DR.T.V.RAO MD 1

Dr.T.V.Rao MD

SKILLS IN MEDICINETO BE A BETTER TEACHER / DOCTOR

DR.T.V.RAO MD 2

COMMUNICATION SKILLS PROBABLY THE MOST IMPORTANT SKILL IN MEDICINE

FOLLOW HIPPOCRATIC OATH

• I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.

• All that come to my knowledge in the exercise of my profession or in the daily commerce with men, which ought I not to be spread abroad, I will keep secret and will never reveal.

DR.T.V.RAO MD 3

MEDICAL SKILLS THE MOST IMPORTANT SKILL IN MEDICINE

DUTIES OF ANY DOCTOR

• Support patients in caring for themselves to improve and maintain their health

• Work in partnership with patients

• Listen to patients and respond to their concerns and preferences.

• Give patients information in way they can understand

• Taking patient’s views into consideration when assessing their condition

• Respond to patients questions and keep them informed about how information is shared within teams.

• Support patients to self care

• Treat patients politely and considerately

• You must make sure, wherever practical, that arrangements are made to meet patient’s language and communication needs.

• Respect patients rights to confidentiality

• You must be considerate to relatives, carers and partners be sensitive and provide information and support.

DR.T.V.RAO MD 4

COMMUNICATING WITH COLLEAGUESI THE MOST IMPORTANT SKILL IN MEDICINE

DUTIES OF ANY DOCTOR

• Communicate effectively with colleagues within and outside the team

• Make sure your patients and colleagues understand your role and responsibilities in the team and who is responsible for each aspect of patient care

• You must treat your colleagues fairly and with respect

• When referring a patient you must provide all relevant information about the patient.

• BOLAM PRINCIPLE• Always do what a reasonable doctor

skilled in their art will do and can justify why they have done it.

DR.T.V.RAO MD 5

WE HAVE TO COORDINATE WITH.. MANY - CHALLENGES

• Physician teams• Fellows

• Senior residents

• Junior residents

• Students

• Clinic teams• Physicians

• Front desk staff

• Nursing staff

• Ancillary staff

• Hospital Teams• Physicians

• Nursing staff

• Ward staff

• Ancillary providers

• Operating Room Teams• Surgeons

• Anesthesia

• Nursing

• Scrub Techs

DR.T.V.RAO MD 6

COMMUNICATION THEORY

Communication is a learned skill or a series of learned skills which is based on 3 pillars:

AccuracyEfficiencySupportiveness

all combine to contribute to effectiveness of communication

DR.T.V.RAO MD 7

Communication is essential for all aspects of life.

Effective communication is the basis of mutual understanding & trust.

Poor communication causes a lot of misunderstanding & hinders work & productivity.

WE SHOULD COMMUNICATE BETTER: WHY?

DR.T.V.RAO MD 8

Doctors need to learn essentials of good communication more than other professionals because patients are humans with sensitive needs.

Doctors can not practice medicine without effective communication skills.

Poor communication causes a lot of medico-legal and ethical problems.

DO DOCTORS NEED TO BE BETTER COMMUNICATORS ?

DR.T.V.RAO MD 9

COMMUNICATION SKILLS THE MOST IMPORTANT SKILL IN MEDICINE

CONSULTATION MODELS-WHY?

• To get the most out of the consultation for the patient foremost and for the doctor.

• To plan the consultation using a framework• To adapt your style of consulting to meet the needs of the

patient • To handle difficult situations• To have “rescue” plans when things go wrong• To use time efficiently in the consultation• To be able to assess and improve the consultation

DR.T.V.RAO MD 10

• Doctor centred I• Patient centred I• Task orientated I• Behavioural

orientated I

• Plan your skills

CONSULTATION SKILLS THE MOST IMPORTANT SKILL IN MEDICINE

CONSULTATION MODELS- THE DOCTOR PERSPECTIVE

DR.T.V.RAO MD 11

Task Orientated

Behaviour Orientated

Doctor centred Patient centred

DR.T.V.RAO MD 12

The ability to integrate

- knowledge base

- communication skills

- examination skills

- problem-solving ability

YOU ARE SKILLED PERSON IF YOU HAVE ABILITIES..

DR.T.V.RAO MD 13

CAN COMMUNICATION SKILLS BE TAUGHT?

l communication is a clinical skill

l It is a series of learnt skills

l Experience is a poor teacher

l There is conclusive evidence that communication skills can be taught and that in communication skills

teaching is retained

DR.T.V.RAO MD 14

COMMUNICATION SKILLSSOME TECHNIQUES

• Developed fluent dialogue with patient

• Used silence effectively, allowing patient enough time to express thoughts or feelings

• Actively encouraged patient through use of supportive words or comments

• Dialogue with patient was enhanced by effective use of non-verbal behaviour

• Used open, exploratory questions – inviting patient to become actively involved

• Adjusted language as appropriate, to suit particular needs of the situation

DR.T.V.RAO MD 15

COMMUNICATION SKILLSSOME TECHNIQUES

• Developed fluent dialogue with patient

• Used silence effectively, allowing patient enough time to express thoughts or feelings

• Actively encouraged patient through use of supportive words or comments

• Dialogue with patient was enhanced by effective use of non-verbal behaviour

• Used open, exploratory questions – inviting patient to become actively involved

• Adjusted language as appropriate, to suit particular needs of the situation

DR.T.V.RAO MD 16

• All physicians function as a leader on a daily basis

• Most physicians have some baseline skills

• Some are naturally better at it than others

• Leadership skills can learned, developed and honed

MEDICAL LEADERSHIP SKILLS

DR.T.V.RAO MD 17

• Endless amount of literature, books, courses, seminars, and institutes dedicated to leadership

• Inadequate time to study leadership skills

• Medical curricula do not include an emphasis on leadership

LEADERSHIP SKILLS ARE NOT TAUGHT BUT TO BE LEARNT

???

DR.T.V.RAO MD 18

Developing rapport to enable

the patient to feel understood,

valued and supported.

Encouraging an environment

that maximizes accurate and

efficient information gathering,

planning & and explanation.

Enabling supportive

counseling as an end in itself.•

GOOD DOCTORS-PATIENTS RELATIONSHIP MINIMIZES CONFLICTS

DR.T.V.RAO MD 19

ARE THERE PROBLEMS IN COMMUNICATION

BETWEEN DOCTORS AND PATIENTS?L Reasons for the patient's attendance

L Gathering information

l Explanation and planning

l Adherence to plans

l Medico-legal

l Lack of empathy and understanding

DR.T.V.RAO MD 20

LEARNING SUCCESSFUL LEADERSHIP SKILLS

• Find a mentor• Someone you respect

• Someone you can approach repeatedly and in a crisis

• Ask if they will consent to being your mentor

• Recognize your mentors efforts

• Expect to do the same for others (be a mentor)

DR.T.V.RAO MD 21

• Seek input

• Spread authority

• Treat people with respect

• Don’t dictate

• Challenge your team members

TRAITS OF SUCCESSFUL LEADERS

DR.T.V.RAO MD 22

• Patience• Not everyone has your

agenda, goals or motivation

• That doesn’t mean they aren’t an important part of the team

• Doesn’t mean they are wrong

TRAITS OF SUCCESSFUL LEADERS

DR.T.V.RAO MD 23

• Sense of humor

• Don’t take yourself or the world too seriously

• A smiling cheerful leader wins more cooperation than a grim or gloomy one.

TRAITS OF SUCCESSFUL LEADERS

DR.T.V.RAO MD 24

TRAITS OF SUCCESSFUL LEADERS

• Know yourself

• Have/demonstrate a sense of direction and mission

• Make the hard decision

• Part of leadership is making the decision no one else will or wants to make

• Take responsibility for the decision

DR.T.V.RAO MD 25

THE PARTICULAR PROBLEMS OF TEACHING ESTABLISHED DOCTORS

Many established doctors have received little previous instruction in communicationTheir only "training" has been gained from their experience in medicineExperience alone is a poor teacher: need observation, well-intentioned feedback and rehearsal

DR.T.V.RAO MD 26

THE PARTICULAR PROBLEMS OF TEACHING BY ESTABLISHED DOCTORS

further to fall

L more unlearning

more ingrained habits

l more threatening

l less aware of need

DR.T.V.RAO MD 27

WISH TO CONTINUE IN TEACHING PROFESSION..

You need a methodology that:

l is based on experiential learning - observation, feedback and rehearsal

l tackles the participant's own problems

BUT ALSO

L extends their understanding of underlying communication skills and principles

DR.T.V.RAO MD 28

SEVEN FIVE DEADLY SINS“OF A LEADER”

• Truth, if it becomes a weapon against persons.• Beauty, if it becomes a vanity.• Love, if it becomes possessive.• Loyalty, if it becomes blind, careless trust.• Tolerance, if it becomes indifference.• Self-confidence, if it becomes arrogance.• Faith, if it becomes self-righteous.

Ashley Cooper, Writer

DR.T.V.RAO MD 29

WISH TO CONTINUE AS

DOCTOR/TEACHER• You must become a leader to practice medicine

successfully.• Mid Career requires more complex and

sophisticated leadership skills• Make leadership development a part of your daily

routine.• Learn from those around you.• Seek out opportunities for skill development• Practice at every opportunity.

DR.T.V.RAO MD 30

LEARNING SUCCESSFUL LEADERSHIP SKILLS FROM GOOD BOOKS

Leadership texts• Good to Great

by Jim Collins

• Dealing with Difficult People

by Harvard Press

• Bargaining for AdvantageBy G Richard Shell

DR.T.V.RAO MD 31

• The happiest people don’t necessarily have the best of everything. They just make the best of everything.”

WISH TO BE A HAPPY LEADER FOLLOW…

DR.T.V.RAO MD 32

TO SURVIVE AS A TEACHER / LEADER

• With the increasing life expectancy and growing demands in the Medical Profession with explosion of Knowledge, the

question remains can we survive with progressing age. It is certainly YES if you take positive attitude, and learn effective communion skills. Our Indian Medical Education do not orient

much of the importance of Skills of Communication. We certainly need enlightenment with training on Communication

skills including Electronic communication skills• Dr.T.V.Rao MD

• Professor of Microbiology• doctortvrao@gmail.com

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