Communication skills and confidence in medical school

[han14tra]

This is going to sound like an odd question, but here it goes:

I've noticed several things about myself since beginning medical school.

- I often find it difficult to express myself clearly to other people (especially doctors and patients) and to continue conversations.
- I find it difficult to admit mistakes in clinical settings.

I see some of my classmates with infectious personalities and they come across as very caring and patients would talk to them all day if they could. I, on the other hand, struggle with this. Internally, I am probably one of the most sensitive people in medical school, but I can't really express that. I think I come across as very cold and I make people uncomfortable talking to me. I'm not very comfortable at all in any kind of social situation.

I also find it difficult to admit mistakes because I already feel like I'm completely incompetent.

Anybody know of anything that I can do to improve my communication skills and build confidence in clinical settings? Obviously, this is very important for a future doctor and I want to work on it now.

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[Frodo7]

For some people it comes naturally but for others, it just takes practice. Try getting a job as a waiter for a few weeks -- that definitely will build your communication skills. If all else fails, radiology or pathology may be your best fit.

No but seriously, keep up with current events and you'll be fine 👍

 

[Aphtalyfe]

This is going to sound like an odd question, but here it goes:

I've noticed several things about myself since beginning medical school.

- I often find it difficult to express myself clearly to other people (especially doctors and patients) and to continue conversations.
- I find it difficult to admit mistakes in clinical settings.

I see some of my classmates with infectious personalities and they come across as very caring and patients would talk to them all day if they could. I, on the other hand, struggle with this. Internally, I am probably one of the most sensitive people in medical school, but I can't really express that. I think I come across as very cold and I make people uncomfortable talking to me. I'm not very comfortable at all in any kind of social situation.

I also find it difficult to admit mistakes because I already feel like I'm completely incompetent.

Anybody know of anything that I can do to improve my communication skills and build confidence in clinical settings? Obviously, this is very important for a future doctor and I want to work on it now.

When communicating with a patient a lot of it is loosely based on a script. Start off with open ended questions and then progress to more yes or no questions.

Tell me about <symptom>
How does <symptom/disease> make you feel?
I'm sorry to hear that, but its very admirable that you have dealt with the <symptom/disease> so well.
etc...

It sounds very fake, but really its not. (or it can be, but you said you were sensitive so I assume you actually care)
Its just a way of helping you ask the right questions to get the right answers so you can provide the best treatment. It also has the side benefit of making you seem competent instead of sitting there staring blankly at your patient.


As for dealing with physicians and colleagues... maybe use email if face to face contact makes you uncomfortable. Once you can communicate via a less confrontational medium, then hopefully that will help you with verbal communication.

I'm sure many people will chime in --> clinical communication is a skill... and practice makes perfect. I also agree.

 

[thesauce]

Check out Toastmasters (www.toastmasters.org). There are probably several clubs nearby. It really helps with confidence and communication.

 

[hotshot456]

You probably have aspergers.

 

[han14tra]

You probably have aspergers.

I don't think it's aspergers. I had lots of friends all throughout high school, and I was much more able to communicate with people back then. It all started when I began college. I sort of socially isolated myself (partially because I was pre-med and partially because I didn't really fit in. I don't drink, which isolated me from lots of activities), and I began to feel more and more awkward in the world. It has carried on to med school. I find that I'm very stiff and appear cold in social situations. I have a few friends that I'm comfortable around, but it takes me an extremely long time to be myself around others.

 

[han14tra]

Check out Toastmasters (www.toastmasters.org). There are probably several clubs nearby. It really helps with confidence and communication.

This looks great. Maybe I'll try to get myself into this. Thanks.

 

[VenusinFurs]

I see where you're coming from, because I'm battling with this same thing myself, though it's not nearly as bad for me. So the thing is, in social situations I'm fine because I don't take anything too seriously and I rarely find myself caring what other people think about me. This has resulted in oodles of "friends." But I usually lose that sense of fun and confidence in professional settings where I feel I'm being judged and it actually matters. It's not easy to battle insecurity.

 

[andie gustafson]

I used to feel the same way as you during my first semester because I don't drink either and my idea of fun has nothing to do with alcohol and parties and being mean to others, that is **** to me, I'm not a weirdo, actually I have lots of friends and I'm respected and admired (as any other cool girl) at med school and you know why? because I'm comfortable with who I am. For example when I'm invited to parties sometimes I go and sometimes I just tell no I don't want to and nothing happens! When someone is mean to other I'm like oh please be ****ing polite haha.. U know, the key is to be comfortable with your own life which isn't perfect at all I know but be ok with it! I mess up yeah... so what? Nothing happens, I still like me because I'm funny, peaceful kind ... I have to recognize I'm good first. Being comfortable in my own skin makes me have a great conversation with patients because I'm not afraid of saying something stupid or wrong I just share who I am as a doctor and as a person and that inspires patients to be comfortable and opened. With professors and authorities students tend to think they're superior and better... hell no.. they're just people and I'm as smart, inteligent, capable vauable as them... I always have that in mind in order to free myself from being a kiss asser or isolate myself. I'm just one student among students.. a doctor among doctors, a pretty girl among pretty girls... I'm part of something wether I like it or not and I rather like it and enjoy it the best way I can.

 

[Random Anesthesiologist]

When you talk to those you think are "good communicators", take note of what they do that makes them good communicators.

Chances are, it's not necessarily the words that come out of their mouth, but body language that makes them appear more open and inviting to communicate with. So don't worry too much about not knowing much - at our level, I think that's pretty much expected. What you should focus on is how to make yourself more personable to your patient - eye contact, body stance, facial expressions, verbal interjections ("I see, yes, of course", etc).

Seriously, do a short study on those people. Take mental notes. Practice.

 

[Go Ducks]

I totally second Toastmasters! A great but awkward friend of mine started attending weekly a year ago, and he's getting waaaaay better at communication.

I would also say that smiling and using a positive, upbeat tone of voice sometimes makes a bigger difference than the words you choose.

 

[rmbsstock]

I could be wrong but my intentions are to help. Therefore, please forgive me if I make mistakes. I feel that you might be a perfectionist and you ask a lot of yourself. That is why, when you do not give 100% you get frustrated and your frustration will make you perform even worse.
When you have difficulties expressing yourself clearly with doctors and patients, its because this is a new setting and you want to do well in this setting. What I advise you to do is: Practice, practice, practice. Practice scenarios in your head, in front of a mirror, even in front of your own camera. Then watch yourself. Think, what do you like about your style, and what you don't like. Emphasize the good, and improve the part that you do not like. Pretend you are talking to other doctors, pretend you are talking to male and female patients..etc.

I see some of my classmates with infectious personalities and they come across as very caring and patients would talk to them all day if they could. I, on the other hand, struggle with this. Internally, I am probably one of the most sensitive people in medical school, but I can't really express that. I think I come across as very cold and I make people uncomfortable talking to me. I'm not very comfortable at all in any kind of social situation.
I think you might have a hard time admitting your mistakes because you put your heart and your mind in everything you do, and you truly want to do it correct. Also, I still feel that this could be part of your perfectionist streak.
But you know, it takes a big person to admit their mistakes. So, as you practice everything, go home and practice how you are going to talk about admitting your mistake. You can also feel safe to talk about your mistakes to your close friends or family and that might give you good practice.
One of the ways also to help in your communication skills and build
confidence is to learn to laugh at yourself and quit taking yourself too seriously.
As you probably can tell, English is my second language. Many times and during very sad counseling sessions, I would say something that is totally stupid (example: I want to say" Oh honey you are grieving like a lonely swan. I say "Oh honey, you are grieving like a lonely swine" . my patient/client among the tears they will laugh, I know I said something wrong. I usually say something to the fact" did I say something silly/stupid/inappropriate right now" they usually say yes, and they laugh and I laugh and I say what my intentions were. That will be the end of it. The less you are stressed the more they are understanding and accepting of you, and the more practice you get.
Good Luck, I hope I was of any help

 

[MacchinaDaCaffe]

This is going to sound like an odd question, but here it goes:

I've noticed several things about myself since beginning medical school.

- I often find it difficult to express myself clearly to other people (especially doctors and patients) and to continue conversations.
- I find it difficult to admit mistakes in clinical settings.

I see some of my classmates with infectious personalities and they come across as very caring and patients would talk to them all day if they could. I, on the other hand, struggle with this. Internally, I am probably one of the most sensitive people in medical school, but I can't really express that. I think I come across as very cold and I make people uncomfortable talking to me. I'm not very comfortable at all in any kind of social situation.

I also find it difficult to admit mistakes because I already feel like I'm completely incompetent.

Anybody know of anything that I can do to improve my communication skills and build confidence in clinical settings? Obviously, this is very important for a future doctor and I want to work on it now.

I'm just curious what you mean by finding it difficult to express yourself clearly to doctors and patients? Is it an issue of not knowing the medical terminology or do you get nervous and your mind goes blank, etc, etc.? It may be helpful to find a mentor, either attending, resident or even upper year med student to talk with them about specifically what you can do to improve.

In terms of conveying empathy to patients, the fact that you are sensitive to their situation is a very good sign and likely means that as you mature as a medical student and physician you'll come to be a medical professional that patients and their families trust and look to for support. Just listen well, be honest with them and responsive to their needs and they'll be eternally grateful.

As far as small talk and carrying on conversation is concerned - it's no lie that med students live an extremely boring life consisting of studying, attending lecture, sleeping, eating, taking tests and occasionally going to the gym. Just stay fairly up to date on current events and you should have plenty of useless stuff to talk about. Trust me, patients appreciate it if you can smile or laugh with them when they say stuff like "They gave me the Michael Jackson drug" after their surgery.

I agree with everyone else who responded that you'll get better with practice as these are all things that can be worked on. You're an MS1 so you have lots of time to improve through practice, observing others etc.

 

[han14tra]

I'm just curious what you mean by finding it difficult to express yourself clearly to doctors and patients? Is it an issue of not knowing the medical terminology or do you get nervous and your mind goes blank, etc, etc.?

The problem is that I tend to get tongue tied or not know the right words to choose because I'm nervous and uncomfortable.

I found tons of toastmasters organizations around where I live. It's $32 for six months. I'm still debating whether or not to join. I'm just worried that it is going to focus on giving speeches. Oddly, I'm fine with giving prepared speeches because I can practice what and how I say things beforehand. My problem is spontaneously expressing myself (e.g. presenting a patient to an attending or making small talk with a patient).

 

[Jolie South]

I think it's just a matter of practice. With patients, I always find something meaningless to joke about or that I notice we have in common. It usually ends up making both of us more comfortable. Also, realize patients don't know what you're "supposed" to ask them. If you stumble or forget something, you can always go back and re-do it.

With presentations to attendings, I find it's best to be as prepared as possible. You'll mess up less if you're sure of what's going on. Plus, no one expects you to be perfect. Just keep trying and pick one thing to improve upon each time.

 

[BlueElmo]

Yeah, I did Toastmasters for a short while, and it was mostly about going up in front of people and making speeches. Probably not what you need, OP. I suggest maybe looking at a mirror, imagine yourself talking to a patient, and practice that way. It seems kind of foolish at first, but you can watch yourself talking and try to improve how you express yourself, how your face looks, how much you smile, etc.

 

[unsung]

I see where you're coming from, because I'm battling with this same thing myself, though it's not nearly as bad for me. So the thing is, in social situations I'm fine because I don't take anything too seriously and I rarely find myself caring what other people think about me. This has resulted in oodles of "friends." But I usually lose that sense of fun and confidence in professional settings where I feel I'm being judged and it actually matters. It's not easy to battle insecurity.

Interestingly, I'm the exact opposite! I'm confident/fine in professional settings, with patients, etc. Basically, in settings where I know what's expected of me (what to say, how to say it, etc.) and the relationships between people are very clear. I'm also good in class discussions or debates.

I'm very insecure in social situations tho'- especially in large social groups where there's no real structure, no real purpose of the conversation, etc. Aka "parties" haha. I just don't know what to say, or when to say it. And I'm not the type of person who feels like talking whether or not the other person's listening. So I'm uncomfortable.

Weird, eh?

 

[unsung]

I'm just curious what you mean by finding it difficult to express yourself clearly to doctors and patients? Is it an issue of not knowing the medical terminology or do you get nervous and your mind goes blank, etc, etc.? It may be helpful to find a mentor, either attending, resident or even upper year med student to talk with them about specifically what you can do to improve.

In terms of conveying empathy to patients, the fact that you are sensitive to their situation is a very good sign and likely means that as you mature as a medical student and physician you'll come to be a medical professional that patients and their families trust and look to for support. Just listen well, be honest with them and responsive to their needs and they'll be eternally grateful.

As far as small talk and carrying on conversation is concerned - it's no lie that med students live an extremely boring life consisting of studying, attending lecture, sleeping, eating, taking tests and occasionally going to the gym. Just stay fairly up to date on current events and you should have plenty of useless stuff to talk about. Trust me, patients appreciate it if you can smile or laugh with them when they say stuff like "They gave me the Michael Jackson drug" after their surgery.

I agree with everyone else who responded that you'll get better with practice as these are all things that can be worked on. You're an MS1 so you have lots of time to improve through practice, observing others etc.

This just occurred to me as I'm reading through everyone's posts advising the OP to make smalltalk about current events, etc.

I think these ideas are good, but something which hasn't been mentioned yet is the importance of simply being a good listener! Patients are just like everyone else in that they like to hear themselves talk.

So I think it's not necessarily the charmingly outgoing doctor who is able to procure the patient's trust and make the patient comfortable. If you're quiet but manage to convey your empathy, caring, etc. through being attentive and making the patient FEEL s/he is being heard... then I think the patient will be comfortable and will trust you.

And becoming a good listener is easier than becoming gregarious, imo. It involves paraphrasing and reflecting what the patient says and is an easily practiced skill.

 

[han14tra]

Just wanted to say thanks to those of you who suggested Toastmasters. I decided to try it. I went to the first meeting tonight, and I think it is exactly what I need.

You have to come up with some speeches off the top of your head. Talk about scary . It will be a good challenge.

 

[Omkar]

Just wanted to say thanks to those of you who suggested Toastmasters. I decided to try it. I went to the first meeting tonight, and I think it is exactly what I need.

You have to come up with some speeches off the top of your head. Talk about scary . It will be a good challenge.

Hey han14tra! How did toastmasters go for you? I feel the exact same way you did. I feel things that pt's are saying at an emotional level, but i find it difficult to verbalize and show empathy in my responses.

Same goes for my small groups sessions. I know the stuff, but I have for some reason, an inferiority complex 🙁 which makes me stumble on my words. I feel that I'm just not as good as the other students, who are obviously smarter, more knowledgeable, and more charming than i could ever be. Which makes me very soft-spoken and people don't listen to me, even if what i'm saying is right, and is repeated by another member of the team, word-for-word two minutes later!

today, i received this feedback from my tutor: " lacks self-confidence. has the ability and knowledge but sometimes comes across otherwise." a very insightful observation on his part. i've felt this way for quite a while. i just didn't realise it was that palpable that my tutor would comment on it. 🙁

have you got any self-development tips?

 

[MCAT guy]

This is going to sound like an odd question, but here it goes:

I've noticed several things about myself since beginning medical school.

- I often find it difficult to express myself clearly to other people (especially doctors and patients) and to continue conversations.
- I find it difficult to admit mistakes in clinical settings.

I see some of my classmates with infectious personalities and they come across as very caring and patients would talk to them all day if they could. I, on the other hand, struggle with this. Internally, I am probably one of the most sensitive people in medical school, but I can't really express that. I think I come across as very cold and I make people uncomfortable talking to me. I'm not very comfortable at all in any kind of social situation.

This is contagious. Your emotion of discomfort or comfort. When you feel uncomfortable, the other person does too and they aren't sure why.

Likewise, when you feel relaxed and focus 100% on the other person, you will make them want to be around you. Not to be political in anyway, both Bill Clinton and George W. Bush had great social skills 1 on 1. Watch those guys with people and you can see how to make others feel great around you.

I also find it difficult to admit mistakes because I already feel like I'm completely incompetent.

Like I said above, this translates in your voice, gestures, etc.

Anybody know of anything that I can do to improve my communication skills and build confidence in clinical settings? Obviously, this is very important for a future doctor and I want to work on it now.

Imitate the best. That's how everyone gets good at something. Imitate the best at first, then as you do that for years you will have your own style come out of it.

Good luck

 

[MCAT guy]

Just wanted to say thanks to those of you who suggested Toastmasters. I decided to try it. I went to the first meeting tonight, and I think it is exactly what I need.

You have to come up with some speeches off the top of your head. Talk about scary . It will be a good challenge.

I did toastmasters for a few years. It is great. It will definitely help you communicate.

But always remember, being a good communicator isn't about how good of a speaker you are.

It's about how relaxed you are and how much you can focus on other people. It isn't about you, it's about them. Trust me, I've spent years studying and making an excellent living, fueled solely off of communicating with others.

 

[MCAT guy]

Yeah, I did Toastmasters for a short while, and it was mostly about going up in front of people and making speeches. Probably not what you need, OP. I suggest maybe looking at a mirror, imagine yourself talking to a patient, and practice that way. It seems kind of foolish at first, but you can watch yourself talking and try to improve how you express yourself, how your face looks, how much you smile, etc.

Or just talk to real people. 👍

 

[han14tra]

Hey han14tra! How did toastmasters go for you? I feel the exact same way you did. I feel things that pt's are saying at an emotional level, but i find it difficult to verbalize and show empathy in my responses.

Same goes for my small groups sessions. I know the stuff, but I have for some reason, an inferiority complex 🙁 which makes me stumble on my words. I feel that I'm just not as good as the other students, who are obviously smarter, more knowledgeable, and more charming than i could ever be. Which makes me very soft-spoken and people don't listen to me, even if what i'm saying is right, and is repeated by another member of the team, word-for-word two minutes later!

today, i received this feedback from my tutor: " lacks self-confidence. has the ability and knowledge but sometimes comes across otherwise." a very insightful observation on his part. i've felt this way for quite a while. i just didn't realise it was that palpable that my tutor would comment on it. 🙁

have you got any self-development tips?

I did join toastmasters for a few months and the Table Topics sessions did help because you have to speak without having time to prepare anything in your head. However, Toastmasters is a lot of business people trying to learn how to give presentations to large groups so I didn't feel like it was the ideal organization for me.

The most effective thing that I've done is to learn to accept that I am a human being who makes mistakes, and I have learned to love myself unconditionally. There are way too many critics in the world already. Don't be your own critic.

When I accepted that the only person I cared about making happy was myself, I started to let myself go without trying to censor everything I said or how I acted. Yes, I made myself sound stupid a few million times and got some weird stares from classmates, but I would just tell myself that I still love and accept who I am and that's all the matters to me. Eventually, I could relax in social situations and say witty intelligent things. When you accept and love yourself, you will come across as more confident and others will start to see you differently and realize that you do have important things to say.

Self-acceptance is the key as corny as it sounds. Good luck!

 

[Omkar]

I did join toastmasters for a few months and the Table Topics sessions did help because you have to speak without having time to prepare anything in your head. However, Toastmasters is a lot of business people trying to learn how to give presentations to large groups so I didn't feel like it was the ideal organization for me.

The most effective thing that I've done is to learn to accept that I am a human being who makes mistakes, and I have learned to love myself unconditionally. There are way too many critics in the world already. Don't be your own critic.

When I accepted that the only person I cared about making happy was myself, I started to let myself go without trying to censor everything I said or how I acted. Yes, I made myself sound stupid a few million times and got some weird stares from classmates, but I would just tell myself that I still love and accept who I am and that's all the matters to me. Eventually, I could relax in social situations and say witty intelligent things. When you accept and love yourself, you will come across as more confident and others will start to see you differently and realize that you do have important things to say.

Self-acceptance is the key as corny as it sounds. Good luck!

Thanks! you're right! Your advice has actually helped me feel calmer. i should revisit this often. 🙂

 

[OpalOnyx]

anybody else feel like you generally talk more slowly and process information at a slower rate than everyone else?

if someone asks me a question, it takes a while for me to answer. Or while I'm talking there are a lot of pauses. It makes it difficult when communicating with someone who talks or thinks more rapidly (and does less internal processing). I'm not sure if it's good to think/talk/process slowly in medical school or if this will hurt me in the long run.

 

[mindsg]

i did join toastmasters for a few months and the table topics sessions did help because you have to speak without having time to prepare anything in your head. However, toastmasters is a lot of business people trying to learn how to give presentations to large groups so i didn't feel like it was the ideal organization for me.

The most effective thing that i've done is to learn to accept that i am a human being who makes mistakes, and i have learned to love myself unconditionally. There are way too many critics in the world already. Don't be your own critic.

When i accepted that the only person i cared about making happy was myself, i started to let myself go without trying to censor everything i said or how i acted. Yes, i made myself sound stupid a few million times and got some weird stares from classmates, but i would just tell myself that i still love and accept who i am and that's all the matters to me. Eventually, i could relax in social situations and say witty intelligent things. When you accept and love yourself, you will come across as more confident and others will start to see you differently and realize that you do have important things to say.

Self-acceptance is the key as corny as it sounds. Good luck!

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