Threatening , judging and giving opinion Essentials of active listening: 1. Stop talking : give the patient space , time and permission to speak 2. Look at you patient, maintain eye contact , node when you agree or ask question for more explanation . 3. Silence, avoid interrupting your patient to encourage him to continue. 4. Watch your own emotions and facial expressions 5. Offer reassurance, and reduce patient anxiety by statements like (Don’t worry). 6. Don’t criticize , argue or disagree 7. Don’t comment by (yes) before the sentence is finished or the point made. Frequent comment by “yes” conveys disinterest or impatience 8. Facilitating Techniques patients can be encouraged to talk further with simple comments such as “And then?” or by repeating a portion of the statement just made
communication skillsClinify plus page 1 2) Dealing with patient : 3) Develop rapport with the patient: N.B Rapport comes from the French en rapport, which means “in harmony with.”= Good doctor patient relationship The physician should deal in a bedside manner (Compassion, interest ) ,So : The physician with the best bedside manner is the one who makes no special effort to communicate these feelings but acts in a concerned, natural, and comfortable manner. Patient rapport is achieved by good communication with the patient which gives him sense of confidence and trust in his physician. This is could achieved by : Efforts of the physician to educate the patient regard his illness, the meaning of the diagnosis, management plan, prognosis and cost of the treatment increase rapport with him. Try to answer all questions of your patient. Repeat information many times to him A) Patient education: 1. Patient becomes more satisfied with their medical care when they feel that they give them information about every aspect of their health care. 2. Help people to maintain healthy practice and change their unhealthy habit. 3. Reduction of unnecessary office visit and phone contact. Importance of patient education :
communication skillsClinify plus page 1 Paraphrase important issues , summarize the conversation and reflecting what you understand Summarization is a brief restatement by the physician, of what the patient has said B) Summarization or Paraphrasing: 1) It demonstrates the physician's interest in the patient's history and efforts to collect the facts. 2) A summary gives the patient an opportunity to add more details 3) Lets the patient knows that the physician was listening. The physician can restate what the patient has said and emphasize the important points to ensure clear understanding. 4) Summarization ensures that physician and patient are using the same definitions and gives the physician and the patient a chance to correct errors or misunderstanding. 5) Summarizing is also a subtle way of focusing on the important facts in the history without asking closed-ended questions that may inhibit the patient. 6) A summary also can be used to change the subject when the physician wants to move on to another topic. Importance of summarization and paraphrasing : To avoid leaving gaps in the history or allowing patients' concerns to go unattended, it is wise to conclude every complete history with “Is there anything else you would like to mention?” or “Is there anything that we have not discussed?” C) Concluding the history :
communication skillsClinify plus page 1 ex: why you look un happy? Or why are you nervous? E) Confrontation when needed : Confidentiality is a cardinal principle of professionalism. Effective communication requires that the patient feel secure in the knowledge that all information will be kept strictly confidential. It is the ethical responsibility of each physician to maintain this bond of confidentiality. Assurance that all information and actions will be kept confidential is especially important when dealing with adolescents. They may not be aware of this basic ethical principle in the medical profession or realize that it applies to them. They must be secured completely for fear that parents or peers may find out. Complex problems of confidentiality can arise for the physician who cares for several members of the same family. Unfortunately, information sometimes may be offered only on the promise that it will not be disclosed to the patient. Physician should avoid to discus patient case or with other doctors which increase his fear about his illness. D) Confidentiality :
communication skillsClinify plus page 1 ولﻷا ﺮﺘﺑﺎﺸﻟا رﻮﺻ White coat and smile Sitting posture Help
communication skillsClinify plus page 1 ولﻷا ﺮﺘﺑﺎﺸﻟا رﻮﺻ Hand shaking Environment Active listing Maintain eye contact
communication skillsClinify plus page 1 Types of communications A) Verbal communications: B) Nonverbal communication (unspoken communication): C) Hidden agenda or masked communication: Open-Ended Questions Closed-Ended Questions Idea Concern Expectations a) Paralanguage b) Empathy c) Touch D) Body language 1) Body Position 2) Head position 3) Facial expression 4) Hands 2nd chapter ( Types of communications )
communication skillsClinify plus page 1 Types of communications A) Verbal communications B) Nonverbal communication (unspoken communication) C) Hidden agenda or masked communication Most of communication in the clinical practice depends on verbal interchanges (symptoms- past medical history –family history- psychological data …..etc.). How to do appropriate verbal communication? 1. Clear, easy and accurate words. 2. Language corresponding to the patient level of understanding. Consider the patient culture background and educational level 3. Avoid medical terms and medical jargon except if it’s well known to the patient. Physician interview and prescription shouldn’t contain medical terms 4. Physician should avoid using slang or a different accent, because the patient will detect the artificiality and consider this patronizing. 5. Metaphors can be harmful as it raises the patient's anxiety level. If he asks you about his heart sound don’t reply “it’s like a music.” If he asks you about his health don’t reply ”your are like a lion. “
communication skillsClinify plus page 1 How to do appropriate verbal communication? 6. Repeat many times and ask for feedback from the patient. 7. Make sure that the patient words give the right meaning (ex: if he said I vomit a lot of blood ask, did it fills a cup? 8. Humor: Can be helpful in establishing rapport and can strengthen the doctor-patient relationship. It can be used to break the ice. Tasteful humor can reduce anxiety and create a bond of friendship, but humor used inappropriately can magnify the distance between patient and doctor, especially if it belittles the patient. 9. Ask him well chosen questions and use open ended question (could you tell me about …, what do think ...?) more than closed ended one which answered by yes or no. closed ended questions limit the patient’s response to just a specific answer . ﻊﺑﺎﺗ Open-Ended Questions: Probably the single most valuable rapport-promoting element of verbal communication is the use of open-ended questions at the onset of an interview. “Tell me more about it” is an interview technique and a state of mind. For example, you can start the interview by asking an open-ended question, such as “How are you feeling today?” instead of a closed- ended question, such as “Are you feeling well today?” The first approach allows for the patient to answer in free form and possibly give you more detail about the condition of his or her health, whereas the second way leads the patient to answer with either a yes or no. This type of questions create an atmosphere of sensitivity and interest that contributes greatly to the early establishment of rapport.
N.Bcommunication skills Clinify plus page 1 Once the broad outlines of the patient's situation are covered , detailed questioning starts (closed ended questions). Closed ended questions: Closed ended questions are specific questions need specific answers. The physician may wish to use this it when dealing with patient who refuses to stick to the point or when specific information is needed. Close-ended questions used also if you want to know specific information that helps you in diagnosis or management. Leading questions: Leading questions are those that suggest a particular answer. Leading questions should be avoided, an example of a leading question is “You do not smoke any more , do you?” By phrasing the question in this manner, the patient feels obliged to say, “No, I don’t” because the question give sense that the patient should not be smoke, and, rather than contradicting your expectation, the patient merely agrees. N.B
communication skillsClinify plus page 1 Types of communications A) Verbal communications B) Nonverbal communication (unspoken communication) C) Hidden agenda or masked communication Nonverbal communication is the sending of messages to or from your patient without the use of words. Communication between two people is usually one-third nonverbal. What is said verbally often is emphasized nonverbally, and personal attitudes and emotions usually are communicated at the nonverbal level. This type of communication plays an important role in your interactions with your patients because it can be as powerful as the words that are spoken. B) Nonverbal communication (unspoken communication) a) Paralanguage b) Empathy c) Touch D) Body language 1) Body Position 2) Head position 3) Facial expressions 4) Hands ”ﺔﻳﺎﺠﻟت اﺎﺤﻔﺼﻟا ﻲﻓ هﺪﺣﻮﻟ انﻮﻨﻋ ﻞﻛ حﺮﺸﻨﻫ“
communication skillsClinify plus page 1 a) Paralanguage b) Empathy c) Touch D) Body language (The effect of voice or emotions beyond the words): Velocity of speech (fast , slow ,hesitant) , tone of voice, grunting and pausing . The quality of the voice reflect sincerity, confidence, hesitations, sadness and other emotion between both doctor and patient . When you express empathy, it allows your patient to feel as though you understand his or her unique experience. Sympathy is when you feel sorry for the patient but do not feel the same emotions, whereas empathy is when you place yourself in your patient’s situation and respond based on either similar personal experiences or through vicarious understanding. Shaking hands helps to establish early communication with the patient and break barriers. It is a traditional greeting between friends. Sometimes it shows empathy . Touching can be an effective method for communicating concern or compassion and can break down some of the defensive barriers to communication. Caution should be exercised, however, not to use it if it socially not permissible. (It is the study of body movement and its meaning regarding communication) The physician should be able to read patient's movements. When there is congruence between the verbal and nonverbal message—when the gesture conveys the same message as the spoken word— communication and its meaning are almost sure to be in agreement. When a person indicates something different from the other, however, the nonverbal message usually is more accurate. Attempts by the patient to mask feelings can be detected readily by observing body behavior.
communication skillsClinify plus page 1 1) Body Position 2) Head position 3) Facial expressions 4) Hands Lean forward and rotate towards your patient, look to him to detect sense of fear in his eyes. Tense patient sits erect with rigid posture, while relaxed patient is leaning forwards or backward. Higher patient satisfaction is associated with a physician's forward body lean and rotation of the torso toward the patient. The patient also responds more favorably to the physician who relaxes his chin in his hands and gazes directly at the patient, rather than a physician who elevates his chin (unsupported) as if to imply a more superior status.” Regarding the patient : His head is down in sadness, sham or guilt back in fear and anxiety. The erect head indicates self-confidence and maturity can reflect patient emotions (anger, fear, sadness, happiness…) Maintain eye contact makes the patient more comfortable, if your patient doesn't look to you, he may be depressed or sham dropped or flaccid in sadness, grasping in anxiety, frequent shaking in an anxiety, clench hands in front of the mouth in doubting patient and raising index finger means urge to interrupt. Examples of body language : different positions of hands: The hands of an anxious patient can be observed to shake when holding a pen or cigarette. Nose Rub: This involves a light or subtle rub of the nose with the index finger and signals rejection of a statement being made by the subject or by another individual.
communication skillsClinify plus page 1 A patient listening in “The Thinker” position, with the index finger across the lips or extended along the cheek, or one sitting with elbows on the table and hands clenched in front of the mouth, although listening intently, may not be buying what the physician is saying . Take additional time to amplify the issue or explain the diagnosis or treatment regimen further. Crossed arms can be a defensive posture, indicating disagreement with another's view. It can also be nothing more than a position of comfort and should, as with all other signs, be considered in the context of the individual's total behavior. ﻊﺑﺎﺗdifferent positions of hands: If the patient has assumed a position of resistance or defensiveness, sitting with arms and legs crossed and perhaps with body turned away, search for the reason for this defensiveness and try to eliminate it. Perhaps a recommendation that the patient stop smoking is threatening and difficult to accept. In that case, it is important to make an additional effort to explain the rationale for the recommendation; do not hurry over it with a brief comment or admonition. The Watch Watcher : The person looks at his/her watch or a clock in the room. The person wants to end the conversation. He says “I have better to do. Let me go.” by this sign. The Eye Wiper : One or more finger rubbing over the upper or lower eyelid. The person feels uncomfortable and wants to avoid/flee the situation. “Can we please talk about something else?” The person interrupts eye contact because he/she wants to avoid hearing or seeing
communication skillsClinify plus page 1 The Neck Massager : The person massages and squeezes the neck. It indicates Stress The person feels uncomfortable. “I don’t like this.” ﻊﺑﺎﺗdifferent positions of hands: C) Hidden agenda or masked communication Types of communications A) Verbal communications B) Nonverbal communication (unspoken communication) The patient may think that his minor complain as serious condition, cancer for example so if you feel that your patient is not satisfied about the simple diagnosis ask him about his fear and expectations about that. The patient may give doubt symptoms and he tells that his friend is suffering from myocardial infarction for example so the physician should know the real motivation in seeking medical care. Ask your patient at the end of the visit if he wants to tell you any thing else or if he had any other question. C) Hidden agenda or masked communication a) Idea b) Concern c) Expectations
communication skillsClinify plus page 1 C) Hidden agenda or masked communication: Idea : The patient may think that his minor complain as serious condition , cancer for example so if you feel patient unsatisfaction about simple diagnosis ask him about his fear an expectations about that. Concern : The physician should know degree of concern and the real motivation in seeking medical care Needing sickness leave. Concern about family caring in case of illness. Test for the physician : tell complain as he fears of another thing Expectations: Expect for more details Expect for investigations or medications ( as tonics for example) Expect for referral: - Communicate with patient’s family helps for successful care: Assure their support to the patient, they may be important source of information, They support the patient in following management plan as (diet, exercise, period of rest and time of medications).
communication skillsClinify plus page 1 ﻲﻧﺎﺜﻟا ﺮﺘﺑﺎﺸﻟا رﻮﺻ Body Position Touch Facial expressions
communication skillsClinify plus page 1 ﻲﻧﺎﺜﻟا ﺮﺘﺑﺎﺸﻟا رﻮﺻ The Thinker position a position of resistance or defensiveness Nose Rub
communication skillsClinify plus page 1 ﻲﻧﺎﺜﻟا ﺮﺘﺑﺎﺸﻟا رﻮﺻ The Eye Wiper The Neck Massager The Watch Watcher
communication skillsClinify plus page 1 Rapport with children : White coat may annoy the children Examine mother's ear or older sibling before examine the child Let him handle the stethoscope or the otoscope Simple rewards can make the physician office a place of interest for the child. 3rd chapter ( Rapport with children )
communication skillsClinify plus page 1 ﺔﻤﻬﻣ ﺔﻘﺑﺎﺳ ﻦﻴﻨﺳ ﺔﻠﺌﺳأEnumerate : 1- List four types of listening ? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 2- Enumerate Five tips for communicating with older patient ? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 3- Enumerate 2 examples of technology used in medicine ? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 4- Enumerate Four complications of poor team communication in healthcare ? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 5- List ( 7 ) principles of communication? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................
communication skillsClinify plus page 1 ﺔﻤﻬﻣ ﺔﻘﺑﺎﺳ ﻦﻴﻨﺳ ﺔﻠﺌﺳأEnumerate : 6- Enumerate How to establish Rapport with children? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 7- Enumerate Principles of patient education? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 8- Enumerate(4 )essential requirements for active listening? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 9- Enumerate components should be included for Effective team communication in healthcare? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ 10- Mention (5)Barriers of Communication? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ ........................................................................................................................
communication skillsClinify plus ﺔﻤﻬﻣ ﺔﻘﺑﺎﺳ ﻦﻴﻨﺳ ﺔﻠﺌﺳأ page 1 problem solving : Doctor : Hello, Mr. Ahmed. "How may I help you?" (1) Patient : My hand becomes red and itchy Doctor : When did the situation start ? (2) Patient : Since yesterday Doctor : And you've never experienced anything like this before? Is it right? (3) Patient: Yes A. Choose the appropriate questioning technique matching with each question number ? Closed question → ............... Probing question →.............. Open end question →........... B. This ordering in questions is called ? ............................................................................................................................. Mr. Ahmed is a visual impaired person who came to a doctor with his son for a consultation on health issue. Doctor: welcome Mr. Ahmed, I hope you doing well. Mr. Ahmed :unfortunately, I have a health problem. Doctor: Do you have pain? Mr. Ahmed: yes! Doctor: oh, l feel sorry about that (and doctor start to touch Mr. Ahmed gently to show empathy but that surprise Mr. Ahmed ) Doctor to Mr. Ahmed son : you should give him these medications to relieve his pain. 1) Enumerate 3 mistakes done by doctor in this session? ........................................................................................................................ ........................................................................................................................ 2) Mention main point in strategy for dealing with visual impaired patient. ........................................................................................................................
communication skillsClinify plus ﺔﻤﻬﻣ ﺔﻘﺑﺎﺳ ﻦﻴﻨﺳ ﺔﻠﺌﺳأ Doctor : Hello, Mr. Nader . "How may I help you?" Patient : I have an abdominal pain since yesterday after eating junk food. Doctor :Describe what did you eat yesterday ? (1) Patient : I ate burger from a street food car. Doctor : Don’t eat any junk food any more. (2) Patient: ok!! Doctor : I will write some medication you should take now after session. Patient: ok, but I wonder if that pain is due to junk food. Doctor : not important just take the medication. a) Fill in space with appropriate words : 1- Type of question technique in (1) is : ........................................................................................................................ ........................................................................................................................ 2- Type of tone used by doctor in (2) is: ........................................................................................................................ ........................................................................................................................ b) Mention types of tone and which one is preferred in communication? ........................................................................................................................ ........................................................................................................................ ........................................................................................................................ page 1 problem solving :
communication skillsClinify plus page 1 ﺔﻤﻬﻣ ﺔﻘﺑﺎﺳ ﻦﻴﻨﺳ ﺔﻠﺌﺳأMatch : Choose the best terminology of effective communication skills which describe the following: 1- If the patient develops good relationship with the patient. 2- A comfortable distance when speaking to patients. 3- Crossed arms or legs when talking to the patient. 4- Put the idea into some form that can be communicated. MessageRapport Body language awareness Proxemics Choose: a) "Eating so many cheeseburgers every day for the past five years could be a contributing factor in your high blood pressure. Cheeseburgers contain a lot of sodium, and sodium is often associated with high blood pressure” b)"Eating so many cheeseburgers is going to make you fat and give you a heart attack. Is that what you want?” c) Don’t miss a single dose of this pill .If you do infection won't go away and you will feel even worse. Problem solving toneExpressive toneDirective tone
communication skillsClinify plus page 1 ﺔﻤﻬﻣ ﺔﻘﺑﺎﺳ ﻦﻴﻨﺳ ﺔﻠﺌﺳأMatch : According to effective steps of listening Choose from A which is suitable for B ?? a) Getting the information through hearing b) Decoding the information to find its meaning c) Storing away the information for later use. Also, retrieving previous information so that the response can be formed d) Examining the message and deciding what is the response e) Forming and sending out the response message EvaluatingRespondingUnderstandingReceivingRemembering