Perhaps you have set yourself the goal of improving your conversation with your patients.
To become better at guiding your patient through their recovery with better communication skills.
There’s a good chance that it didn’t work.
Not because you were lazy or lax, or lacked motivation.
No, there may be other reasons that caused it to fail.
First: why is improving your communication skills difficult?
Improve your conversations with patients, do things you do in conversations with patients differently than you always did, stop fiddling with your pen during a conversation, stop looking at your computer while you are talking, really active listening, asking open-ended questions, etc.; it’s hard to accomplish.
It sounds easy, but it isn’t.
Three reasons why things go wrong.
First, we humans are strongly focused on automation.
Letting go of old behaviours and (continue to!) use new behaviours is slowed down as a result. Purely through your own autopilot or default mode.
In addition, during a conversation, you cannot constantly think about what you are doing because you will probably lose contact with the other person. And that in turn leads to all kinds of unpleasant situations.
The second reason is that we humans suffer from perception bias.
In other words, the image we have of ourselves and therefore also the image we have of our communication is strongly distorted.
If we are very dissatisfied with ourselves and also very dissatisfied with our conversation, this influences how we look at how we do it at a loaded moment. In this case, we are more likely to see ourselves negatively than we actually do.
On the other hand, if we are neutral or positive about ourselves in general and neutral/positive about our performance in a conversation, we also tend to look at our actual performance through these glasses.
Result: we don’t see a lot of things that we don’t do well.
By the way: viewing yourself more positively than you actually do is significantly more common than looking at yourself more negatively. This positive perception bias is therefore lurking in many of us.
The third reason is… we don’t do it the right way.
Getting better at something, such as communicating with patients in a professional way, doesn’t happen by itself.
Practising was used as a credo for many years.
Malcolm Gladwell made this even more concrete in his book by indicating that many experts in their profession had simply practised a lot.
And with that, the 10,000-hour rule was born. So 10,000 hours to really master something.
Fortunately, it turned out that this is not the whole truth…..
Deliberate practice means you practice what you have not yet mastered.
So don’t keep repeating what you are already good at.
In his book ‘Peak, secrets from the new science of expertise‘ Anders Ericsson writes about how deliberate practice works.
His book is the result of thorough scientific research.
Ericsson did numerous experiments with his research group. Fascinating to read, by the way.
I would like to give you one example. Ericsson investigated whether someone can remember long series of numbers by deliberately practising them.
What do you think, how long can that number sequence eventually be if someone wants to be able to reproduce it right after?
Over 250 random numbers in a row!
Deliberate practice makes this possible. Don’t simply stomp or repeat.
No, practise deliberately and with the help of certain strategies you will get far, very far.
And, of course, practice stays necessary.
Deliberate practice to improve communication skills
The central point of deliberate practice is practising in the ‘zone of proximal development‘. The latter means that you practice what you ‘just don’t master’. So you have to step out of your comfort zone.
In addition, feedback is extremely important.
You can always supply yourself with feedback (provided with a good feedback form or observation list).
However, the ‘perception bias’ is lurking here!
Making sound or video recordings of yourself and listening/watching them helps you to overcome this for the biggest part.
In addition, it’s necessary that you regularly receive feedback from others, preferably also from experts.
Because practising and getting feedback is not always easy, you need to be well motivated.
You have to see the usefulness, find it important yourself, and experience a certain urgency.
In the end, you slowly progress in the learning process, with ups and downs.
At some point there will be stagnation. Those are important moments.
Overcoming this stagnation, breaking through it, is crucial for your further development.
A coach or trainer can often help you to overcome this point. Intervision or supervision are instruments that will do the job
In short, you need deliberate practice to develop communication skills. That means:
- Practice concentrated and focused on the goal and the result (so work from a personal mission)
- Practice in your zone of proximal development
- Provide systematic feedback
- Measure Progress
- Continue if there is (a threat of) stagnation, ask for help from a coach, trainer or colleagues (intervision)
So learning to communicate professionally is hard. It requires a lot.
At the same time: it is the key for every expert physiotherapist.
And therefore well worth the investment!
Apply the principles of deliberate practice and you will succeed!
You want some literature and evidence about improving communication skills? Here are some of my sources:
- Bennett, Gerald A., et al. “Strengthening motivational interviewing skills following initial training: a randomised trial of workplace-based reflective practice.” Addictive Behaviors 32.12 (2007): 2963-2975.
- Britt, Eileen, and Neville M. Blampied. “Motivational interviewing training: a pilot study of the effects on practitioner and patient behaviour.” Behavioural and cognitive psychotherapy 38.2 (2010): 239.
- Ericsson, K. Anders, and Jerad H. Moxley. “The expert performance approach and deliberate practice: Some potential implications for studying creative performance in organizations.” Handbook of organizational creativity. Academic Press, 2012. 141-167.
- Kurtz, Suzanne, et al. Teaching and learning communication skills in medicine. CRC press, 2017.
- Miller, William R., and Theresa B. Moyers. “Eight stages in learning motivational interviewing.” Journal of Teaching in the Addictions 5.1 (2006): 3-17.
- Madson, Michael B., Andrew C. Loignon, and Claire Lane. “Training in motivational interviewing: A systematic review.” Journal of substance abuse treatment 36.1 (2009): 101-109.
- Söderlund, Lena Lindhe, et al. “A systematic review of motivational interviewing training for general health care practitioners.” Patient education and counseling 84.1 (2011): 16-26.