5. Communication

Definition

Communication is the verbal, nonverbal, and written sharing of information. The communication process consists of a sender who encodes and presents the message and the receiver(s) who receives and decodes the message. Communication involves both the message (what is being said) and the delivery method (how the message is presented).

Skillful communication is the ability to convey information to and receive information from others effectively and is a foundation of MCH practice, policy, and research. It includes the essential components of attentive listening and clarity in writing or speaking. An understanding of the impact of culture and disability on communication between MCH professionals and the individuals, families, and populations that they serve is also important.

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Knowledge Areas

Through participation in this program, a participant will know:

  • Principles of communication for all three communication modalities – verbal, written, and nonverbal.
  • Challenges to communication, such as contextual mediators, literacy levels, cultural meanings, professional terms, and acronyms; and approaches to overcome those challenges.
  • The MCH vocabulary (for example, acronyms and terms specific to the MCH field) to express and understand information.

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Skills

Basic. Through participation in this program, a participant will:

  1. Share thoughts, ideas, and feelings effectively in discussions, meetings, and presentations with diverse individuals and groups.
  2. Write clearly and effectively to express information about issues and services that affect MCH population groups.
  3. Understand nonverbal communication cues in self and others.
  4. Listen attentively and actively.
  5. Tailor information for the intended audience(s) (consumers, policymakers, clinical, public, etc.) by using appropriate communication modalities (verbal, written, nonverbal).

Advanced. With more experience and building on the basic skills, MCH leaders will:

  1. Demonstrate the ability to communicate clearly through effective presentations and written scholarship about MCH populations, issues, and/or services.
  2. Articulate a shared vision for improved health status of MCH populations.
  3. Employ a repertoire of communication skills that includes disseminating information in a crisis, explaining health risks, and relaying difficult news.
  4. Refine active listening skills to understand and evaluate the information shared by others.
  5. Craft a convincing MCH story designed to motivate constituents and policymakers to take action.

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Educational Experiences

  1. Oral presentations
  2. Written presentations
  3. Presentation of oral or written testimony
  4. Write an OP ED article

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Resources/Assessment Tools – 5. Communication

Assessment Tools

Inclusion Criteria –

To be considered for initial inclusion in this web site, the materials had to meet several criteria:

  • the material needed to focus on one or more of the skills listed for a particular competency
  • the material needed to describe either a measurement instrument or theory that could support the creation of such an instrument
  • the material had to be publicly available, that is, where the item is not a commercial entity available for purchase
  • the material needed either psychometric information about its properties as a measure or, particularly in the case of material found only on the Web, a high degree of face validity

Copyright and Use Issues –

The materials initially described were identified for consideration by MCH interdisciplinary training programs. Many of these materials are copyrighted and thus, may not be copied, distributed, transmitted, or published without the express written permission of the copyright owner. It is the responsibility of each user to ascertain whether materials may be freely used or whether such permission is needed.

360 Degree Feedback

Observed Encounters, OSCEs and/or Other Videotaped Encounters

Analysis Of Written Communication (Referral Letter, Short Article or Essay, Section Of Grant Proposal)

Communicating with colleagues

Rating components of consultation letters: Communicating effectively with other health care professionals is an important component of communication skills. One venue in which this communication commonly takes place is consultation letters written as follow-up to referring physicians. Myers and her colleagues (1999) developed a rating scale for use in assessing the written communication skills of residents. Many of the items in the scale are applicable to other health care learners. This scale could be a useful tool for evaluating MCH learners’ ability to communicate in writing with other health care professionals.

Information at:
Myers, K. A., Keely, E. J., Dojeiji, S., & Norman, G. R. (1999). Development of a rating scale to evaluate written communication skills of residents. Academic Medicine. 74(10):S111-3.

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Patient Note

Stillman (1992) and her colleagues described the use of a patient note to assess the adequacy of residents’ clinical skills including data gathering and interview skills. They correlated results of the patient notes with more traditional measures of adequacy including standardized patient checklists and ratings by physician faculty. Although this study was conducted with first-year residents who were also foreign medical school graduates, the methodology has potential for use with a broader group of health care learners.

Information at:
Stillman, P. (1992). The use of a patient note to evaluate clinical skills of first-year residents who are graduates of foreign medical schools. Academic Medicine. 67(10): S57-9.

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Communicating with clients and families

Davis Observation Code: The Davis Observation Code provides definitions of medical interview behaviors. This tool, which could be adapted to refer to member of the health care team other than physicians, covers essential components of the medical interview. While it is designed for use in coding direct or videotaped observations, it could easily be structured into a checklist of desired behaviors appropriate for evaluating the collecting of pertinent information during an interview process.

Observing learners while they conduct an interview or having them present the findings from an interview are ways to assess the ability to collect pertinent information during an interview process. Comparing learner behaviors to a checklist of expected behaviors provides a way to both assess behavior and to provide feedback aimed at guiding future behavior.

Information at:
http://www.acgme.net/outcome/downloads/IandC_3.pdf

Parents’ Perceptions of Physicians’ Communicative Behavior: The ACGME Outcome Project includes Interpersonal and Communication Skills as one of their six core competencies for residents. The project provides a set of definitions, suggested ways of measuring, and examples of assessment tools for interpersonal and communication skills that are focused mainly on the physician-patient relationship.

One of these assessment examples, in particular, could be appropriate for evaluating the MCH leadership communication skill of building and sustaining relationships to accomplish goals.

The Parents’ Perceptions of Physicians’ Communicative Behavior tool is a 14-item questionnaire that can be completed by children’s family members. This tool, which could be adapted to refer to members of the health care team other than physicians, covers three aspects of communication that are needed for healthy provider/consumer relationships: informativeness, interpersonal sensitivity, and partnership-building.

Information at:
http://www.acgme.org/outcome/downloads/IandC_7.pdf

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Self-assessment of and reflection on communication

Portfolios: Portfolios are collections of information that can be used to evaluate MCH knowledge in action.

Portfolios include materials prepared by a learner to demonstrate learning in response to a plan. There is increasing evidence of the utility of portfolios for assessment of learning and for competency assurance in health care.

For a portfolio to be effective, it should include:

  • a learning plan that contains specific goals and objectives
  • materials that demonstrate achievement relative to the learning plan
  • learner reflections
  • learner and faculty evaluations of the material

The ACGME, in its draft Toolbox of Assessment Methods, provides some information about the properties and uses of portfolios for assessment.

Information at:
http://www.acgme.org/outcome/assess/toolbox.asp

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