COMMUNICATION MANUAL Short Description and Rationale Short History

1. COMMUNICATION BASICS BASICS OF ORAL INTERPERSONAL COMMUNICATION Definition of Communication Language Conscious vs. Unconscious Communication Transactions vs. Interactions Communication Channels The Communication Model The Processing of Information Communication Skills Effective Person-to-Person Communication: Some Characteristics Effective vs. Ineffective Person-to Person Communication Efficient vs. Inefficient Communication Quality of Communication Learning to Increase Your Communicative Competence Communicative Competence and Ethics

2. COMMUNICATION IN HEALTH CARE COMMUNICATION IN HEALTH CARE A Variety of Contexts Causes and Consequences of Misunderstanding Language or Culture Communication and Professional Status Learning to Communicate with MoM

3. STRATEGIES AND SKILLS COMMUNICATION STRATEGIES AND SKILLS Introduction The Patient-Centred Model of Medicine The Two-Tier Track Model of Consultation The Triad of Ideas, Concerns and Expectations (The ICE Triad) Appropriate Verbal Language. Understandable Language. Concrete and Unambiguous Language. Tactful Language. Appropriate Non-Verbal Language Active Listening Active Listening as Attentive Listening Basic Skills of Active Listening Structuring the Consultation MoM’s Structure of The Consultation The MoM Table of the Consultation Content, a timeline Structuring Skills: The Mind Map of The Consultation Relationship building Skills Background Basic Strategy: Being The Doctor The Patient Is Expecting Skills

4. CONSULTATION SKILLS Introdution

4-I. INITIATING THE SESSION INITIATING THE SESSION: GREETING AND ESTABLISHIN RAPPORT Background for greeting and establishing rapport Strategy for greeting and establishing rapport Tips for greeting and establishing rapport Prepare yourself to be in the right mood Prepare yourself to be ready to give full attention to the patient Have the consultation room prepared Smooth out any unpleasantness Entrance of the patient Social non-verbal contact Social verbal contact Naming

4-II. INFORMATION GATHERING INFORMATION GATHERING 2.1 Initiating Information Gathering Background for patient’s opening narrative Eliciting patient’s opening narrative: the opening question Listening to patient’s opening narrative Exploring Patient’s Perspective Picking up cues Recognising a patients’ internal search Responding to cues Asking directly for patient’s perspective Asking directly for patient’s personal, social and occupational circumstances Agenda screening Agenda setting 2.2. Exploring the biomedical perspective of patient’s problem(s) and the contex Background Exploring the biomedical perspective of patient’s problem(s) is your – the doctor’s – agenda Sequence of events Eliciting patient’s narratives Listening to patient’s narratives Symptom analysis: the analysis of symptom dimensions Relevant systems review Exploring the (relevant) background and context information 3.3. Closing information gathering

4-III. THE PHYSICAL EXAMINATION THE PHYSICAL EXAMINATION Talk the patient through the procedure Background -for communication during the physical examination Procedural Strategies Relational strategies Tips -ordered thematically - for communication during the physical examination

4-IV. EXPLAINING AND PLANNING EXPLAINING AND PLANNING 4.1 Explaining differential diagnosis-hypothesis A specific strategy for explaining the diagnosis 4.2 Explaining plan of management 4.3. Planning with patient 1 Negotiating the planning 2 Enabling the patient to manage his problem

4-V. CLOSING THE SESSION CLOSING THE SESSION 5.1 Forward planning: contracting and safety netting Background Tips for contracting Tips for safety-netting 5.2 Appropriate point of closure: end-summary end final checking Background Strategy 5.3 Farewell Strategy for bidding farewell Tips for saying farewell

5. SPECIAL CHALLENGES SPECIAL CHALLENGES IN MEDICAL COMMUNICATION Background General strategies Specific strategies and skills The specific approach of the silent patient The specific approach of the confused patient The specific approach of the patient with altered capacity The specific approach of the talkative patient The specific approach of the emotional or crying patient The specific approach of the angry patient The specific approach of the aggressive patient The specific approach of the older patient The specific approach of children and their parents The specific approach of the patient with impaired hearing The specific approach of the patient with impaired vision The specific approach of the patient with moderately limited intelligence The specific approach of the patient with severe mental retardation The specific approach of the patient with personal problems The specific approach to bringing bad news The specific approach to conflicts with patients The specific approach to patients in telephone consultations The specific approach to when consulting and communicating with the help of an interpreter Addendum about Counselling