Effective Communication Richard Lanoix, MD Director, Emergency Medicine Residency St. Lukes-Roosevelt Hospital Center, New York
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1 Effective Communication Richard Lanoix, MD Director, Emergency Medicine Residency St. Lukes-Roosevelt Hospital Center, New York Chief Resident s Forum SAEM, San Francisco May 18-21, 2006
2 True or False? The major determinant to success in Emergency Medicine is how smart you are?
3 Two most important predictors of success: Communication Skills Ability to Work with Others Survey conducted by the University of Pittsburg Business School of Recruiters from companies w/ > 50,000 employees
4 Chief Resident Job Description Motivate colleagues to excel Mediate between & for residents Negotiate conflict resolutions Support your colleagues Serve as intermediaries bet. faculty & EMR s Serve as role models Delegate tasks
5 Chief Resident Job Description Common Denominator? Effective Communication!
6 "If all my possessions were taken from me with one exception, I would choose to keep the power for speech, for by it I would soon regain all the rest Daniel Webster
7 Nonverbal Communication A "majority" of the meaning we attribute to words comes NOT from the words themselves, but from nonverbal factors such as gestures, facial expressions, tone, body language, etc.
8
9 Attitude Is Infectious and Drives Behavior Your attitude is the first thing people pick up on in face-to-face communication Your attitudes can infect the people who see you with the same behavior When operating from attitudes, such as enthusiasm, curiosity, and humility, your body language tends to take care of itself and sends out unmistakable signals of openness
10 Nonverbal cues can play Five roles: Repetition: repeat the verbal message Contradiction: contradict the message conveyed Substitution: substitute for a verbal message Ex: a person's eyes can often convey a far more vivid message than words and often do Complementing: add to or complement a message A boss who pats a person on the back in addition to giving praise can increase the impact of the message Accenting: non-verbal communication may underline a verbal message
11 Great Leaders use Nonverbal cues to increase their effectiveness by: Clearly understanding what is said via visual clues from people's reactions via behavioral/body language clues, which is valuable feedback. by refining their senses to interpret how others are responding to our line or style of communication
12 The Secrets of Effective Communication
13 Top 10 Effective Communication Tips
14 Top 10 Conflict Resolution Tips
15 Top 10 Leadership Tips
16 Listening is an underrated skill! Listening is a leader s skill!
17 Levels of Communication Facts Thoughts/ Beliefs Feelings/ Emotions Often, the speaker & listener tune-in to the level each believes is important, which results is crossed wires
18 "Conversation in the United States is a competitive exercise in which the first person to draw a breath is declared the listener" -Nathan Miller Two monologues do not make a dialogue
19 Why Emphasize Listening? Best way to get people to listen to you! Shows you understand their self-interest by focusing on their point of view at the start, before you tell them about yours. Demonstrates what's in it for them That will motivate them to listen to you
20 Modes of Listening Competitive Listener is vested in promoting their own viewpoint Formulating what to say next, rather than listening Looking for breaks to interject/ attack
21 Modes of Listening Passive/ Attentive Listener sincerely interested in message Actively listening However, does not verify what is heard
22 Modes of Listening Active/ Reflective Listening Listener sincerely interested in message Interested in what the speaker thinks, feels, & wants Verifies message by repeating it to the speaker Confirms understanding before reacting
23 Being an Active Listener First & foremost, STOP TALKING! It s difficult to listen & speak simultaneously Nature gave you two ears & only one tongue Hint: Listen twice as much as you talk
24 STOP TALKING! The thing that most people want to hear in a conversation is their own voice. Use this to your advantage by asking opinion type questions. Allow them to elaborate Ask open-ended questions. They can make you a hero. Ex: "How do you feel about...?, What is your thinking on...?, Do you believe that...?.
25 Being an Active Listener Put the other person at ease Make eye contact Give them space, time, & permission to speak their piece Be observant, flexible, & open to their needs N.B.: Agreement is not a requisite!
26 Being an Active Listener Eliminate Distractions (internal & external) Give your full, undivided attention Cell phones/ Beepers/ Phone calls Most important: Choosing the Best Time & Location!
27 Caveat: Resident really needs to talk to you about something important during your busy shift Avoid this set up for disaster Must we have this conversation now? I cannot talk now, but let s set up a time to meet when I can give you my undivided attention Briefly tell me about the issue so that I can think about it before we meet
28 Being an Active Listener Pay attention to the Purpose & Words What is the purpose and intent of the speaker? What do you think their goal is in sharing their information? for facts and emotions Don't rush to make a comment or give advice
29 How to become an Active Listener Empathize Be patient! Watch your emotions Judge the content, not the messenger or delivery
30 Being an Active Listener Be very slow to disagree, criticize, or argue. If you are compelled to speak: Ask questions Ask speaker to clarify, say more, give an example, or explain further
31 Being an Active Listener STOP TALKING! Applause is the only appreciated interruption Arnold Glasgow
32 More Tools Effective Parroting / Paraphrase Ensures you heard the message How? Repeat the facts Share the thoughts & beliefs you heard Convey underlying feelings/emotions/intents you believe are involved
33 Caveat Refrain from your desire to ask questions during the process in which the speaker is sending the message to you. N.B.: The answer to your question may be in the message! Timing, timing, timing!
34 More Tools Recount/Reflect what the other says Do you mean? Are you saying? for concepts, not facts Silence: If given to the sender- they will fill it. People like people who give them silence & listen!
35 Once you are certain that you understand the message, you can quit active listening & respond with your own message
36 But before you do Consider your goals & the goals of the other person Is this the right time and place to deliver your message? What are the potential consequences of delivering this message?
37 Finding the Right Balance Effective Listening is an interactive process Listening Hearing Responding N.B.: Asking for clarification on a few points is actually part of listening!
38 Follow-up is Key! your understanding of the message & its intent Highlight the most important parts Deadlines Project Goals Concerns, etc Request a reply to ensure your interpretation of the message
39 Clearing Hurdles Be wary of rehearsing what you might want to say before you say it Do not judge the sender & message too early
40 Clearing Hurdles Fight the urge to identify with everything the sender says to you Rather, understand how it relates to the sender Even if you have the solution, hear the message before conveying it Being informed is more important than being right
41 Clearing Hurdles Do not pretend to listen (Mind-drift) Live in the moment Be nice & supportive, but do not placate The goal is not to be popular, but rather Hearing the message Acting accordingly
42 What type of Listener are You? Developing these skills requires work Take a few minutes/day &: Detail your listening experiences Grade yourself What could you have done better?
43 Parting Gifts The Power of Yes! Do not focus on being a pushover Can you afford to grant this 100th request? When put on the spot, reiterate the request, confirm its accuracy, pause, the say: Yes, it should not be a problem, but let me think about it/ discuss it with & I ll get back to you by the end of
44 Parting Gifts Most of the time, people just need to vent and be heard. As a leader, this is part of your role/duties. Just listen and be empathetic. No one is expecting you to solve all their problems, or even try to. Always ask for the other s problem-solving suggestions before presenting your own.
45 Parting Gifts When put on the spot, promise nothing! Reiterate the request, confirm its accuracy, pause, then say: Yes, it should not be a problem, but let me think about it/ discuss it with & I ll get back to you by the end of
46 Parting Gifts Don t take it personally. The buck does not stop with you. Involve your PD/ Co-Chiefs. Leadership is a collaborative process It is not your job to defend the program. Don t be so defensive! s: Write it & save it. Later, review it & decide if you really need to send it.
47 Parting Gifts React to the message, not to the person When you make a mistake, admit it and do your best to recover from it Never attempt to communicate when emotional. Take a 'timeout' Be gentle with yourself and others Remember: We tend to judge ourselves by our intentions and others by their behavior
48 The 4 steps to defuse an angry/upset person Give them time to talk & say whatever is on their mind, & as long as necessary to say it. Assume an active listening posture & let the sender know you are interested in the message
49 When Finished Wait There is usually one more thing that they want to say & will say if given an opportunity. By waiting, you indicate to the individual that you are interested in what they have to say & want to hear the entire story
50 Ask Them to Restate it Even if you clearly & fully understood it. Reflect back. Paraphrase it back to them This gives them a chance to confirm that you got the message, or to correct your misconception.
51 Explain/discuss But only after defusing the other person s anger If not ready, return to the 1st four steps
52 Do Not Forget! As Chief Resident, you are still a resident. Your colleagues certainly have not lost site of this! Don t take yourself so seriously. Be humble!
53 Wisdom has two parts: 1) having a lot to say, & 2) not saying it
54 Take home message: The 51% solution If you assume that 51% of the responsibility of communications is always yours you will maximize communications!
55
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