091013L - COMMUNICATION: INTRODUCTION

Background material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

COMMUNICATION PROCESS

The communication process consists of conceptualization of ideas, encoding and transmitting the message, decoding and interpretation of the message, and feedback.

Words have power and must be selected carefully because they determine and restricts thought.

Language must be appropriate (by intimacy, professional circles, age group, and gender), individualized, precise, believable, credible, and pleasant.

Communication style reflects basic personality. You get to know people by the way they communicate.

Barriers to effective communication are prejudgment before communication, differences between communicators (self-image, status, roles, personality, cognitive ability, physical situation, social status, culture, vocabulary, and language), distractions, emotional resistance to being on the receiving end, time constraints, poor listening, poor speech, bad timing, and unsuitable circumstances.

Other causes of communication failure are multiple meanings of words, information overlord, verbosity, value judgment, and filtering.

COMMUNICATION IN SMALL GROUPS

Face-to-face communication is usually the best form of communication because of immediate feedback.

Success of oral communication (speaking and listening) is affected by language use, voice and inflexion, speed and volume, periods of silence, active listening, body language, clear speech with an objective, repetition, conciseness, and feedback.

When urguing a case, start from a common ground, use only logical reasoning, and do not be emotional.

Silence is better than careless, wrong, offensive, or misleading talk.

What leads to confusion should not be said even if it is true.

Listening can be active (with feedback) or passive (no response). Barriers to effective listening are weak extrinsic motivation, personal constraints, environmental constraints, and poor timing of the message.

0910L-PRINCIPLES OF SUCCESSFUL PUBLIC SPEAKING

Background material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

Purposes of public speaking

Public speaking has several purposes. It informs, entertains, inspires, convinces, motivates, teaches, and trains.

Elements of public speaking

Public speaking involves the speaker, the message, the delivery, and listeners.

The speaker

The speaker must have integrity, knowledge, a positive attitude, sensitivity to the audience and the situation, oral skills, self-confidence, self-control, good preparation, energy, sincerity, and credibility (based on physical appearance, posture, gestures, movements, and voice quality).

The message

The message of a successful speech is short, simple, sincere, related to the audience, well prepared, based on knowledge of the subject, innovative, and creative. The topic is narrowed to 2-3 points. The introduction is a concise overview that raises interest and expectations. The body of the speech consists of main points as well as links and transitions to ensure a smooth flow. The conclusion summarizes key ideas, gives a sense of completeness, and appeals to the audience.

The delivery

The language must be clear and appropriate for the topic, situation, and audience. Rehearsing a speech increases the speaker's confidence. The methods of delivery are from memory, by reading manuscript, ex-tempore, and impromptu. Retention is increased by audio-visuals, repetition, periods of silence, audience participation, short and simple speeches, examples and stories, acronyms, memorable quotes, sincerity, appropriate body language and emotion.

The audience

Problems from the audience are heckling, hostility, inattention, and challenges by experts. The speaker must anticipate questions and prepare for them. He must empathize with the questioner and show he understands them.

0910L-SCIENTIFIC WRITING

Discussion material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

The goal of scientific writing is clarity. The following must be observed about sentences: short concise sentences, use of personal pronouns, subject-verb agreement is a common mistake, using active and avoiding passive sentences, proper organization of parallel ideas, and proper use of parentheses.

A paragraph must start with a short and simple topic sentence that is an overview of the message contained in that paragraph. Each paragraph should convey only one message. The sentences following the topic sentence provide details and support for the topic sentence. Ideas in a paragraph should be presented in the right order with no missing steps using one of the following alternatives: least to most important, most to least important, concise to the detailed, time chronological order, problem followed by solution, or solution followed by the problem. Links and transitions such as ‘which is’ should be used when moving from one group of ideas to another to ensure continuity in the paragraph. There must be consistency in the order in which information is mentioned. If certain objects were mentioned in a certain order in the introduction, they must be mentioned in the same order all through the writing. The writer should maintain a consistent viewpoint all through the paper and not appear to be jumping from point to point. Important messages must be given emphasis.

The purpose of the title is to identify the main topic or message of the paper so as to attract readers. A good title is unambiguous, concise, and contains important words. It should contain the following: independent variable(s), dependent variable(s), the study subjects or materials, and statement of the main message like ‘to study the effect of’, ‘to determine’ etc.

The abstract is an overview of the report with a few significant details. It should be written to be read by both those who read the full paper and those who do not read the full paper. Normally the abstract should not exceed 250 words. The abstract should mirror the sections of the paper: introduction, materials & methods, results, and discussion. The present tense is used to state the research hypothesis and the answer. The past tense is used for the experiment. An abstract is accompanied by keywords that are used for indexing.

The introduction should be short. It should start with stating the research question or research hypothesis and then go on to elaborate. The transition should be from the known to the unknown and from the big picture to the detail. The introduction should mention the type of study, the study subjects or materials (substances, animals, and persons). In some cases the introduction may briefly mention the proposed experimental approach to answering the research question. Results should not be mentioned in the introduction.  The introduction should state whether the work is new or original.

The aim of the materials and methods section is to describe the experimental techniques in detail sufficient for another trained scientist to replicate the procedures. The order of presentation is different for animal and clinical studies. For animal studies the order is: materials and animals, preparation, study design, interventions, methods of measurement, calculations, and data analysis. For clinical studies the order is: study subjects, inclusion criteria, exclusion criteria, study design, interventions, method of measurement, calculations, and data analysis. Independent and dependent variables should be identified. Intermediate results can be put in the materials and methods section. Final results should be put only in the results section. Details of sample size determination should be provided.

The results section presents the findings of the procedures carried out in the methods section. It should be brief and to the point. A distinction must be made between results and data. Result refers to summary information obtained from data analysis. Results of hypothesis-based studies should be in the past tense. Data of descriptive studies should be in the present tense. Data is the actual numerical information often presented in a summarized form. The result is presented followed by presentation of supporting data. Data are presented in the form of tables and diagrams (figures, bar diagrams, graphs, pie-charts, maps etc). Presentation of numerical data in text should be kept to a minimum. Only results relevant to the research hypothesis should be presented. Both negative and positive results are presented. It is considered scientific fraud to present only those results that the author thinks favor a particular hypothesis. The results section is written in chronological order. The most important results are presented before the least important. Magnitude of change should be presented as a summary statistic such as percentage change instead of presenting the raw data. Summary statistics normally used as the mean, the median, and the the proportion. The mean should be presented properly as mean +/- standard deviation or standard error of the mean (SD or SE) with units of measure indicated. Measures of effect are normally the chisquare and the t statistics. Actual p values should be given instead of indicating <0.05 or >0.05. When specifying the sample size the type of sample should be explained for example ‘the sample was 20 rats’ instead of the sample size was 20’. Emphasis can be put on some results and not others. Not all the data from the study need be reported. Citing data in the text takes less space but is more difficult to read. A topic sentence is used to give an overview. Important results are put first.

Figures used to present results must have a strong visual impact and must be simple. The following types of figures are used: line graph, scatter-gram, bar graph, histogram, and the frequency polygon. The title of the figure should reflect its contents. It must be labeled correctly. Symbols must be defined. The names of variables and units of measurement must be labeled appropriately. Tables must be properly titled and column headings clearly indicated. Footnotes, subscripts, and superscripts can be used.

The discussion section states the research hypothesis, answers it, and supports the answers using data from the current study and other studies. It provides reasons to show that the answer to the question is reasonable. It explores and explains possible sources of error and bias. It also identifies and explains differences between the study results and published results. As part of intellectual honesty it discusses the strengths as well as the weaknesses of the study and how they impact on the interpretation of the results. Issues of validity and precision are also addressed. Also discussed is whether the result is new and how important it is.

References are used to acknowledge information obtained from others. The references must be the most recent and most easily available on the subject. Review articles are better than original articles. They may be journal articles, books, PhD theses, abstracts of meetings, or conference proceedings. The reference should be put immediately after the relevant text. If there are several references in a sentence, cite each reference at the relevant point and do not wait to put all of them at the end of the sentence. References should be written using the Vancouver style which is: Author. Title. Journal Year; Volume (number): starting page – ending page.

0910L-USE OF MASS MEDIA FOR HEALTH COMMUNICATION

Discussion material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

Medium	Strengths	Weaknesses
Newsletter
Magazine
Newspaper
Poster
Radio
Television
Cable TV
Religious Sermons
Outdoor advertizing

0910L-EFFECTS OF MASS COMMUNICATION

Background material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

Lively controversy centres on the effect of public communication upon audiences, not only in matters concerning public opinion on political issues but in matters of personal life-styles and tastes, consumer behaviour, the sensibilities and dispositions of children, and possible inducements to violence. Feelings regarding these matters vary greatly. Some people construe the overall effects of mass communication as generally harmless to both young and old. Many sociologists follow the theory that mass communication seems to influence attitudes and behavior only insofar as it confirms the status quo—i.e., it influences values already accepted and operating in the culture. Numerous other analysts, usually oriented to psychological or psychiatric disciplines, believe that mass communications provide potent sources of informal education and persuasion. Their conclusions are drawn largely from observations that many, or most, people in technological societies form their personal views of the social realities beyond their immediate experience from messages presented to them through public communication.

To assume that public communication is predominantly reflective of current values, morals, and attitudes denies much common experience. Fashions, fads, and small talk are too obviously and directly influenced by material in the press, in films, and in television to support this view. The success of public communication as an instrument of commercial advertising has also been constant and noticeable. Present evidence indicates that various instruments of mass communication produce varying effects upon different segments of the audience. These effects seem too numerous and short-lived to be measured effectively with currently available instruments. Much of the enormous output on television and radio and in print is probably simply regarded as “play” and of little consequence in affecting adult dispositions, although many psychologists believe that the nature of children's play experiences is critical to their maturation.

The role of newspapers, periodicals, and television in influencing political opinion is fairly well established in the voting behavior of the so-called undecided voters. Numerous studies have shown that while the majority of citizens in the United States cast their votes along party lines and according to social, educational, and economic determinants, middle-of-the-road voters often hold the balance of power that determines the outcomes of elections. Politicians have become sensitive to their television images and have devised much of their campaign strategy with the television audience in mind. Advertising agencies familiar with television techniques have been brought into the political arena to plan campaigns and develop their clients' images. The effectiveness of television campaigning cannot yet be determined reliably.

Public communication is a near-ubiquitous condition of modernity. Most reliable surveys show that the majority of the people of the world (including those of totalitarian countries) are usually satisfied with the kind of mass communication available to them. Lacking alternatives to the communication that they easily and conveniently receive, most people seem to accept what they are given without complaint. Mass communication is but one facet of life for most individuals, whose main preoccupations centre on the home and on daily employment. Public communication is an inexpensive addendum to living, usually directed to low common denominators of taste, interest, and refinement of perception. Although mass communication places enormous potential power in the hands of relatively few people, traditional requirements for popular approval and assent have prevented its use for overt subversion of culturally sanctioned institutions. Fear of such subversion is sometimes expressed by critics. (adapted from Encyclopedia Britannica 2004)

0910L-NATURE and PURPOSE OF NEGOTIATIONS

Backgtround material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

 

1.0 OVERVIEW

Negotiations are pervasive: Leaders spend a lot of their time in negotiations. Daily life, public or private, revolves around negotiating with others. You may not even be conscious of being involved in negotiations. Most major decisions, private and public, are not unilateral. They involve negotiations with others to reach an acceptable consensus.

2.0 PURPOSES OF NEGOTIATIONS

Negotiation is necessary to protect your interests, and get as much advantage as possible without entering into costly and bruising confrontations. Most conflicts can be resolved through negotiation. Good negotiation turns confrontation into cooperation. Physicians must be able to negotiate with their patients and relative to agree on a treatment plan otherwise a lot of conflicts and misunderstandings will occur.

Learning negotiation skills: Negotiation skills can be learned. They can be improved by experience and discussions with experienced negotiators.

3.0 WIN-WIN NEGOTIATIONS

What is win-win negotiation?: Negotiations can be win-win in which each party leaves satisfied or win-lose in which one party leaves with a feeling of winning and the other leaves with a feeling of having lost. A win-win outcome is the best in a negotiation. It ensures that each party gets the maximum it can from the transaction, part as friends who can work together again. Both objectives and relations have to be considered. Future relationships may be lost by aggressive pursuit of objectives.

Win-win negotiation requires avoiding stereotyping the other party. Such stereotypes confuse your judgment. Win-win negotiation requires avoiding extremes. The just equilibrium is the way to negotiate. Win-win negotiation is joint problem-solving; the alternative is power negotiation using threats, intimidation, and other power tactics that will end in deadlock. Win-win negotiation focuses on positive solutions. It aims at reaching an agreement satisfactory to both sides by a process that is as painless as possible. Satisfaction could be achieved even if one party has through miscalculation compromised its interests. It is all well as long as they are not aware of their mistake.

Elements of win-win negotiation: Win-win negotiation has the following elements: separating people from the problem, looking at interests and not positions, creating options for mutual gain, getting all parties to use objective criteria,  enough time to prepare for and carry out negotiations. and optimum circumstances under which negotiation is carried. The focus should be on solving problems and not on personalities. Interests and not positions should be defended. A negotiating position can be given up or changed without giving up your interests. Options for mutual gains should be vigorously explored. Win-win negotiators concentrate on objective criteria. A win-win outcome in negotiations requires enough time to prepare so that decisions and moves are well-studied and are not emotional reactions.

Alternative to win-win: If you are not interested in a win-win outcome, you have the liberty not to negotiate at all and to use other approaches to solving the problem.

0910L– ETIQUETTE WITH PATIENTS AND THEIR FAMILIES

Backgtround material by Professor Omar Hasan Kasule Sr. for the Communication Module FOM KFMC 6^th and 13th October 2009

1.0 BED-SIDE VISITS

The physician-patient interaction is both professional and social. The bedside visit fulfills the brotherhood obligation of visiting the sick. The human relation with the patient comes before the professional technical relation. It is reassurance, psychological and social support, show of fraternal love, and sharing. A psychologically satisfied patient is more likely to be cooperative in taking medication, eating, or drinking. The following are recommended during a visit: greeting the patient, dua for the patient, good encouraging words, asking about the patient’s feelings, doing good/pleasing things for the patient, making the patient happy, and encouraging the patient to be patient, discouraging the patient from wishing for death, nasiihat for the patient, reminding the patient about remembrance of God. Caregivers should seek permission before getting to the patient. They should not engage in secret conversations that do not involve the patient.

2.0 ETIQUETTE OF THE PATIENT

The patient should express gratitude to the caregivers even if there is no physical improvement. Patient complaints should be for drawing attention to problems that need attention and not criticizing caregivers. The patient should be patient because illness is expiation for sins, kaffaarat, and Allah rewards those who surrender and persevere. The patient should make dua for himself, caregivers, visitors, and others because the dua of the patient has a special position with Allah. When a patient sneezes he should praise Allah and the mouth to avoid spread of infections. It is obligatory for the attendants to respond to the sneezer. The patient should try his best to eat and drink although the appetite may be low. The caregivers can not force the patient to eat. They should try their best to provide the favorite food of the patient. The believing patient should never lose hope from Allah. He should never wish for death. The patient should try his best to avoid anger directed at himself or others. Getting angry is a sign of losing patience.

3.0 ETIQUETTE OF THE CARE-GIVER

The caregiver should respect the rights of the patient regarding advance directives on treatment, privacy. access to information, informed consent, and protection from nosocomial infections. Caregivers must be clean and dress appropriately to look serious, organized and disciplined. They must be cheerful, lenient, merciful, and kind. They must enjoin the good, have good thoughts about the patients and avoid evil or obscene words. They must observe the rules of lowering the gaze and khalwat.

Caregivers must have an attitude of humbleness, They cannot be emotionally-detached in the mistaken impression that they are being professional. They must be loving and empathetic and show mercifulness but the emotional involvement must not go to the extreme of being so engrossed that rational professional judgment is impaired.

They must make dua for the patients because pre-determination, qadar, can only be changed by dua.. They must seek permission, izin, when approaching or examining patients. Medical care must be professional, competent, and considerate.

Medical decisions should consider the balance of benefits and risks. The general position of the Law is to give priority to minimizing risk over maximizing benefit. Any procedures carried out must be explained very well to the patient in advance. The caregiver must never promise cure or improvement. Every action of the caregiver must be preceded by basmalah. Everything should be predicated with the formula inshallah, if Allah wishes.

The caregivers must listen to the felt needs and problems of the patients. They should ask about both medical and non-medical problems. Supportive care such as nursing care, cleanliness, physical comfort, nutrition, treatment of fever and pain are as important as the medical procedures themselves and are all what can be offered in terminal illness. Caregivers must reassure the patients not to give up hope. Measures should be taken to prevent nosocomial infections.

4.0 ETIQUETTE OF INTERACTION BETWEEN GENDERS

Both the caregiver and patient must cover nakedness, awrat, as much as possible. However, the rules of covering are relaxed because of the necessity, dharurat, of medical examination and treatment. The benefit, maslahat, of medical care takes precedence over preventing the harm inherent in uncovering awrat. When it is necessary to uncover awrat, no more than what is absolutely necessary should be uncovered. To avoid any doubts, patients of the opposite gender should be examined and treated in the presence of others of the same gender.

The caregivers should be sensitive to the psychological stress of patients, including children, when their awrat is uncovered. They should seek permission from the patient before they uncover their awrat. Caregivers who have never been patients may not realize the depth of the embarrassment of being naked in front of others.

Medical co-education involves intense interaction between genders: Teacher-student, student-student, and teacher-teacher. Interacting with colleagues of the opposite gender raises special problems: norms of dress, speaking, and general conduct; class-room etiquette; social interaction; laboratory experiments on fellow students; Clinical skills laboratory: learning clinical skills by examining other students;

Medical personnel of opposite genders should wear gender-specific garments during surgical operations because our culture frowns on any attempt to look like the opposite gender.

Guidelines on interaction with patients of the opposite gender should be followed. Taking history, physical examination, diagnostic procedures, and operations should preferably be by a physician of the same gender. In conditions of necessity a physician of the opposite gender can be used and may have to look at the ‘awrat or touch a patient. The conditions that are accepted as constituting dharuurat are: skills and availability.

5.0 DEALING WITH THE FAMILY

Visits by the family fulfill the social obligation of joining the kindred and should be encouraged. The family are honored guests of the hospital with all the  rights of a guest. The caregiver must provide psychological support to family because they are also victims of the illness because they anxious and worried. They need reassurance about the condition of the patient within the limits allowed by the rules of confidentiality. The family can be involved in some aspects of supportive care so that they feel they are helping and are involved. They should however not be allowed to interrupt medical procedures. Caregivers must be careful not to be involved in family conflicts that arise from the stresses of illness.

0910L-PRACTICAL SESSIONS

Communication module FOM KFMC on 6^th and 23th October 2009

1. Meeting and greeting the patient for the first time

2. Giving bad news

3. Explaining a prescription to a patient

4. Explaining a lab report to a patient

5. Getting patient consent to an operation