Veterinary Clinics of North America: Small Animal Practice
Four Core Communication Skills of Highly Effective Practitioners
Section snippets
Underlying premises
Based on 40 years of research in human medicine, three underlying premises guide communication skills training [8]:
- 1.
Communication is a core clinical skill essential to clinical competence, alongside physical examination, medical knowledge, and problem solving.
- 2.
Communication is related to significant outcomes of care, including diagnostic accuracy, time management, a collaborative physician-patient relationship, patient and physician satisfaction, adherence, patient health, and malpractice risk.
- 3.
Communication skills
Communication skills are a vital component of interpersonal interactions. Three broad types of communication skills have been identified: content skills, process skills, and perceptual skills [9], [10]. Content skills are what doctors communicate—the content of their questions and the information they give. Process skills relate to how doctors communicate through verbal and nonverbal methods of communication. Verbal communication is composed of what is said, in particular word choice. Nonverbal
Veterinarian-client-patient relationship
A “gold standard” does not exist for assessing veterinarian-client interactions, nor is there an accepted definition of the ideal veterinarian-client relationship. In fact, under different clinical circumstances, different models may be appropriate and effective [12]. Flexibility is of utmost importance, and the choice of communication style should be tailored to the individual client and patient [13].
In human medical practice and veterinary practice, the most common model for the
Nonverbal Communication
Nonverbal communication includes all behavioral signals between interacting individuals exclusive of verbal content and occurs in several modes [8]. These behavioral signals include body language (ie, facial expressions, gestures, body position, tension, touch); spatial relationships, including the distance between the veterinarian and client and objects that may act as potential barriers to communication (ie, examination table, animal, computer, seating); paralanguage (ie, voice tone, rate,
Implementation
The key steps to teaching and learning clinical communication skills are as follows [8]:
- 1.
Delineation of the skills
- 2.
Observation of skill use
- 3.
Self-reflection on videotaped interactions
- 4.
Feedback
- 5.
Opportunities for practice
The focus of the first part of this article is defining and delineating the four core communication skills to enhance clinical outcomes. The next step in skill development is to create opportunities for observation, self-reflection, feedback, and practice within the clinical setting.
Summary
For 40 years, medical researchers have been studying physician-patient interactions, and the results of these studies have yielded three basic conclusions: physician-patient interactions have an impact on patient health, patient and physician satisfaction, adherence to medical recommendations, and malpractice risk; communication is a core clinical skill and an essential component of clinical competence [8]; and appropriate training programs can significantly change medical practitioners'
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