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Week 3 nonverbal communication ch3new

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Week 3 nonverbal communication ch3new

  1. 1. Communication and Counseling Skills Nonverbal Communication in pharmacy week 3 Hiwa K. Saaed Ph.D. School of Pharmacy 2015-2016 References: Communication skills in pharmacy practice 6th ed. Chapter Three, p:31-41 www.ikinesics.com
  2. 2. Nonverbal Communication • Nonverbal vs Verbal Communication • Elements of Nonverbal Communication • Distracting Nonverbal Communication • Detecting Nonverbal Cues in Others • The Importance of Nonverbal Communication in Health Care Encounters • Overcoming Distracting Nonverbal Factors 4/19/2016 2
  3. 3. Overview • Interpersonal communication involves both verbal and nonverbal expression. i.e., Words are not the only way; Words normally express ideas, whereas nonverbal expressions convey attitudes and emotions. • A large measure of how you relate to others and how they relate to you IS NOT BASED ON WHAT IS SAID, BUT ON WHAT IS NOT SAID. • You are constantly providing “messages” to those around you by your- dress, facial expression, body movements, and other aspects of your appearance and behavior. 4/19/2016 3
  4. 4. Nonverbal vs Verbal Communication • Nonverbal communication involves a complete mix of behaviors, psychological responses, and environmental interactions through which we consciously or unconsciously relate to another person. • approximately 55% to 95% of all communication can be attributed to nonverbal sources. 4/19/2016 4
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  6. 6. Importance of Nonverbal Communication Nonverbal communications are important for three reasons. First, they mirror innermost thoughts and feelings. Second, it is difficult, and almost impossible, to “fake” during an interpersonal interaction. Third, congruence between your verbal and nonverbal messages “Must be CONSISTENT” ; or people will be suspicious of the intended meaning of your message. 4/19/2016 6
  7. 7. Interpretation of Nonverbal cue • In nonverbal communication, we perceive and interpret a given nonverbal message or “cue” in a personal manner. • Various interpretations emerge from the different social, psychological, cultural, and other background variables of the senders and receivers of nonverbal messages. • Therefore, nonverbal “cues” can and often do have multiple interpretations. • However, within a given society, groups of nonverbal cues or “cue clusters” generally result in interpretations that are universally agreed upon. 4/19/2016 7
  8. 8. Nonverbal cue Cue clusters are combinations of nonverbal acts that communicate certain global messages. For example, a patient who gives you a friendly handshake, a pleasant-sounding “thank you,” and a warm smile at the end of your interaction is probably more pleased with the interaction than a patient who abruptly turns around and quickly walks away mumbling something under his breath. When analyzing nonverbal communication: 1. avoid focusing on just one cue. 2. Look at all the nonverbal cues that you are receiving 3. and use verbal communication to fully understand the meaning of the nonverbal behavior. 4/19/2016 8
  9. 9. Nonverbal expressions include: 1. kinesics, (body movement), 2. Proxemics (distance between persons trying to communicate), 3. elements of the physical environment in which communication takes place. 4. Distracting factors 4/19/2016 9
  10. 10. Kinesics The manner in which you use your arms, legs, hands, head, face, and torso may have a dramatic impact on the messages that you send. It should reflect interest, empathy, sincerity, respect. In general, individuals from various societies use different body movements to communicate certain messages. for example, • A handshake is a way by which we nonverbally indicate friendship or acceptance of the other person. • However, in some cultures, it is more appropriate to bow to each other rather than shake each other’s hand. 4/19/2016 10
  11. 11. Kinesics open posture: • An open stance can nonverbally communicate sincerity, respect, and empathy for another person. • The classic example of an open posture is standing (or sitting) with a full frontal appearance to the other person. • As an open communicator, you should also have your legs and arms comfortably apart (not crossed) and a facial expression that expresses interest and a desire to listen as well as speak. 4/19/2016 11
  12. 12. Kinesics Closed posture • occurs when you have your arms folded in front of your chest, legs crossed at the knees, head facing downward, and eyes looking away from the patient. • Communication from a closed posture may shorten or halt further productive interactions. • Sometimes it is appropriate to use a closed posture, for example, when you want to limit the interaction with an overly talkative person. 4/19/2016 12
  13. 13. Key Components of Kinesics • Varied eye contact (consistent, but not a stare) • Relaxed posture • Appropriate comfortable gestures • Frontal appearance (shoulders square to other person) • Slight lean toward the other person • Erect body position (head up, shoulders back) 4/19/2016 13
  14. 14. Proxemics Distance between two interacting persons Most protected space is that from full contact to ≈ 18 inches (45 cm) from our bodies. We experience anxiety when somebody venture into this space ( e.g. crowded elevator) for public rather than private communication. Interpersonal distances of more than 4 to 6 feet (1 foot= 30.48 cm) are generally reserved 4/19/2016 14
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  16. 16. Proxemics • Thus, you must consider the distance factor whenever you consult with patients. • You want to stand close enough to ensure privacy, You do not want to invade a patient’s intimate zone nor conduct the counseling session in the public zone. • For sensitive issues, such as explaining the use of a rectal or vaginal medication, you may need to enter the patient’s private zone, especially if others are around. • Patients usually indicate nonverbally whether they feel comfortable with the distance by either stepping backward or leaning forward. 4/19/2016 16
  17. 17. ENVIRONMENTAL NONVERBAL FACTORS • Pharmacy’s décor: the colors, the lighting, and the uses of space. • The counter and related shelving serve to keep the prescription dispensing process from the public’s view. However, they can also serve as communication barriers if they inhibit your interaction with your patients. • In addition, the presence of a private consulting area may indicate to your patients that you are interested in counseling them in a private manner. 4/19/2016 17
  18. 18. ENVIRONMENTAL NONVERBAL FACTORS • The general appearance within the pharmacy setting conveys nonverbal messages to patients. • Dirt, clutter, and general untidiness carry negative nonverbal messages. • In addition, the physical characteristics of pharmacy employees also send nonverbal messages to patients. Professional staff should dress appropriately. • You want to convey a friendly appearance, but you also want to convey professional competence. 4/19/2016 18
  19. 19. Distracting Nonverbal Communication 1. Lack of eye contact, limits your ability to receive feedback from the patient about the messages that you are giving. • If you do not look at patients while they are talking, they may get the impression that you are not interested in what they are saying. • Using good eye contact does not mean that you continually stare at patients, because that may make them feel uncomfortable as well. The key is that you spend most of the time looking at them . 4/19/2016 19
  20. 20. Distracting Nonverbal Communication 2. Facial expression: An inadvertent facial expression may send a message that you did not intend to transmit. For example, if you roll your eyes as a patient explains something to you, you may be communicating a feeling of disinterest or lack of concern toward the patient. • This is especially damaging when your facial expressions are not consistent with your verbal expressions. For example, if you say, “Go ahead, I am listening. Tell me about it!” but your eyes are distracted by something else in the pharmacy, you may be communicating mixed messages. 4/19/2016 20
  21. 21. 3. Body position can be somewhat distracting. Most patients will judge your willingness to talk to them based on their perception of your body position. For example, a closed stance with folded arms or a body position that is slouched forward or tilted to one side may be communicating reluctance on your part to talk with them. You must be aware of your body position. Does it project your sincere desire to talk with your patients or does it show a lack of concern or interest? 4/19/2016 21 Distracting Nonverbal Communication
  22. 22. Distracting Nonverbal Communication 4. Tone of voice: Another potential distraction to communication may be your tone of voice. People interpret the message not only by the words you use, but also by the tone of voice you use. • For example, a comment in a sarcastic or threatening tone of voice will produce a different effect than the same phrase spoken with an empathic tone. • In addition, conveying a message in a dull, monotone voice may convey a lack of interest on your part. 4/19/2016 22
  23. 23. Detecting Nonverbal Cues in Others • Detect messages and assessing the meaning behind the nonverbal messages of others is difficult, • because We tend to interpret nonverbal cues based on our own personal backgrounds and experiences. • We need to avoid making false assumptions or jumping to conclusions based on inaccurate interpretations of nonverbal cues. 4/19/2016 23
  24. 24. The Importance of Nonverbal Communication in Health Care Encounters • For a patient, the illness experience can produce profound feelings of vulnerability and dependence. These emotions are often conveyed primarily through nonverbal channels. • Pharmacists too experience emotions in providing care to patients, especially to those who are facing a serious illness. 4/19/2016 24
  25. 25. The Importance of Nonverbal Communication in Health Care Encounters CASE STUDY 3.1 • During his first externship experience in a community pharmacy, a pharmacy student (John) was assigned the task of receiving new prescriptions from patients. • John wanted to help the patients and was looking forward to the opportunity of talking with them about their problems. • One day, Mr. Stevens approached the prescription counter to have his prescription for levodopa refilled. John, who did not realize that Mr. Stevens had Parkinson’s disease, noticed that his hands were shaking and commented, “I see you are a bit nervous today, Mr. Stevens. What’s the matter?” 4/19/2016 25
  26. 26. The Importance of Nonverbal Communication in Health Care Encounters • John observed a nonverbal message (rapid hand movement) from Mr. Stevens and assigned a wrong (and embarrassing) meaning to it. • John should not have jumped to the conclusion based on just one nonverbal cue but should have noticed that Mr. Stevens’ head was also moving and that he walked with a shuffled gait, which are other characteristics of Parkinson’s disease. • Another example occurs when elderly patients move closer to you or put a hand to their ears. What message might these nonverbal cues indicate? Possibly, they may indicate that they are having difficulty in hearing. You may also observe hearing aids, glasses, and other devices that indicate possible communication difficulties. 4/19/2016 26
  27. 27. The Importance of Nonverbal Communication in Health Care Encounters • Another example occurs when patients are reluctant to speak to pharmacists and we do not know the real reason behind this behavior. Could it be – a lack of respect for the pharmacist? – Or could it be embarrassment? • Harris Survey (1997) found that embarrassment was the most common reason. • A wide variety of embarrassing issues could exist within practice, including incontinence, sexual dysfunction, depression, menopause, hemorrhoids, contraception, and breast or prostate cancer. • As a pharmacist, you should be prepared to recognize situations that may be sensitive areas for patients. 4/19/2016 27
  28. 28. The Importance of Nonverbal Communication in Health Care Encounters Some tips and tactics to help with sensitive situations: • Watch your patients. Before engaging in a conversation, watch their behavior to get a clue about their feelings. They may appear to be embarrassed before they reach the prescription counter. • Discuss sensitive issues with clarity and avoid potentially frightening scenarios. For example, you may bring up the subject of incontinence by saying, “Miss Smith, would you like to step away to a quieter area so that we can talk?… 4/19/2016 28
  29. 29. Overcoming Distracting Nonverbal Factors • the first step in improving interpersonal communication is recognizing – how you communicate with others. – distracting nonverbal elements then try to overcome them. • In this regard, videotaping yourself is particularly helpful, since it reveals the positive and negative aspects of your nonverbal communication. • Once you have discovered what aspects you need to change to become more effective, the next step is a difficult one: finding strategies to overcome these distracting elements. 4/19/2016 29
  30. 30. Overcoming Distracting Nonverbal Factors • For example, you may find that you naturally cross your arms while talking to others. You can overcome the possible perception that you are acting defensively by using other nonverbal elements, such as smiling, using a friendly tone of voice, or moving closer to the patient. • Another example is that if you have a soft voice and you sense that the patient cannot hear you, then you should lean toward the patient, raise your voice, or move the patient into a quieter section of the pharmacy. 4/19/2016 30
  31. 31. Summary • Certain nonverbal behaviors are universal; however, many are culturally specific. • Interpreting body language is ambiguous. You could assign the wrong meaning to the nonverbal message. • Nonverbal behavior is more powerful than verbal. If the spoken word contradicts nonverbal behaviors, the observer will believe the nonverbal messages. • Even simple advice, such as “Store this in the refrigerator and shake it well every time you use it,” may be influenced by your facial expression and tone of voice. 4/19/2016 31
  32. 32. Summary • The physical attributes of your practice environment have important effects on communication with patients. – The location, – design elements of the counseling area, – employee appearance, – and even the color scheme and signage on the walls all contribute to the messages that patients receive about your philosophy and attitude toward patient counseling. 4/19/2016 32
  33. 33. Review Questions • 1. How much communication is attributed to its nonverbal component? Why is this so? • 2. What is the importance of cue clusters? • 3. List the many ways that body language can improve your role as a pharmacist. • 4. Differentiate between kinesics and proxemics. • 5. Examine your own nonverbal behavior and list ways you may overcome any distracting styles. 4/19/2016 33
  34. 34. REVIEW CASE STUDY 3.1 • Mary Jane Marvel is a 22-year-old college senior. • For the past semester, she has had what she perceived to be a nagging vaginal infection. • She went to the Student Health Center and received a diagnosis of gonorrhea. • She was so embarrassed and upset that she really didn’t talk to the nurse practitioner about her treatment. • She approaches the campus health pharmacy with trepidation and stands off to one side while Stephanie, the pharmacist, fills her prescription. 4/19/2016 34
  35. 35. REVIEW CASE STUDY 3.1, cont. • Stephanie notices Mary Jane’s behavior and leaves the prescription counter to talk with her. • Stephanie: Hello, Miss Marvel, I am Stephanie Gonzales, and as the pharmacist who filled your prescription, I would like to talk to you a little bit about it. But before we talk, let’s step over here to a more private area. Is this okay? • Mary Jane: Sure, why not (said nervously). • Stephanie: I was watching you a moment ago and you seem very distressed. 4/19/2016 35
  36. 36. REVIEW CASE STUDY 3.1, cont. • Mary Jane: How would you feel if you had this disease? Besides, why should I confide in you? • Stephanie: I can appreciate how you might feel, but I may be able to help by providing information about your treatment. • Mary Jane: Well, I guess I have to talk with someone … I do want to discuss the medicine. • Stephanie: I respect your trust. • Mary Jane: I’ve got gonorrhea and I am scared I won’t be able to have sex for a long, long time. 4/19/2016 36
  37. 37. REVIEW CASE STUDY 3.1, cont. 1. Discuss the various nonverbal messages that Mary Jane was sending. 2. Analyze Stephanie’s ability to notice Mary Jane’s nonverbal behavior. 3. Describe the environmental and emotional barriers that Stephanie needed to overcome in order to speak effectively with Mary Jane. 4. What nonverbal behavior could Stephanie display that indicates she is ready to listen and talk with Mary Jane? 4/19/2016 37