Communication Skills Training for Health Professionals

High standards of interpersonal communication are fundamental to effective health care delivery. Communication Skills Training for Health Professionals succeeds in providing the sound theoretical basis and practical approach needed to implement a higher standard of care through better communication. This is an essential part of the relationship between the health care provider and both the client and carer, and of course, between providers themselves. By giving an explanation of the underlying rationale for CST, together with the principles of training programme design, implementation, transfer and evaluation, the book becomes essential as a resource, applicable in any health care setting.The importance of skilful interpersonal communication to the provision of effective health-care is now widely recognized. In addition to the various other dimensions of expertise which health professionals draw upon, they must be able to interact successfully with colleagues and other health workers as well as patients and clients. It would seem, however, that standards of practice, in this respect, frequently fall short of public expectations and levels of professional acceptability. Interpersonal communication is consequently beginning to emerge from the 'hidden curriculum' to form an integral part of the training of, for instance, doctors, dentists, nurses, pharmacists, health visitors, physiotherapists, occupational therapists, speech therapists and dietitians. This handbook has been prepared to meet the need for information and advice by tutors faced with the task of contributing inputs in this area as part of either pre- or in-service education programmes.The book is essentially concerned with elaborating a structured and systematic instructional procedure for enhancing skilful face-to-face communication. It is organised in four parts. Part One contributes a firm conceptual base for the rest of the text by introducing and examining the notions of communication and communicative competence. The importance of effective interpersonal communication in the health professions is assessed and contrasting approaches to facilitating performance considered. An initial overview of CST is also given. Part Two is devoted to the content of training. Here a theoretical model of skilled communication is developed incorporating interpersonal, intrapersonal and situational determinants. A range of skills, commonly documented as being relevant to health-care personnel, are presented and analysed. These include nonverbal communication, questioning, listening, explaining, reinforcement and assertiveness. Furthermore the incorporation and integration of such skills within the strategic contexts of interviewing, counselling and influencing is discussed.The CST process encompassing preparation, training and evaluation stages is the subject of Part Three. Having established the aims and objectives of the training intervention, techniques are presented for isolating and identifying appropriate skills content. Sensitisation, practice and feedback phases of training per se are expounded and guidelines offered as to their implementation. This section is concluded by focusing upon methods of programme evaluation. The fourth and final part of the book brings a more integrative perspective to bear upon CST. A detailed exposition is given of the major considerations which the tutor must acknowledge in designing and implementing training and the influence of these, at different levels, on the instructional sequence formulated. Finally the impact of CST upon the communicative competence of professionals is discussed.It has been our intention to produce a book which is fundamentally practical in orientation, containing not only information and guidance but also material which trainers can directly apply in planning, teaching and evaluating programmes. Practical exercises are inserted throughout, together with suggestions as to how they may best be made use of. Material is also contained which can be utilised in analysing performance, identifying skills and presenting structured feedback to trainees. This can either be accepted in its present form or adapted to more fully meet particular requirements.In outlining CST procedures and techniques we have, however, avoided a 'cook-book' approach which merely describes a stereotypical sequence of steps to be reflexively followed on each and everv occasion. This is not how we see CST. Rather we have resolved to document the underlying rationale for this type of training and illuminate the theoretical, conceptual and empirical underpinnings of the various instructional mechanisms which contribute to it. Trainers who have a firm understanding of why they are doing what they are doing are infinitely better prepared to maximize the potential which CST has to offer with different groups in disparate settings.