Interpersonal skills – skills that are used between people who are attempting to communicate with each other.

• Non-verbal communication – the message is conveyed through a person’s body.
• Verbal communication – it is related to speech.

Non-verbal communication

1. Paralanguage – speed, tone, volume, fluency of speech.
2. Facial expressions – how emotions are conveyed.
3. Gestures – hand movements, shrugging shoulders (must be aware of cultural differences.)
4. Physical proximity
5. Appearance – dress.

ARGYLE (1975) suggested that non-verbal communication is more effective than verbal communication because it:

• Assists speech
• Replaces speech
• Signals attitudes
• Signals emotional states

MCKINSTRY and WANG (1991) found out that people, who preferred formally dressed doctors were older in age or from the professional class.

• 11% of patients said that doctor’s dress was VERY important
• 53% of patients said that doctor’s dress was QUITE important

For more detailed information –McKinstry and Wang (1991)

Verbal Communication

It is based around speech and used by doctors to gain information about the patient’s condition and communicate the possible treatments available.

MCKINLAY (1975) found out that health workers and doctors use medical language to look more knowledgeable, important and keep the conversations brief. On the other hand, patients are afraid to ask questions if they don’t comprehend a word because they don’t want to look stupid and uneducated.

• 39% of women understood the medical jargon used.
• The women had a far better understanding than the doctors expected.

For more detailed information – McKinlay (1975)

LEY (1998) found out that patient recall of verbal communication was improved by:

• Categorization
• Signposting
• Summarizing
• Repetition
• Use of diagrams
• Primacy effect

For more detailed information – Ley (1998)

Practitioner Style 

BYRNE AND LONG (1979) found out the features of the doctor-centred style and the patient-centred style and concluded that meaningful dialogue led to more compliance by patients.

Features of doctor-centered style:

• Impersonal atmosphere
• Intent on establishing the link between the symptoms and organic disorder.
• Patient was passive during consultaion.
• No open discussion on diagnosis and alternatives.

 Features of patient-centered style:

• Personal atmosphere
• Less controlling role by the doctors
• Open questions, allowing patients to share information

For more detailed information – Byrne and Long (1979)

SAVAGE AND ARMSTRONG (1990) found out that the doctor-led style had a better effect in terms of patient satisfaction as measured by:

• their perception of the doctor’s understanding of the problem
• the quality of the doctor’s explanation
• the subjective improvement one week later

For more detailed information – Savage and Armstrong (1990)

Practitioner Diagnosis 

There are occasions where doctors will gather up information wrong and there are two types of errors they can commit:

1. Type I error – occurs when the doctor diagnoses someone to be healthy when in fact the patient is physically and/or psychologically ill. This is also said to be a FALSE POSITIVE.
2. Type II error – occurs when the doctor diagnoses someone to be ill when they are in fact healthy. This is also said to be a FALSE NEGATIVE.

It is quite obvious which error is more significant and may lead to more complications, however both can cause harm and distress to the patient.

Disclosure of Information

For a diagnosis to occur, the patient needs to give information to the doctor. Unfortunately, everyone has their own styles of communication; therefore, it may be difficult to reach a diagnosis that is correct if patients do not contribute effectively.

Sarafino (2006) noted that it becomes difficult to communicate with patients when they:

• Want to criticize the doctor or become angry.
• Ignore what the doctors is asking or saying.
• Insist on taking more tests or on being prescribed medication they do not need.
• Want a certificate for an illness they do not have.
• Make sexual remarks towards the doctor.

ROBINSON AND WEST (1992) found out that patients are less worried about social judgments and disclosing information about symptoms and undesirable behavior of STDs when they are communicating these to a computer.

• Patients gave more information and admitted to having more sexual partners to the computer than to the doctor they met afterwards.

Strengths:

+ Useful – it encouraged the development of communication systems in hospital to make patients more comfortable and make it easier to reach a correct diagnosis.

+ No demand characteristics – the research was carried out in a real hospital with real patients, doctors, meaning that the participants would not  change their behavior to conform with the experiment.

Weaknesses:

– Ungeneralizable – the research was only carried out at one clinic, making the results less applicable to the entire population and less reliable.

– Patients may have felt it to be useless to mention everything to the doctors since they had just told the computer.