Skills in Medicine to be a better teacher / doctor

1. Skills in Medicineto be a better teacher / doctor Dr.T.V.Rao MD Dr.T.V.Rao MD

2. 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. Communication skills Probably the most important skill in medicinefollowHippocratic oath Dr.T.V.Rao MD

3. 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. Medical skills The most important skill in medicineDUTIES OF any doctor Dr.T.V.Rao MD

4. 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. Communicating with colleaguesI The most important skill in medicineDUTIES OF any doctor Dr.T.V.Rao MD

5. 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 We have to coordinate with.. many - challenges Dr.T.V.Rao MD

6. Communication is a learned skill or a series of learned skills which is based on 3 pillars: Accuracy Efficiency Supportiveness all combine to contribute to effectiveness of communication COMMUNICATION THEORY Dr.T.V.Rao MD

7. we should Communicate better: Why? • 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. Dr.T.V.Rao MD

8. Do doctors need to be Better communicators ? • 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. Dr.T.V.Rao MD

9. 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 Communication skills The most important skill in medicineCONSULTATION MODELS-Why? Dr.T.V.Rao MD

10. Consultation skills The most important skill in medicineCONSULTATION MODELS- the Doctor perspective • Doctor centred I • Patient centred I • Task orientated I • Behavioural orientated I • Plan your skills Dr.T.V.Rao MD

11. Task Orientated Patient centred Doctor centred Behaviour Orientated Dr.T.V.Rao MD

12. You are skilled person if you have abilities.. The ability to integrate - knowledge base - communication skills - examination skills - problem-solving ability Dr.T.V.Rao MD

13. 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 Can communication skills be taught? 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. Medical Leadership Skills • 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 Dr.T.V.Rao MD

17. Leadership Skills are not taught but to be learnt ??? • 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 Dr.T.V.Rao MD

18. Good Doctors-Patients Relationship minimizes conflicts • 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. Dr.T.V.Rao MD

19. 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 Are there problems in communication between doctors and patients? Dr.T.V.Rao MD

20. 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) Learning Successful Leadership Skills Dr.T.V.Rao MD

21. Traits of Successful Leaders • Seek input • Spread authority • Treat people with respect • Don’t dictate • Challenge your team members Dr.T.V.Rao MD

22. Traits of Successful Leaders • 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 Dr.T.V.Rao MD

23. Traits of Successful Leaders • 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. Dr.T.V.Rao MD

24. 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 Traits of Successful Leaders Dr.T.V.Rao MD

25. Many established doctors have received little previous instruction in communication Their only "training" has been gained from their experience in medicine Experience alone is a poor teacher: need observation, well-intentioned feedback and rehearsal The particular problems of teaching established doctors Dr.T.V.Rao MD

26. The particular problems of teaching by established doctors further to fall Lmore unlearning more ingrained habits lmore 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. 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. SevenFive Deadly Sins“of a Leader” Ashley Cooper, Writer Dr.T.V.Rao MD

29. 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. Wish to continue as doctor/teacher 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 Advantage By G Richard Shell Dr.T.V.Rao MD

31. Wish to be a happy leader follow… • The happiest people don’t necessarily have the best of everything. They just make the best of everything.” 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 YESif 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 Dr.T.V.Rao MD