Communication is more than just saying the right thing. No matter how long you have been in practice, refining your communication skills will have positive effects, as Liz Mossop and Zoe Belshaw explain
- British Veterinary Association
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‘TO be able to communicate effectively with others is at the heart of all patient care’ (Faulkner 1998). While communication is central to being a vet, many vets have not received any formal communication skills training.
Communicating effectively minimises stress levels in the practice and reduces complaints; at least 80 per cent of complaints to the Veterinary Defence Society include an element of poor communication (Anon 2001). With good communication, clients are more likely to comply with your treatment recommendations and mention a key part of the history, which they might otherwise have omitted to tell you.
The profession is starting to realise that training in communication isn't an optional extra; all recent graduates will have received formal communications skills teaching as part of their training, and the impact of communication is part of the A module of the RCVS's Certificate in Advanced Veterinary Practice.
There are several easy strategies that will help you to improve what you do. Don't forget that these contribute to your CPD hours required by the RCVS.
One of the simplest methods is to ask a colleague to observe you consulting. Discuss beforehand what you feel your strengths and weaknesses are, and what you would like them to look out for. Ask for constructive feedback: ‘You were great’ doesn't help anyone; ‘You were great because . . .’ is a lot more useful.
Liz Mossop and Zoe Belshaw are lecturers at the School of Veterinary Medicine and Science, University of Nottingham, where they deliver communication skills teaching
Even better, observe them in return – you can learn a lot from watching others. It may be useful to organise your observations around a particular consultation structure, or you could ask for thoughts around simple aspects, such as the use of open and closed questions or your body language. Make sure you return to the feedback after you have tried to improve – are you doing what you said you would? Has anything changed?
Use of video
The use of video recordings is common for GPs in training, but is rare in the veterinary profession. It is a really useful way of reflecting on what you do, and is accessible to anyone with a video camera or with a video function on a digital camera or smartphone. Of course, you must get permission from your clients to do this, and it can be a little disconcerting at first.
Recording several consultations in a series is usually a good idea. Once you have the recordings it is up to you how to use them. You could choose to review them privately and reflect on what you do, set yourself targets around aspects you wish to change, or review them with a colleague and ask for feedback. However you use them, record your thoughts, and go back and review your targets after a period of time to see whether you have met them.
There are a number of commercial CPD courses that aim to help improve communication skills. Many are aimed at the practice team, rather than just veterinary surgeons. Practical courses are usually the most rewarding, and they often involve the use of actors to simulate clients – as scary as this sounds, it is good to be able to try different techniques without risking upsetting clients! To get the most from a CPD course, share your thoughts about it afterwards with a colleague, and record your aims for the next few months.
There are also a number of written resources, which can be useful alongside any feedback you may receive. There are numerous textbooks aimed at doctors on how to improve communication skills, and these can be a good starting point. Veterinary-specific versions are available. The National Unit for the Advancement of Veterinary Communication Skills (NUVACs) website (www.nuvacs.co.uk) includes a suggested consultation structure, which can be useful to guide feedback and reflection. This structure is based around the Calgary-Cambridge guidance, which is a common medical structure (Kurtz and Silverman 1996).
Everyone in the practice team can improve their communication skills. In-house training can be a fun team-building experience. Packages are offered by several commercial companies, and may be an economical way of delivering CPD to everyone. It could also be a good topic for discussion at a staff meeting, which need not cost anything. Pick a particular aspect to discuss – for example, discussion of fees, or a difficult euthanasia consultation – and ask everyone for their experiences and tips.
Improving your communication skills has an instant feel-good result and can be tremendously satisfying, and it doesn't need to cost anything.
Being observed and videoed by a colleague is a great way for you to see what the client does, and it might not be what you think.
Potentially embarrassing? Yes. Worth considering? Without doubt.
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