Effective
Communication Skills
After reading this chapter, you will be able to:
·
Identify the general principles of effective communication
·
Explain the ethical issues of translating
·
Distinguish between the important features of telephone and personal
communication
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·
Mastering certain skills will help you become a more effective communicator
·
Watching facial and body gestures and listening to tone of voice are as important
as listening to words for understanding
·
Telephone communication has many different characteristics from personal
communication
·
There are important ethical considerations when translating
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6.1
Be An Effective Communicator
The
following sections highlight three general communication principles and six
special skills needed for effective communication.
1.
Three Communication Principles
a.
Planning: LHAs need to plan for any encounters with community members in
promoting cancer screening. Who is
the audience? What kinds of
objections are expected? When is a
good time to present information? What
is the ideal place to give information? What
is the major objective of today’s presentation?
b.
Listening: Before one eagerly
presents any information, it is important to listen to one’s audience.
What are their concerns? What
makes them happy or unhappy? What turns them off?
Why do they dislike going to clinics or hospitals in Michigan?
It is surprising to see the extent of understanding that active and
intensive listening can bring to an experienced listener. One can safely say that listening to and understanding of
one’s audience are prerequisites of effective communication.
c.
Positive Atmosphere: Before any
information is provided, it is important for LHAs to create a positive
atmosphere in which friendly relationships with community members are fostered.
A positive atmosphere can be created through active listening and
understanding of the audience and through the LHA’s ability to show empathy,
sympathy, and respect for the audience’s difficulties in life.
2. Six
Specific Skills34
There
are some specific skills that LHAs may find useful in promoting regular cancer
screening. These skills mainly
consist of continuous testing and summarizing of one’s understanding.
They are:
a.
Clarifying and Confirming
When you
get upset by what someone says, take time to first clarify and confirm the
intended message. Ask what and why
and afterwards summarize the speaker’s message ask whether you understood
correctly.
This is a
very important skill. There are
bound to be some differences of opinion between people. When one senses there are differences or when one is tempted
to disagree right off hand, one needs to find common ground from which to build
new agreements or new ideas. One
can clarify and confirm by asking questions.
For example, one can say, “I don’t understand (or I’m not
clear about) what you meant. Would
you please explain it another way?” This
is a general open-ended question. Or,
one can pick a specific aspect of what the other person has said, paraphrase it
in a different way, and then seek confirmation.
For example, one can say, “Do you mean that you never go
to a clinic when you feel OK? Have
you seen a doctor or nurse for flu shots?”
More
examples:
·
Would you tell me more about why you don’t want to have a mammogram?
·
Let me understand what you just said.
Are you saying that you’ve lived long enough and do not need a mammogram even if you might have breast cancer?
b.
Building
When one
sees a way to increase the usefulness of an idea, one acknowledges the
connection to the other person’s idea, and adds value to the idea by
specifying:
(i) Slight modifications
(ii) Additional benefits
(iii) Other applications
(iv) A more effective way to realize the original intent
Examples:
·
That is a good idea. And if
we add this it will really have a great impact!
·
You have made a great suggestion but perhaps you don’t realize that your idea will also have a great
effect on….
c.
Crediting
When the
other party has done something that deserves positive feedback, one needs to
(i)
Make a general reference to behaviors being credited
(ii)
Give specific examples
(iii) Mention personal
qualities
(iv) Mention resulting
benefits
Examples:
·
You’re always on time!
·
You arrived at exactly 3 o’clock as we agreed.
It’s wonderful.
·
You are a considerate person.
·
You’re so considerate that you never make people wait for you.
·
I’m so glad that you mentioned this important point.
d.
Constructive criticism
If, after
you have summarized the speaker’s message and are sure of the meaning, but you
disagree with an idea, you can offer constructive criticism by:
(i) Give an itemized
response- specify the merits and
your concerns
(ii) Identify ways to retain
merits and eliminate concerns:
·
invite/make suggestions
·
give/invite reactions
(iii) Summarize
suggestions/steps agreed to
Example:
·
I believe that you’re a very considerate and loving mother and do not want to burden your working
children too much by asking them for a ride to have
your annual mammogram. But
my concern is your own health and your quality of life. Actually,
by asking them to give you a ride, they also learn about the importance of mammography screening and breast cancer
detection. This way,
everyone in the family learns about mammography through your example. What
do you say? I suggest that you ask
your children to arrange a ride for you to get a mammogram and tell your daughter
that she should get mammograms when she is 40 too.
Don’t you agree?
e.
Managing differences
When you
have confirmed that a difference of opinion exists and are willing to consider
alternatives, you need to manage the differences by doing some or all of the
following:
(i) Explore the difference:
·
State or check what’s important
·
Temporarily change some of the conditions
that lead to the differences
(ii) Invite or suggest
alternatives
(iii) End the discussion
·
Acknowledge the other person’s right to
differ
·
Explain what one’s position is and why
f.
Giving and sharing information
When
giving presentations, whether to one person or a group, you not only plan for
the presentation but also need to continually test for understanding during the
presentation. Is the audience
paying attention? Are they nodding
their heads in agreement? In
planning, one needs to prepare mainly four parts:
(i) Introduction: what will
be presented
(ii) Contents
(iii) Summary: what has been presented
(iv) Questions and Answers
6.2
Using Telephone Communication Efficiently
As
an LHA, you will need to talk with people about some health issues over the
phone. In order to use telephone
communication efficiently, it is important to understand the special
characteristics of telephone communication:
1.
Voice Control: Non-verbal
communication, such as gestures, is absent during telephone conversation so
voice control is even more important. In
telephone communication, the voice needs to be clear and pleasant, not too loud,
and not too soft.
2.
Identifying the Caller:
Due to the absence of visual aids, the caller needs to identify
him/herself at the beginning of the conversation.
3.
Know the Receiver’s Readiness:
The person you are calling may not be ready to take your call.
The receiver may be taking a nap, tending to a child’s needs, or just
getting ready to step out of the house. When
the person answers, identify yourself, explain why you are calling, and ask
whether or not it is convenient to talk. If
not, ask when is a good time and schedule an appointment to call.
4.
Length of a telephone conversation:
A telephone conversation needs to be short and concise. The caller needs to plan the objectives of the conversation
and the call needs to end when all the objectives have been accomplished.
5.
Leaving a message:
When no one answers the phone, be prepared to leave a message.
To leave a message, the caller still needs to identify him or herself
clearly, to briefly state the purpose of the call, leave a phone number,
including the area code, and the best time to call or when you will call again.
It is a good practice to read the phone number slowly and clearly. It is also important to remember that many non-English
speakers do not answer the phone but instead screen calls waiting to see if the
caller speaks Chinese. If no one
answers the phone, do not forget to try speaking Chinese too.
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6.3
Be A Good Interpreter 35
Because the Asian population
consists of a large proportion of recent immigrants who are non-English
speakers, you may need to interpret for women who cannot overcome the language
barrier.
Simply
being bilingual does not qualify someone to be a medical interpreter.
Being an interpreter involves linguistic, cultural and international components. Interpreters need to
have excellent listening and comprehension skills in addition to a
well-developed memory. They must
also have a good knowledge of medical terminology involving breast cancer,
mammography, cervical cancer, and Pap smear testing.
Above all, they must maintain high ethical standards and professionalism.
In order to be a good
interpreter, you need to keep in mind the following points.
1. The Interpreting Session
a. Arriving at the
appointment
(i) When you accept an appointment, you should already
know the patient’s name, the appointment day, time, and location.
(ii) Please arrive at the
appointment 10 to 15 minutes before the scheduled time.
(iii) Upon your arrival, check
in with the receptionist.
Tell the receptionist your name
and who you are there to interpret for.
b. Introducing yourself
Introduce
yourself to both the patient (if you don’t know her) and the health care
provider in a culturally appropriate way. Explain,
in English and Chinese, that you are the interpreter and that you will be
interpreting everything that is said and that you will keep all information
confidential.
2. After the Appointment
Tell the Healthy Asian Americans
Project office that the appointment has been completed and report any problems
that resulted from the appointment.
3. Code of Ethics
The medical interpreter will:
a. Maintain client
confidentiality
All information regarding
patient care, including verbal, printed, and electronic resources or documents,
must be maintained as confidential information.
The interpreter will not contact any resources for the patient without
prior permission from the patient. Also,
the patient must be present or be a participant in a three-way call.
Furthermore, verbal communications, including phone calls, that discuss
patient information, must take place in non-public areas.
b. Interpret accurately and
completely the content and spirit of what is said
The interpreter should interpret
accurately in the tone and spirit of the original messages without filtering or
censoring any information. The
interpreter should interpret any side conversations that take place in the
presence of the patient.
As a non-medical professional,
you may not know all the medical terms used.
Don’t feel bad about that and never pretend that you know everything.
Tell the health care provider and patient that you are not familiar with
a specific term and get an explanation. A
glossary of medical terms is included in the back of the manual to assist you
with learning important and frequently used medical terms.
(i) Remain impartial
·
The interpreter should be aware of any personal biases and opinions that may affect an interpreting situation
and repress them or withdraw from the interpreting assignment if necessary.
·
The interpreter should not attempt to influence the patient in any way.
·
The interpreter should not counsel, advise, or interject personal opinions even when asked by the patient or
the health care provider.
The only exception is when informing the provider of the client’s cultural
beliefs and practices.
(ii) Maintain a professional
distance
·
The interpreter will respect the patient’s personal/emotional privacy and will not ask any
personal or probing questions outside the scope of the interpreting tasks.
(iii) Use discretion in
accepting assignments
·
The interpreter shall refrain from interpreting in any situations where there may be a conflict of interest.
·
The interpreter has the right to not participate in a “specific aspect of patient care based on their
values, ethics and religious beliefs.”
c. Convey cultural
differences
The
interpreter should convey any cultural differences when appropriate.
Your cultural competency in Chinese American culture and American culture
will play an important role in helping patients get annual mammography:
(i) It makes more
effective use of time with patients
(ii) It increases disclosure of
patient information
(iii) It helps with negotiating
differences
(iv) It increases patient compliance with
treatment protocol
(v) It positively affects clinical
outcomes
(vi)
It decreases stress
(vii)
It builds trust in a relationship
(viii) It increases patient satisfaction
d.
Keep a low profile
The
interpreter should remain as neutral as possible.
e.
Refuse compensation from patients
The
interpreter should not accept any compensation from the client(s).
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Back to Chapter 6
Objectives