Handbook of Veterinary Communication Skills

Carol Gray, Jenny Moffett

• Publisher: Wiley-Blackwell
• Year: 2013
• ISBN:
  9781118699706
• Edition: 1
• Topic: Medicine
• Subtopic: Veterinary Medicine

This is the first definitive textbook on veterinary communication, written specifically for students and veterinary professionals by a group of international experts. Communication is a core clinical skill, and is now taught as a compulsory part of most veterinary degree courses. Good communication is crucial to the veterinarian-client-patient relationship, to patient health and ultimately to the success of any veterinary business.

The book covers all the key areas of communication including: the basic framework for the veterinary consultation; professional, ethical and legal aspects; communication with clients and colleagues; and coping with end-of-life and other difficult situations. It combines the most up-to-date research with a wealth of practical information, such as:

• Real-life case studies to help you apply your learning to real scenarios
• Simple step-by-step guidelines showing you how to deal with specific situations
• Examples of written resources you can use in practice

This valuable textbook has been written and edited by a carefully chosen group of specialists, comprising veterinary communication lecturers, veterinary practitioners, training managers and counsellors.

1
Basic communication skills

Mary Kirwan

Introduction

This chapter introduces the veterinary student and practitioner to the skills necessary for effective communication with clients (owners), animals, colleagues and support workers they meet on a daily basis. The importance of communication for all professionals is explored, making particular reference to health professionals. The skills required for successful communication are specified, with key terms relating to communication skills defined and some theories examined. Some of the models used to describe the communication process are outlined and their relevance is considered. A circular model that may be useful in the context of the veterinary consultation is proposed. The verbal and non-verbal aspects of communications are explored, and it is hoped that the reader will recognize the interdependence of both elements in communicating effectively. The ability to be able to ask effective questions is recognized and some general guidelines are offered. Following this, the importance of listening as a core element of communication is considered. Finally, the influence of the environment and culture on the communication process is considered.

BACKGROUND AND ORIGINS

The topic of communication and its importance in establishing and maintaining human contact can be traced back to the Bible. In the Old Testament story of the Tower of Babel, the builders of the Tower to the Heavens were punished and given different tongues. They were separated according to their language, with each group banished to a different land (Sundeen et al. 1998). Later in the New Testament, the story of Pentecost further illustrates the importance of communication: the disciples of Christ were given the ‘gift’ of tongues so that they could be understood by people of all languages (Sundeen et al. 1998). Nevertheless, in the field of health care, such as medicine, nursing and physiotherapy, communication skills training is a relatively recent addition to curricula. The notion that ‘talking isn’t working’ was identified in nursing in a number of papers published in the early 1980s (Melia 1982). In relation to medicine, there is a view that effective medical consultations are still difficult to achieve despite the vast amount of communication literature (Roberts et al. 2003).

THE IMPORTANCE OF COMMUNICATION

‘It is impossible not to communicate.’ This idiom is often used by communication theorists (Laurent 2000). Communication helps us to learn about others and ourselves and is concerned with what is transmitted, how it is to be conveyed and what hinders or aids the process (Arnold & Underman-Boggs 2007). We are also reminded that interpersonal communication is vitally important to all caring professionals, and it is suggested that many of the problems associated with patient non-compliance could be avoided by improving the health professional’s communication skills (Ley 1988). The lack of effective communication is a constant facet of complaints received by those dealing with complaints in health facilities (Roberts & Bucksey 2007). Hence, communication between health professionals and the client for whom they provide the care is important so that the client has a positive experience of the interaction (Roberts & Bucksey 2007).

In the field of medicine and nursing, communication has long been seen as a core competency for elucidating the patients’ symptoms, problems and concerns and, according to recent research, an important clinical skill for ensuring health promotion, treatment and compliance (Ammentorp et al. 2007). Effective communication is largely considered to be a key factor in client satisfaction, compliance and recovery (Chant et al. 2002; Rider & Keefer 2006). The remark by Faulkner (1998), ‘to be able to communicate effectively with others is at the heart of all patient care’, is pertinent to any discussion on the importance of communication. Studies have shown that when clients are involved in decision making they are more likely to adhere to the recommendations (Rainer et al. 2002). The statement written for nursing students and nurses is equally relevant to those in the veterinary profession. Internationally, the teaching and assessing of interpersonal and communication skills are now accepted as an integral component of medical and related education programmes (Rider & Keefer 2006; Roberts et al. 2003).

Despite this increasing awareness of the importance of good communication in health care, a significant number of patients’ complaints still relate to communication problems (Ammentorp et al. 2007). Misinformation, lack of information and lack of responsiveness are deemed to be at the forefront of such complaints in patients’ satisfaction ratings (Ammentorp et al. 2007). The interface between communication skills and clinical skills is a common source of debate (Chant et al. 2002; Noble & Richardson 2006). In the medical literature, an example of the centrality of communication is illustrated in relation to cancer care in which the researchers predict that oncologists conduct between 150 000 and 200 000 consultations with patients and relatives during a 40-year clinical career (Noble & Richardson 2006).

It is imperative that health care providers develop an awareness of what exactly constitutes effective communication. Previous researchers and theorists have attempted to enumerate the skills required for effective communication. According to MacLeod Clark (1983), the following may be included:

• Observing and listening
• Reinforcing and encouraging
• Questioning
• Responding
• Giving information

Thus, to communicate is more than just the utterance of words but also the exchange of ideas and information between two or more people. In developing the Calgary–Cambridge framework to the medical interview, its authors established the importance of guidelines for doctors and medical students (Kurtz et al. 2003; Silverman et al. 1998). The veterinary consultation model is a version adapted for veterinary practitioners and students (Chapter 2). As in human medicine, communication in the veterinary consultation is goal-directed, time-limited and focused (Arnold & Underman-Boggs 2007).

DEFINITION OF KEY TERMS

Communication is the basic element of human interaction that allows people to establish, maintain and improve contact with others. It is the means by which a message is transmitted, how it is conveyed and what hinders or aids the process. There is inconsistency in the literature as to what constitutes a communication skill, if this skill is the same as an interpersonal skill and if it differs from a social skill (Chant et al. 2002). The literature would suggest that these terms are often used interchangeably (Chant et al. 2002; Hargie 2007). This poses difficulty in presenting an all-inclusive definition. This variant is particularly evident in the area of human resources. In the current era of competency requirements, many employers require candidates applying for a post to have high levels of social, interpersonal or communication skills.

Communication is the process of understanding and sharing meaning. Communication experts now appear to accept communication as a process with no beginning and no end (Hargie 2007; Wolvin & Coakley 1996). As such, it is continually occurring and constantly changing because no two interactions are the same (Wilson & Sabee 2003). This poses a difficulty if competence in the skill of communication is to be assessed (Hargie 2007). Some guidance in this area is provided in the work of Wilson and Sabee (2003), who suggested that competence is related to three qualities, namely knowledge, motivation and skill (Hargie 2007).

At a simple level, communication is the ‘act of imparting of/or transmitting’ and the word ‘communicate’ means ‘to impart, to transmit, to be connected’ (Simpson & Weiner 2005). For those in the helping professions, the latter ‘to be connected’ appears to be the most important. Communication skills are also associated with outcomes where the objective of the interaction is to achieve a particular outcome, as is generally the case in face-to-face interactions and professional consultations (McConnell 2004). Noticeably, some of the literature involving communication emphasizes the importance of the two-way function, the exchange of information between a sender and a receiver, while others stress the importance of understanding and feedback (Odell 1996).

Hargie (2007) proffers that communication emerges in childhood as a skilled performance and views interpersonal communication as a skill. He equates the acquisition of communication skills in the same way as gross or fine motor skills. Given that the basic elements of social skills are verbal and non-verbal behaviours, we begin to acquire a repertoire of social skills to a greater or lesser extent from infancy. In attempting to differentiate between social interactions and interpersonal communication, Hargie (2007) reviewed previous research and asserts that there are elements of commonality with social skills and other skills. He cites the six basic elements identified by previous studies (Michelson et al. 2007) as central to social skill acquisition:

1. Are learnt
2. Are composed of verbal and non-verbal behaviours
3. Entail appropriate initiation and responses
4. Maximize available rewards from other
5. Require appropriate timing and control of specific behaviours
6. Are influenced by prevailing contextual factors

Based on the assumption that these elements are central to the skill aspect, the following definition of social skills is presented (Hargie 2007):

A process in which the individual implements a set of goal-directed, interrelated, situationally appropriate social behaviours which are learned and controlled.

In order to put this definition in context, the theoretical components of communication, which are believed to have a basis in ...

Table of contents

• Cover
• Table of Contents
• Title
• Copyright
• Contributors
• Foreword
• Acknowledgements
• Introduction: The veterinarian–client–patient relationship
• 1: Basic communication skills
• 2: A framework for the veterinary consultation
• 3: Professional, ethical and legal aspects of communication
• 4: Compassionate communication: working with grief
• 5: Dealing with difficult situations
• 6: Communicating with colleagues
• 7: Communicating with a wider audience
• 8: Communication and self-care in the veterinary profession
• Index
• End User License Agreement