Bridging the Divide: Enhancing Communication for Specialists

Bridging the Divide: Enhancing Communication for Specialists

Bridging the Divide: Enhancing Communication for Specialists


 

Audience Audience: All ACVIM Diplomates and candidates, other veterinary specialties CE Hours CE Hours: To be determined
Category Category: All Specialties  Date Date: January 2021
Type: Interactive, on demand  Location Location: Anywhere via ACVIM Online

The Modules

Module 1: Introduction, Transparency and Open-Ended Questions

Inspiring Dialogue in the Consult through Healthcare Transparency and Open-Ended Questions

Communication Skills that will be Emphasized:

  • Transparency
  • Open-Ended Questions
Module Description:

Transparency in healthcare is often discussed with regards to disclosure about medical mistakes; however, medical errors are not the only circumstance in which transparency may be warranted or desired.  Building a culture of transparency also requires honesty and directness, both about known entities, such as diagnosis and prognosis, as well as that which is unknown. When clinical communication pairs transparency and open-ended questions, a frank dialogue results. This module will introduce the learner to both skills and provide opportunities to practice the delivery of each through an interactive simulated encounter.

Module 2: Non-verbal cues, Empathy and Reflective (active) listening

Bridging Gaps in Mutual Understanding through Appropriate Use of Non-verbal Cues, Empathy, and Reflective Listening


Communication Skills that will be Emphasized:

    • Non-verbal cues
    • Empathy
    • Reflective (active) listening


Module Description:
Challenging conversations arise in clinical practice when client perspective, perceptions, or expectations surrounding patient care do not align with medical findings or the anticipated case trajectory. These gaps in mutual understanding may halt forward progression in case management, particularly if lack of alignment precipitates an “us versus them” standoff. Such gaps can be overcome when the veterinary team makes use of non-verbal cues, empathy, and reflective listening as bridges to renew partnership and strengthen connections. This module will introduce the learner to all three skills and provide opportunities to practice the delivery of each through an interactive simulated encounter.

Module 3: Unconditional Positive Regard and Pausing

Replacing Judgment with Regard to Acknowledge, Address, and Resolve Conflict

Communication Skills that will be Emphasized:
  • Unconditional Positive Regard
  • Pausing

Module Description:

The concept of unconditional positive regard was developed by Carl Rogers, a prominent psychologist. Although this term originated to advance the practice and delivery of human healthcare, unconditional positive regard also has a place in veterinary practices, particularly when navigating conflicts between clients and veterinarians or members of the veterinary team. Clients and colleagues’ actions may not always be appropriate, though they may be well-intentioned. This module introduces the concept of regard and how it can be paired with intentional pauses to help team members acknowledge, address, and move beyond conflict


Module 4: Signpost, Chunk and Check and Summary

Structuring the Consultation with Signposting, Check-ins, and Summary Statements

Communication Skills that will be Emphasized:

  • Signpost - Signposting is sometimes called mapping out the consultation. What mapping out the consultation means is that we verbally provide structure. We acknowledge openly where the conversation is headed. Mapping out the consultation is a way to orient the client. Just like a compass tells you which direction you’re facing, a consultation map tells the client the order in which consultation events will happen. 
  • Chunk and check - Consultations work better when we break down what we have to say into segments. Each segment represents two or three sentences of material that we want to convey. We deliver that chunk. Then we check in with our client. We are checking that the client is with us. We are checking for mutual understanding. Only then, can we move on to the next chunk. This prevents us from losing our client. This prevents us from getting to the end of the consult, only to have the client say, “I didn’t catch any of that, can you start over?” Chunking and checking allows us to identify sources of misunderstanding early so that we can correct misconceptions before it is too late.  
  • Summary - Summarizing is a communication tool that allows you, the clinician, to review key data or concepts with the client. Summarizing may be used to review case history that the client provided; our list of concerns for a given patient; the order of diagnostic tests that will be performed; our clinical findings; and our treatment plans, including recommendations for at-home patient care. Summarizing is also often used to wrap-up a consultation by emphasizing key take-away messages that we want our clients to hold onto long after they have departed from the clinic.

Module Description:
Case management is often complicated by the complexities of clinical disease for which there are no easy answers. Clients may desire or expect guarantees concerning diagnosis or prognosis when in fact such guarantees may not be possible. Such situations require a fusion of communication skills to invite dialogue that solicits and acknowledges the client’s perspective yet balances unrealistic expectations against the patient’s clinical reality.  Structuring skills, such as signposting, check-ins, and summary statements facilitate these conversations by guiding the client through transparent decision making and taking the time to ensure mutual understanding. This module will introduce the learner to all three structuring skills.

With the global impact of COVID-19 and the postponement of the Bridging the Divide: Enhancing Communication for Specialists live event to 2021, we understand that this is an extremely challenging time for specialists. Now more than ever the need for specialists to communicate effectively is prevalent.  As a result, we will be delivering a portion of this course as an interactive, online program starting in January.

The Approach 

Client and veterinary team communication are essential both to the delivery of high-quality medicine and to the success of specialty veterinary practice. The ability to manage an animal’s healthcare effectively and efficiently depends upon communicating with and understanding the perspective of the people connected to that animal. Like any other skill, communication requires attentive practice. Communication tools and techniques evolve in the same manner as our clinical acumen. 

What’s Involved 

The professional skills and tools offered throughout this course center on communication skills and techniques that contribute to positive patient outcomes in the veterinary consultation. Examples used during the course are relevant to residents and specialists; no specialty-level resources like this exist currently. The knowledge and skills gained from this course is expected to be amplified within the profession since specialists typically consult with many primary care veterinarians on a given day.  


This course provides four modules that are developed specifically for the challenges veterinary specialists face. The modules, building upon each other, will guide the learner’s journey through clinical communication as an evidence-based discipline, all within a safe yet interactive, virtual environment. You will be able to identify and practice core communication skills that are essential building blocks for subsequent simulations that will be offered during the in-person course in 2021.

Speaker

Ryane E. Englar, DVM, DABVP (Canine and Feline Practice)
Director, Veterinary Skills Development
Associate Professor
The University of Arizona, Oro Valley, AZ

Dr. Ryane E. Englar graduated from Cornell University College of Veterinary Medicine in 2008. She practiced as an associate veterinarian in companion animal practice before transitioning into academia to advocate for skills-based training. Her role as founding faculty at Midwestern University between 2014-2017 introduced her to the Calgary-Cambridge model. This framework gave her a solid foundation for teaching clinical communication skills that she ultimately incorporated into a 27-event standardized client communication curriculum. She is currently on faculty at the University of Arizona College of Veterinary Medicine, where she plans to further develop the key content areas of clinical and professional skills.


What You'll Learn

Upon completion of all modules, a successful participant will be able to: 

  1. Describe how effective clinical communication enhances the delivery of relationship-centered care.
  2. Define and strategize how to make use of the following clinically relevant foundational and structuring skills that contribute to positive patient outcomes in the veterinary consultation:
    • 7 Foundational Skills Transparency 
      • Open-Ended Questions 
      • Non-Verbal Cues
      • Empathy
      • Reflective Listening
      • (Unconditional Positive) Regard
      • Pausing
    • Three Structuring Skills
      • Signpost
      • Chunk and Check
      • Summary
  3. Consider how working through the different decision points and receiving immediate feedback can help with communicating in similar real-life situations in the future.
  4. Recognize how effective communication between veterinarians, clients, and supporting members of the veterinary team impacts patient outcomes and improves both client compliance and satisfaction with the delivery of healthcare.  

Choose Your Own Adventure

Each module offers a unique clinical vignette that unfolds before the learner’s eyes. Case details will be provided as necessary to frame clinic conversations. As each module progresses, the learner will be prompted to make communication-based choices that facilitate relationship-centered care and decision making. With each module acting as a building block it creates a layered approach for learning. Feedback will be provided for choices that are made, including supportive evidence from peer-reviewed literature when applicable. This “choose your own adventure” approach is intended to help the learner observe real-time how words and phrases impact interpersonal relationships, the delivery of healthcare and patient outcomes.   

The online interactive modules will lay the foundation for an in-person forum in which individuals at all stages of their careers can hone their communication skills. While learners may elect to participate in individual modules, it is recommended to complete the full coursework.

Sponsor

A special thank you to our Strategic Partner

RACE Application Status: 

This program will be submitted for continuing education credit (pending final agenda content) in jurisdictions which recognize AAVSB RACE approval.

Any questions, please contact Learning@ACVIM.org.