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• General

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    Learning Objectives Lesson

    "I WILL" Principles for effective clinical communication.

    Learning Objectives:

    1. Gain deeper insights into I WILL principles
    2. Practical strategies for putting I WILL principles into practice
    3. Enhance your clinical communication by applying I WILL principles

    
    

• Introduction

  “I WILL” Campaign For A Better Healthcare Communication

  Facing the context of strained Doctor-Patient relationships, we need to act immediately to rebuild trusting relationships with Patients. For rebuilding trusting relationships with patients, effective clinical communication skills are essential.

  Glocal academy (UK) has recently lunched “I WILL” Campaign for better healthcare communication.

  “I WILL” is an acronym that stands for I: Intention, W: Welcome, I: Introduction, L: Listen, L: Language.

   

  It is not just a phrase or a set of words but it is a “Campaign” with a potential to rebuild trusting relationships with patients.

   

  How does this translate into clinical practice?

   

  With an INTENTION to pay attention, a Doctor WELCOMES his patient and INTRODUCES himself to establish a rapport. He will LISTEN to understand his patient's ailments and use simple and clear LANGUAGE (avoiding medical jargon) when giving information to the patient.

   

  Imagine a time in Indian healthcare system where there is (once again) an immense trust between Doctors and Patients. Well, the “I WILL” campaign has the potential to turn that imagination into a reality.

  
  

• First Principle

  First Principle: Intention to Pay Attention

  The attitude of intention to pay attention enables you to put aside everything that is happening in your mind and focus on the patient’s narrative.

  It shows to the patient that—

  • you care,
  • you are there for them,
  • you are curious,
  • you want to listen. 

  When you are present with an intention to pay attention, the patient feels safe and secure and want to share their true story with you. This will not only build rapport but also establishes humane connection with the patient. 

  Apply this principle of Intention to pay attention in clinical practice and reap the benefits. 

  Strategies

  Eye Contact Body Language Practice Being Silent for 2 minutes Clear your mind before talking to the patient

   

  Practise; Practise; Practise.

  
  

• Second Principle

  Welcome

  Being present with a welcoming attitude helps us (healthcare professionals) to establish and maintain humane connections with patients and families.

  So, what do I mean by "Welcome?" Dictionary definition of Welcome is "accept gladly," "receive." In medical consultation, it takes the following forms:

  1. Welcome the patient irrespective of their race, culture, socio-economic status, education etc.
  2. Welcome the patient to share their story by giving them time and encouraging them to talk.
  3. Welcome not only patient's story but also the feelings that accompany the story.
  4. Welcome patient's views and opinions even when they differ from yours.
  5. Welcome the patient into decision-making process.

  I, therefore, request you to adopt the welcoming attitude when consulting with patients and their families.

  Strategies

  W.A.I.T: Why Am I Talking (Adam Bryant) W.A.I.T: Why Am I Tempted to Interrupt (Krishna Naineni)

  Facilitation Strategies to encourage patients to expand their narrative “AEIOU” Framework: A: Ask Open Questions. May I request you to begin at the beginning and tell me all about ‘X’ E: Encourage. Tell me more. Uh, Uh. Go on. Anything else you want to add. I: Invitational. Show that you are interested with your body language. O: Observe. Observe patients’ facial expressions, body language, tone of voice etc. U: Use Silence/Pause. Brief pause after patient finish talking shows that you’re not rushed. Ask questions like— Can I pause little longer before I speak? How can I hold silence longer than I normally would?

  
  

• Third Principle

  Introduction

  Importance of Clear Introduction in Clinical Practice

   Clear introduction is essential for establishing rapport with patients and families. I cannot emphasize enough how important introduction is in healthcare. Common sense and thousands of years of our tradition tells that it is not only customary but also respectful to introduce and greet the other person when we first meet; in clinical practice, however, this behaviour is not consistent.

  Why, I wonder? Whatever may be the reason(s), I am sure you agree with me that the current practice, of not introducing properly, cannot continue. As we are all serious and committed to improve relationships with patients, families and public--we must follow our traditional wisdom and start introducing clearly, whenever we consult with patients and families.

  This small investment will yield you huge returns.

  This simple act of kindness at the start of consultation shows that you care.

   Yes, time and workload are the biggest challenges. It is likely that these challenges are here to stay.

  I think we should be creative in the ways we can introduce to the patients. You may want to have a look at Glocal Academy Instagram page (@glocalacademyuk) where students are creating and posting innovative name badges as a means to enhance their introduction to patients.

   As we are serious about enhancing healthcare communication, we need to practice introducing to patients.

  Did you know that you could introduce effectively in just 5 seconds? That 5 seconds are the best investment a healthcare professional can make.

  Be part of "I WILL" campaign. Always Introduce.

  Strategies

  Please always Introduce to patients  Design a name badge and share on Instagram @glocalacademyuk. I have uploaded a badge designed by Rishika Sharma.

  
  

• Fourth Principle

  Listen to Understand (Author: Taranjot Kaur)

  Listening is an active task, where one must club his ability to hear with a purpose to understand in order to establish a two-way communication. However, most of the times in the consultations rather than listening to understand, we listen to reply or to reach a diagnosis. Thus, jeopardizing the strength of the doctor-patient relationship.

  Understanding is to realize what the other person feels and why does they feel that way. It is about empathizing. To understand one must listen to the unsaid. So, to understand what is not said listen to the gestures and the body language of the patient. Make an eye contact while talking, try picturing what they say. Before responding try repeating what they just said. Rather than interrupting, let them finish their narrative first and then ask the "right" questions. Be considerate and seek to relate to their emotions. Practice to perceive process and express simultaneously while listening to the patients. This way the patient will feel heard, seen, understood and satisfied.

  Hence, rather than listening to just to reply, try “Listening to Understand.”

  
  

  Questions to check whether you are listening:

  Am I giving the patient 100% of my attention? Am I listening to understand OR Am I framing my reply/next question? Why am I tempted to prepare my response while the patient is speaking? Am I aware of what is not being said, as well as what is being said? Am I considering the degree of emotion that is attached to the words? Am I giving signals to the patient that I am listening? Am I facilitating the conversation? Am I valuing the patient and the experience they have gathered in their life so far?

  
  

• Fifth Principle

  Language (Author: Roshni Kharbanda) 

   We have limited time and we need to make it count. The patients might be feeling stressful and emotional when they approach us. Therefore, our aim should be to speak in a local language without using medical terms. Speaking in local language comforts patients and helps them to understand, absorb and remember better. We need them to understand our points, as much as we want to understand their perspective. Using medical jargon in our conversation with the patient will hamper the smooth process of understanding. On the contrary using simple words allows better understanding.

  Key points to keep in mind while giving information to patients:

  • Try to converse in a local language of that area even if it means that you have to learn the local language.
  • Speak words that a layperson can understand. It is important to have grip on local language, idioms etc. If we start early, we can master it by the time we come to our internship. Make it a hobby to learn the local language.
  • Try avoiding medical jargon.
  • If some terms are non-avoidable then try to simplify them. For instance, if you need to tell the person that they have hypertension- you could say it is a condition with rise in blood pressure. Then explain briefly, what blood pressure means by saying it's the flow of fluid against the inner wall of the tube.
  • To ensure that the message is conveyed correctly, ask the patient to repeat what you said.

  I encourage you to speak in a clear and simple language so that the patient and family understands. It is all about them; not about us.