SCENARIO 1 : Effective communication skills in the making..

STEP 1 :

1. General practicioner : the person that do the practition in the medical

institution

2. Micro skills :

 communication skills from doctor to patient to help us make

interaction skills

 process basic skills in communication

3. Listening skills : the ability of person for listening a patient problem

4. Emphaty : the ability to understand and feel the feeling and thoughts of
others

5. Message : the information from one person to other person

6. Communication skills : the ability to convey information to another

effectivelly and eficiently.

7. Attending behavior :

 respect from a person to the other person and environment

 To trigger the patient to talk freely at large may

8. Body language :

 body reaction with movement part of body

 give some message with part of body

9. Anamnesis :

the process to gather the information from patient

The case history of a patient

To do by the doctor

Data collection is done by doctor

 The early stage of medicine examination using conducted from doctor to
the patient to get best therapy

10. Nausea : sensation or reaction of discomfort in upper abdomen

following with urgger to vommit

STEP 2 :

1. What the purpose of anamnesis ?

2. How to do good anamnesis ?

3. How the step of micro skills of communication ?

4. How we can develop our effective communiative skills ?

5. what is the benefit become a communicative doctor ?

6. How to be a good listener ?

7. What are the disadvantages of communicative skills ?

8. The advantages and disadvantages of emphaty ?

9. What is the kind of anamnesis ?

10.What is the different of micro skills and communication skills for get a
good anamnesis ?

11. Why the anamnesis is needed ?

12. What is the relation of doctor and communicatin skills ?

13. How to become communicative doctor ?

14. What the include micro skills of communication ?

15. What is the problem to be a communicative doctor ?

16. How to develope micro skills of communication ?

17. When communication skills is needed ?

STEP 3 :
 Anamnesis

1. What the purpose of anamnesis ?

 To get the data and information about the patient problem are
being felt

 To get the information of health condition from patient

 To help the doctor to make a diagnosis for patient

The purpose of anamnesis is to connect the various symptoms felt by the patient: pain, discomfort,
and associated events.

http://link.springer.com/chapter/10.1007/978-2-8178-0271-8_1?no-
access=true
The purpose of anamnesis is to gain information about the patient disease and other related
information that can lead the doctor to a diagnosis.

http://www.med.unhas.ac.id/meu/index.php?
option=com_docman&task=doc_details&gid=446&Itemid=53

to provide a complete clinical history in the interests of the better

"classification" of the patient
Marnini P, Bonomo E, Guidotti E: [Anamnestic questionnaire of the Italian Diagnostic Center].
Minerva Med; 1977 Mar 10;68(12):773-80

2. How does the doctor make a good anamnesis ?

 A doctor must to have the basic of communication skills

 Ask the chief complaint to ask medical history ask family

history, anamnesis system and anamnesis result

 The doctor have to give best approach to their patient with

clinical reasoning

In doing anamnesis tried to be patient or parent can file a complaint with the
spontaneous, natural, but not prolonged. At the exact moment the examiner
should ask the questions that more detailed and specific, so that the picture of
the patient's condition can be obtained more clearly and accurately. Questions
posed by the examiner should not be suggestive, as far as possible avoided the
question whose answer only 'yes' or 'no', give the opportunity to determine
the patient's medical history in accordance with the perception.

Sumber : http://dokmud.wordpress.com/2009/11/02/anamnesis-pemeriksaan-
anak/pdf

3. What is the kind of anamnesis ?

 Allo anamnesa : information from the family or someone

nearest the 7patient

 Auto anamnesa : information from the patient

 Hetero anamnesis : combain from allo anamnesa and auto

anamnesa

1. Auto anamnesis, an anamnesis of the patients themselves.

2. Allo anamnesis, is anamnesis the family / relationship nearby or bring the
patient to the hospital.
Sumber:
http://kedokteran.unsoed.ac.id/Files/labskill/KomunikasiEfektifdanAnamnesis.pdf

4. What is the different of micro skills and communication skills for get a
good anamnesis ?

Micro skills is the reaction for get the anamnesis but communication
skills is the

5. Why the anamnesis is needed ?

 To help the doctor to make a diagnosis because the doctor dont

know patient feel so the doctor must be ask

 To know the problem of patient in diagnosis

a careful anamnesis is needed to establish a correct diagnosis
Sumber : Allergol et Immunopathol 2000;28(6):311-317

an amnesis is needed to diagnose and to apply proper treatment

Sumber :Stomatologija, Baltic Dental and Maxillo facial Journal, 2006, Vol.8., Suppl . 2
 Communication skills

1. How we can develop our effective communiative skills ?

 Attitude

 Experience

 Our daily activity

a. assertiveness,
If you need to develop your assertiveness skills, use the toolkit on Assertiveness
Training that has already been developed.
b. conversational or verbal communication skills
c. nonverbal communication skills
Although we tend to think that communication is mostly verbal, what we
communicate with our bodies, that is, our nonverbal communication, plays as big a
role.In fact, there is much research suggesting that nonverbal communication can
play an even bigger role than what we say. Nonverbal communication involves
where we look, the tone of our voice and even our body posture. Let’s use a quick
example. Imagine you are speaking to someone and they look disinterested. They
will probably not look you in the eye, but rather look at the wall or clock and turn
away from you. No matter how interested they say they are, their nonverbal
behaviour speaks otherwise.
Sumber :
http://www.montrealcbtpsychologist.com/userfiles/373150/file/Developing_Effective_
Communication_Skills.pdf

A practicing oncologist likely uses just about every medium to communicate. They talk on the phone,
send e-mail messages, converse one-on-one, participate in meetings, and give verbal and written
orders. And they communicate with many audiences—patients and their families, referring
physicians, and office staff.
Sumber : http://jop.ascopubs.org/content/3/6/314.full
2. what is the benefit become a communicative doctor ?

 make a patient feel comfortable

 trust the suggestion from doctor to patient

3. How to be a good listener ?

 Listening the patient problem with caring and patiently

 Increase the emphaty of the doctor

 WHAT IS ACTIVE LISTENING? - The process of listening, clarifying, giving
feedback, and self-disclosing. It involves the participation of both parties in verbal
and non-verbal ways. Use of “I” statements is imperative.
  MAKE EYE CONTACT: Be sure to look the speaker in the face most of the time,
especially look at her/his eyes. If you forget to make eye contact, the speaker may
think you are bored, withdrawn, or simply not listening. Also be culturally sensitive:
some individuals may be uncomfortable with too much direct eye contact.
 TAKE A LISTENING POSITION : Sit or stand in a comfortable position with your body
aimed in the general area where the speaker is. Try to be in a relaxed position. Face
the speaker and make appropriate eye contact. Be aware of other non-verbals:
placement of arms, leaning forward when necessary, head nodding, degree of
personal space, smiling.
 PARAPHRASE THE SPEAKER’S MESSAGE: Paraphrasing means stating in your
own words what someone has just said. Some common ways to lead into
paraphrases include :
What I hear you saying is...
In other words...
So basically how you felt was...
What happened was...
Sounds like you’re feeling...
The speaker then has a chance to know you have understood what she/he has said.
This also gives the speaker the opportunity to try to make the message more clear if
she/he doesn’t think you really understood. Also be sure to reflect feeling words.
 ASK CLARIFYING QESTIONS FOR UNDERSTANDING: If something the speaker
says is unclear to you, ask her/him a question to get more information. Such
questions make you an active, interested listener; the speaker can tell that you’ve
been listening enough to have a question and care enough to ask. Ask open ended
questions when you need more information, e.g., “Could you give me an example of
when you’ve had difficulty talking to your professor?” Avoid the overuse of closed
questions; these are questions that just require a yes or no response and tend to halt
communication.
 MAKE COMMENTS, ANSWER QUESTIONS: When the speaker stops or pauses,
you can be a good listener by making comments about the same subject. If you
change the topic suddenly, she/he may think you weren’t listening. If the speaker
asks a question, your answer can show you were listening. Also, use silence to your
benefit versus attempting to fill the conversation with constant talk.
 PROVIDE APPROPRIATE FEEDBACK: Your students are likely to be interested and
invested in your opinions and feedback. Monitor your reactions to what they have to
say and give reactions in nonjudgmental ways. Feedback should always be given in
an honest and supportive way.
 EMPATHY : Recognize that everyone is trying to survive, get through school
successfully, build a support network and deal with the demands of outside life.
Sometimes is can be difficult to be empathic if we have had different life experiences
or would try a different solution than those tried by our student.
 OPENNESS : Listen with openness. Be a supportive, but neutral listener. This
provides safety for self-disclosure and talk of emotional states. Be careful of
judgments and stereotypes you have that block openness. Attempt to put yourself in
the other person’s shoes in terms of trying to understand how they feel, while also
not becoming consumed with their difficulties. Incorporate your own self-care so that
you do not burn out.
 AWARENESS : Be Aware of your own biases. We all have biases-this is part of
human nature. The key is to not let them get in the way of what others have to say.
Try to fully understand the person and their context versus relying on just your
personal experience to guide them.
Sumber : http://www.twu.edu/downloads/counseling/E-8_How_to_be_a_good_listener.pdf

4. What are the disadvantages of communicative skills ?

  When the doctor have too much problem, the doctors cant
understand patient problem

5. The advantages and disadvantages of emphaty ?

 Advantages : make doctor more caring with the patient, to make a

person feel comfort
General :

1) Eliminate pride.
One way to develop empathy to imagine what is happening to other people will also be able
to happen to us. While imagining this condition, a person will be spared from pride or
arrogant because whatever will be happen to us if the Lord wills. People who have the
capacity for empathy would likely have a humble spirit and understand this life well. Wheel
constantly spinning, that's life.
2) Adjust yourself.
Empathy ease the process of adaptation because there is greater awareness that everyone is
different viewpoint. Dymon (in Hadiyanti, 1992)
stated that he would be a good adjustment manifested in the nature optimistic, flexible, and
emotional maturity.

3) Improving self-esteem.
Empathy plays a major role in social relations. Richard (in Jones, 1992) states that social
relations are expressed fund creative media identity. The existence of social relations and
creative media causes the growth of self-esteem in a person (Kurtinez and Gewirts, 1984).
4) Increase self-understanding.
Ability to understand the perspectives of others, causing an individual aware that someone
else can make an assessment based on its behavior. This will cause the individual more
aware and pay attention to what others think of him.

Specifically :

1 ) Eliminate selfishness and easily provide help . People who have been able to develop the
ability to eliminate the selfish attitude of empathy ( selfish) . By developing the capacity for
empathy , then someone will try to speak , think , and behave in an acceptable also by others
and will easily provide help to others .
2 ) Develop and evaluate the ability of self-control .
Basically empathy is one attempt to do a self-evaluation and develop a positive self-control .
Ability to see the good in others feelings , thoughts and behavior are part of the state reflect
within ourselves to be able to help others in sincerity .
3 ) Speed up relationships with other people . Lauster (1995 ) argues that if everyone tried to
empathize , then get me wrong , debate , and disagreement between individuals can be
avoided so that the possible occurrence of a very large and easy collaboration
Sumber : http://repository.library.uksw.edu/bitstream/handle/123456789/2274/T2_832009021_BAB
%20II.pdf?sequence=3

 Disadvantages : characteristic the people is different, spend time,

6. What is the relation of doctor and communicatin skills ?

To get the good result, the doctor apply the communication skills

Having good communication skills is essential for doctors to establish good

doctor patient relationship.Not surprisingly ,many under graduate and post
graduate medical education and training programmes have made the
attainment of good communication skills acore requirement. With the increase
in demand from patients who value doctors who are patient centred (who
spend time and listen to them), together with the rise of consumerism in
medicine, health service research on doctor patient relationship has become
an important area of interest for both medical researchers and administrators
alike. In this paper ,a brief review will be presented to illustrate and provide
some evidence for the importance of effective communication in health care
delivery . The recognition of the importance of doctor patient relationship and
communication in medicine has particular relevance for primary care physician
whose discipline has long focused on the importance of the doctor patient
relationship quality health care delivery.
Sumber : http://www.fmshk.org/database/articles/607.pdf

7. How to become communicative doctor ?

We must be a good listener

We must more caring with the patient

The doctor must have more emphaty

Give our time to listen the patient problem

8. What is the problem to be a communicative doctor ?

 The patient not open minded

 Language

9. How to develope micro skills of communication ?

 10. When communication skills is needed ?

 Everytime. When we listening our friend, when we explain the

diagnosis to patient, when we solve the patient problem

11. What is basic of communication skill ?

Communication is the process of the operation of the stimulus (stimulus) in
emblem or symbol shape or motion language (non-verbal), to influence
behavior of others. Communication process using stimulus or response
language in the form of both oral and written communication hereinafter
verbal. Whereas if the communication process using symbols called non-verbal communication
(Setiawati, 2008)

Sumber : http://repository.usu.ac.id/bitstream/123456789/30875/4/Chapter%20II.pdf

12. How do the communication ?

refers to the process of delivering a statement by one person to another. So,

which is involved in human communication.

Sumber : http://file.upi.edu/Direktori/FIP/JUR._PSIKOLOGI/195009011981032-
RAHAYU_GININTASASI/Komunikasi.pdf

13. When we use communication skills ?

14. What is islamic communication ?

The word ‘communication’ in islam derives from ‘ittisal’ from the root word
‘wassala’ in Arabic,wich means “to cause to reach” or “to bring” (Hussaain,
2006, p.35). Besides that, the Qur’an (holy book of Islam) contains numerous
terms which charry the meaning “to communicate” such as qul (to say)
(Qur’an,24:33), sami’a (to listen) (Qur’an, 12:55), nabba’a (to tell) (Quran,
12:37), kataba (to write) (Qur’an, 24:33), sami’a (to listen) (Qur’an, 7:204) and
many others. In order to, better understand this islamic communication
paradigm, the theory of tawhid (the unity of God, human beings and the
universe), concepts of tabligh, and amr bil al-ma’ruf wa nahy’ an munkar
(enjoining good and forbidding evil) provide the fundamental explanations.

Sumber :
http://www.researchgate.net/publication/236167419_Cultural_Sensitivity_Health_Communication/
file/3deec516bfc8304a96.pdf
 STEP 4 :
General Practioner

Anamnesis

Communication skills

Basic skill Micro Skills Attending Emphaty Islamic

communication Communication Behavior communication

Effective
Communication

Good anamnesis