Developing Effective Communication in Health and Social Care

AS and A Level Healthcare

BTEC National Certificate in Care

Unit 1 Developing Effective Communication in Health and Social Care

Evidence from placement for observing communication & interpersonal interaction

Date: 08 February 2007

To: Mike Guy – Academic Tutor

From: Chih Lung Cheng

Introduction –

During the course of fifteen weeks I visited my work placement which is a combination of pre- school and primary setting known as 'Oakwood East Sussex School' located near the Hampden park of Eastbourne. The majority of the time spent at this placement was observing and interacting with year 2 and 3 children of different ages, from 6 to 8 years. I also communicated with the staff and observed the way the parents and staff interacted. I thoroughly enjoyed attending this setting every Monday from 8:30a.m until 3:30p.m, because it was interesting to see how a class was run and how communication helped each child to develop in their own learning skills.

In Chapter One I will explain different types of communication and interpersonal interaction that I have observed while on work placement. Communication is the process of sharing ideas or thoughts, information, and messages with others, whether this is with one other person or with several people, at a particular time and place. In Chapter Two I will explain how the communication cycle can be used to communicate difficult, complex and sensitive issues. In Chapter Three I will give examples from work placement, describing some of the factors that can restrict communication and interpersonal interaction.

People will feel value and respected when they have been listened to, and when they feel their needs and wishes have been understood by the care Worker. In Chapter Four I will explain how the communication needs of service users may be assisted and supported. Also, I will give examples from work placement on how the specific communication needs of service users have been met in Chapter Five. I have experienced a one to one and a small group interaction on work placement. I also will explain the communication skills that I have used to interact with service users.

Communication enables the interaction between two people or a group of people and allows people’s needs to be put across, such as what they are thinking or feeling. It is also important for developing relationships. In Chapter Six I will reflect on my own communication skills and identify the ways that could have been used to make the interaction more effective. In Chapter Seven I will look at factors both positive and negative that I think may have influenced the interactions undertaken. Finally, I will analyse how communication in health and social care settings assists service users/ patients and other key people in Chapter Eight.

Chapter One

P1. describe at least 4 types of communication/ interpersonal interaction that you have observed or participated in whilst on work experience.

While on work placement, I have noticed four different types of communication been used, including spoken, written, visual and non-verbal communication. As I was working in a class mixed with year 2 and 3 of children age between 6 and 8 years old. I have been very impressed and learnt a lot from my observation how the communication has been carried out between teacher to students, students to students, teacher to member of staff or parents etc.

I noticed the teacher has used all types of communication and interpersonal interaction skills in her teaching which has made the lessons very interesting and create an effective learning environment in the classroom. Verbal communication used by the teacher is very effective in a way that she can maintain her authority and keeps control of the class as well as to communicate to the students in order to teach them and for them to learn from her. For example, the teacher uses appropriate vocabulary to the students and speaking to them with correct and different rhythm, tone, pitch and volume. Some times she asks questions or repeats what she said to make sure there is not misunderstanding. Also, the teacher would raise her pitch, tone of voice to show that she was angry and annoyed or to convey her excitement. She sometimes uses different humour to lighten the class.

Non-verbal communication such as eye contact, facial expression, body language, posture and gesture etc are used in the class. For instance, the teacher often smiles to encourage, shows pleasure and praise the students. However, she would frown or raise her eyebrows to show her disapproval or disappointment. She would have eye contact with them to show her respect and understanding. Students raise their hands if they want to answer the question asked by the teacher or if they have something to ask. Also, they would show a worrying face if they do not understand what has been said to them. I also learnt a technique that has been used by the teacher when she wants the class to be quite, she would rise up her hand.

Written communication used in my work placement, including a learner achievement board, which displays on-going achievements, scheme of work, weekly timetable and scheduled reviews. This has proved to be an effective communication between teacher and students, as it enables the students to feel that their needs are being addressed and also gives the students more responsibility for their own learning.

There is also visual communication, such as the use of images or pictures and electronic communication to help to make known messages and emotions to people, for example ICT – “information communication technology” with the internet has been installed in every classroom, which provide interactive communication for teacher and students.

Television and Radio are visual and sound systems to communicate information. They come under recorded information as a type of interpersonal communication that enables the re-experience of messages from the past. Other examples are CDs, videos, tapes etc.

Different types of interactions in Oakwood School can be:

Chapter Two

P2, M1 Describe the stages of the communication cycle (P2) and use your placement experiences to explain how the cycle could be used to communicate difficult, complex and sensitive issues (M1).

The communication cycle is the sending and receiving of messages. Messages are sent from one person to another through verbal or non-verbal communication. People use their senses to receive the message. The communication cycle is the process people become involved in when expressing thoughts and interpreting the thoughts of others. It involves the following six steps:

1. Expressing our thoughts – at this stage, we need to think about what it is that we need to communicate and to whom. For instance, the school teacher wants to teach her students how to write a story. She needs to think the best way to communicate this information; if she should use charts, pictures or diagrams; should she make up an interesting story to show the class how to do it.

2. Watching the other person’s non-verbal response and body language – she started by telling a funny story which has attract the students’ attention. The children appear to be very interested and excited by showing their eye contact with the teacher and their face are lightening.

3. Interpreting the other person’s body language and trying to work out what they are thinking – the teacher will know if her techniques work or not by watching the body language of the children. Has her story been followed? Are they interested or bored?

4. Listening to their response to what we said – at this stage, the teacher may ask if anyone who can makeup a sentence to follow her story, or she may ask some questions to find out if the children follow her or not.

5. Trying to make sense of their response – the teacher will know if she had made herself understood and her instruction followed by listening to the feedback from the children.

6. Expressing new ideas to try and clarify our ideas. – the teacher will have to try again from stage one if her communication wasn’t very successful. She might need to think how she can best communicate her ideas.

Verbal and non-verbal communications have different affects on the cycle. For example the first step relevant to verbal communication would be speaking, music or any language based on sounds which are heard. Whereas in non-verbal communication it could be sign language, signs, symbols, gestures, writing etc. After someone has expresses something either verbally or non-verbally the next step would be to watch the other person’s body language to see their response. By analysing the facial expressions, body posture and muscle tone it is possible to try and work out what the other person is thinking. This means that they are expressing their feelings in a non-verbal manner. These physical movements and gestures can be easily misinterpreted, as non-verbal communication is a language that varies with history and culture.

Communicate difficult, complex and sensitive issues

There are times when we have to communicate difficult, complex and sensitive issues with people, which can be distressing; frightening; traumatic or threatening. For instance, if we have to tell someone about a bad news such as the death of a close friend or relative, or if we have to let someone know that he/she has not got the job or pass the exam. can be very distressing. We know the information that we are going to give is very difficult, complex and sensitive but if we handle the situation correctly by understanding and using communication cycle, we can reduce the tension or impact that may have on the receiver.

This is a preview of the whole essay

My first work placement is in a nursing home, where I also saw how the communication cycle is used to handle difficult and sensitive issues. The nurse in charge called Emma has to inform the relative of a patient who is dying. She decides the best way to communicate the message is by using telephone as time is concerned. The relative knows how ill the patient has been so it should not be a surprise to him/her but Emma has to convey her sympathy when she talks. She can not see the body language of the person she talks to so she has to listen carefully if the relative is too upsetting to continue the conversation. Emma tries to talk politely but make sure the conversation is appropriate and not too emotional. The relative said that he/she would like to come to see the resident.

At my last work placement, I witnessed how Ms. Morse uses her communication skills to tell children about violence and other sensitive and complex issues in the world. Sometime students may ask her about drugs, sex, relationships and alcohol, as they can get the information from TV, movies, magazines or from friends.

Once she needs to talk about the violence in the world, she has to consider if what she says will scare the children and how she can communicate this information supportively and comfortably. She may also need to consider simple language so they can understand. Also she may have to give an example from current news coverage.

When she starts talking she needs to watch her audience’s body language. The facial expression can show our emotions. Some children will be sad, anxious and even fearful for their own family's safety, others will be confused about how to make sense of the events, and others will have little reaction. Some will respond with excitement and anticipation, while others will have a mix of emotions—fear, sorrow, and worry, for example.

She needs to listen to their response in a way that can show she is interested and attentive to what they said. Then she needs to understand what they are saying from their point of view. If she can not understand something, she will ask them to explain it.

Chapter Three

P3 Using appropriate examples from work experience (or care studies you have researched) describe factors that may influence communication and interpersonal interactions in health and social care settings.

There are many different factors present in care settings that can have positive and negative effects on communication creating a problem or making it easier to get a point across. There are three main barriers that can prevent communication, these are

If a person can not receive a message for example, they can’t see or hear it. This could be due to disabilities or the environment. Visual or hearing disabilities create a barrier to receiving any message conveyed through signs, symbols, pictures, sound, music etc. Environmental problems could be noise, lighting or speaking from too far away or the people around. These problems could cause distraction or a person may not want to disclose certain information due to lack of privacy.

If a person cannot make valid sense of a message i.e. differences in concepts. This could be due to the use of different languages or physical/intellectual disabilities. Differences in languages, terms and slang can prevent someone from receiving a message. Disabilities, which cause difficulties with language, learning or memory, form a barrier to certain types of communication. A person may not know the meaning of some words, images or sounds that are heard or seen.

If a person misunderstands the message i.e. people interpret messages in different ways. This could be due to cultural influences, stereotyping, social status, pressures and varied personalities. People who have different cultural backgrounds have varied viewpoints and perceptions. For example if a family have a shared private joke, others outside the family may take it the wrong way or just not understand it at all.

Physical, emotional and social factors affect how well individuals communicate with each other. They can enhance or inhibit it depending on the type of communication. Physical factors that have positive effects on communication in care settings could be the environment i.e. a good quality nursing home, workers with good standards of personal hygiene and grooming, privacy and appropriate distances when communicating. For example a nurse sitting too close to a patient may invade the patient’s personal space and cause them to feel uncomfortable. If workers are not clean and hygienic it will deter others from wanting to be near them

Emotional factors such as stress, negative attitudes, inappropriate advice and blocking inhibit effective communication. For instance if a teacher is stressed they may convey a negative attitude towards the pupils therefore blocking their views and not allowing them to get their point across. On the other hand if the teacher had a relaxed, warm manner and gave off an air of sincerity it would encourage successful communication.

Social factors in care settings such as appropriate language and sharing interests encourage others to want to make contact, for example a teacher being attentive to his/her students. Stereotyping, labelling, exclusion and ignorance are other social factors that tend to inhibit correspondence. For example if an individual felt ignored or left out by a group the person would not feel inclined to speak to the people in the group.

Individuals can have certain personality traits that encourage or discourage communication. The positive factors could be assertiveness, respecting silence and using the preferred form of interaction for people who find certain forms difficult. Negative traits people may have which can discourage communication are lack of awareness, inappropriate language, aggression and parroting. This is because if people are unaware of the difficulties and needs of others it is impossible for them to minimize barriers. Also if someone were being aggressive you would not want to communicate with him or her.

Factors that may influence communication and interpersonal interactions in my work placement at Oakwood School

Chapter Four

P4. Identify how the communication needs of patients / service users may be assisted (helped/ supported), including non-verbal communication.

People will feel valued and respected when they have been listened to, and when they feel their needs and wishes have been understood by the care Worker. Good communication skills are vital for this, and care Worker must find ways of overcoming the communication barriers that often arise between the client and Worker.

People who have a serious illness or learning disability can not express themselves effectively therefore an advocate can be employed to assist the situation, for instance, older people with dementia in a nursing home may have an advocate (member of family or other professional) to speak on their behalf. If a person can not speak English, his communication needs can be assisted by a translator or an interpreter. At my work placement (Oakwood School), there are children who have a delayed or disorder language development or difficulty with producing and using speech sounds. Their communication needs are helped by a speech and language therapist.

Technology – Interactive whiteboards has been used at my work placement to assist the interaction between teacher and students. It can be used to write over the top of programs to highlight and annotate points, surf and display websites which the entire room will be able to see. Students/audience members can approach the whiteboard and add their contribution to the discussion by writing directly on the whiteboard.

Languages - I noticed the school teacher uses simple words, which the children are familiar with, because it is important to know that the clients are children and can not understand long words or a long set of instructions. The teacher usually uses ‘bitesize chunks’ this is when a set of instructions is broken down into smaller chunks and when the carer is talking to the client to use simple short sentences and vocabulary that can be easily understood for example ‘how are you?’ ‘I like your picture’ this gives the client time to respond, it also may be needed for the carer to repeat him/herself again so that the child fully understands what the carer is saying because some children may find it hard to listen and concentrate.

Communicating with "signs" is also used at my 2nd work placement, where the staff have to communicate with service users who can not make any speech. The signs given helps the person because it gives them extra visual clues as to what is being said. Makaton includes not only signs but also written symbols which are both used or either one is used depending on a person's particular needs and cultures. British Sign Language differs from Makaton because with Makaton not all the words are signed, the signs are simpler and the words are spoken. For example, when saying "Good morning", you first say "Good" by showing your thumb (fingers folded into palm), then for "morning" you touch your chest with your finger tips from left to right. This image is used as a symbol of the curtains opening in the morning.

Empowerment - Effective communication is making sure clients and service users are empowered. Empowerment means authorising or enabling, whereby you are giving the client the choice or half of the authority, so that you are enabling them to make a decision for themselves. In my work placement a lot of positive re-enforcement is used, this is where every time a child achieves something or does something right; he/she is praised by the teacher. Praising a client for doing something good or right will promote their good behaviour and social practice.

Promotion of rights - The school I did my work placement is a great example of good communication, all the students are called by their name, this gives a child the right to identity, as a young person it is all the little things that are important such as the teachers remembering the students’ individual needs and birthday. These small things help build up a rapport with the students which means in turn the children learn to trust the teachers and will study better as a result

Maintaining confidentiality - It was really important to maintain client’s confidentiality because if the teacher did not then the students may not trust in her and they would not feel valued and it could lower their self esteem. Also it is their right for their information to be kept confidential.

M2. Use examples from work experience or visits to explain the specific communication needs that patients / service users have that require support, including the use of technology.

Problems in communication will include people with special needs. E.g. deafness, blindness and psychological impairments. These problems can however be often overcome or made less disabling through the use of technical equipment and alternative communication strategies. Such equipment is hearing aids, text phone or an electronic communicator. These and many other devices can provide people with speech, hearing and complex physical disabilities with effective communication assistance.

None of the students have any special needs at my work placement. Only a few of them have difficulty with producing and using speech sounds and this affect their learning at school as well as their social ability. There is a speech and language therapist who comes to school twice a week to support those students. Some students need to have one-to-one support to help with their reading and writing, which may due to the lack of confidence. Usually teaching assistant will help the teacher to carry out this task. I was asked to support 4 students in the class when I was doing my placement.

Makaton is used by the staff to communicate with service users, at my second placement, where some of service users have difficulty in making speech and sound. Also, one service user who can not talk and show feeling to others has an advocate to express her needs.

Chapter Five

P5, P6 Participate in 2 interactions (P5) in the role of a carer, using communication skills to assist service users/ patients, and review how effective (P6) you feel your own communication skills were.

One-to-One Interaction

On the 13th week of my work placement at Oakwood Primary School, I decided to carry out my one-to-one interaction because I have learnt most of children’s name in Ms. Morse’ class and also they know me well enough. Firstly, I asked Ms. Morse’s permission and she kindly chose 2 girls for me because I can compare the difference between year 2 and 3 students. Anyway, in this assignment, I will present only one interaction with Helen, although this isn’t her real name. I changed the clients name for confidentiality reasons.

Helen is 8 years old, year three at Ms. Morse’s class. She is very bright, friendly and I have had several interactions with her before, so I am very happy I can have one-to-one interaction with her.

The environment in which I carried out my interview is vital to how effective the communication is. Which is why I found a small table outside the computer’ room to interview Helen, where distractions would be minimal and where we could hear each other speak. I tried to interview Helen outside the classroom as to be near to the group so that she wouldn’t feel isolated, but she kept looking around distracted by the noise from the class.

Once I got seated with her, I said hello to Helen, which she responded to, and started the conversation off by using a closed question to ask if she felt comfortable for me to interview and share a one to one interaction with her. She said it was fine for me to interview her, which encouraged me to spend more time with Helen, to take an interest in her life as I knew she felt at ease round me.

As the conversation continued I began asking open questions, to encourage and provide an opportunity for a broad- ranging response. I also demonstrated a number of verbal and non-verbal skills as different types of communication methods. Throughout the interaction I spoke slowly and softly to Helen, so that she could interpret what I was saying, but I didn’t want her to feel intimidated by the tone of my voice. I was also aware that I could scare the listener, if they believe that I am shouting, whilst having a conversation with them. This is how Helen and I communicated verbally, by not shouting at each other, or raising our voices, instead by talking calmly and relaxed. To show that I was listening to Helen I used prompts, by making noises for her to feel as though I was listening and interested in the conversation.

Furthermore, during the interview I used different forms of non-verbal communication, by expressing body language to illustrate my thoughts and feelings, which I could not verbalise. I used facial expressions whilst talking to Helen by smiling at the things she said, and by raising my eyebrows when she was speaking to show that I was paying attention. I also wanted her to know that she could talk for as long as she wanted, with me patiently listening, which made her smile as she knew from my expressions that I was interested. This is why I used eye contact as a sign of respect and to show that I was a friendly person. I continued using open questions by asking Helen what sort of activities or subjects interest her here at school, as she replied, her face lit up with excitement. This demonstrated to me that she was happy talking about her hobbies here.

Throughout this one to one interaction, I gave Helen plenty of personal space, without making her feel that I was moving away from her. I sat a reasonable distance from her, in which we both felt comfortable and where she did not feel overcrowded. When Helen and I were seated I made certain that we were both positioned at the same level, so she did not feel threatened or overpowered. I noticed that Helen and I started to use gestures with our hands, when we got onto the conversation of favourite day of the week. As we both had an interest for it and talking about a subject we like made us use gestures to emphasise meaning and to express emotion.

However looking comfortable and feeling comfortable is a very important part of communication, therefore I made sure that Helen felt secure around me. I used open postures where I had arms loose and leaned slightly forward to her to show that I was relaxed and that I wanted her to be like that to. I become aware that when I sat relaxed, Helen’s posture then became more open.

There were times during the interview where the conversation became silent, so I would have to think of useful strategies to keep the conversation going. To prevent unwanted silences, I used non-verbal behaviour, like smiling and nodding, and used probes and prompt to follow up my questions.

Some barriers that effected the communication between Helen and me were because my accent is too strong for her to understand that sometimes, I had to repeat twice what I said. Overall Helen and I didn’t have too many problems, as the conversation went very smoothly.

Here I have included a transcript of some of the conversation between Helen and myself, to show just a few of the questions I asked her:

Q: Helen, How do you enjoy attending the school? And which part of activities you like most?

(I sat down relaxed across the table with Helen leaned forward slightly to keep my body posture open and to maintain eye contact because I was ready to listen to her. This kind of position is important because Helen wouldn’t feel like I am not over empowering her instead she would feel empowered.)

A: Yes, I like school. I like Friday because it was fun to get together in assembly.

Q: (nodding my head to show interest), I like Friday too because it was the last day of school. She laughs. Can you explain what you mean by getting together in the assembly?

A: pardon! ( looks confused)

Q: you said you like the assembly on Friday, what do you mean you get together?

A: we have yr1 to yr6 all in the assembly.

Q: ok. Which part of activities do you not enjoy and why?

A: I don’t like Golden time

Q: You don’t like golden time? (look surprised) why is that?

A: because it plays toys.

Q: can you tell me what subjects you are good at and which subject you need more help?

A: I like math and I am good at spelling. I think I need help with English and Geography.

Q: do you get any help at home with your homework?

A: yes, my mum, she helps me with my homework.

Throughout the interaction I used a variety of communication skills, to enable myself to develop an appropriate relationship with the service user. I understood the communication cycle, which was the process of sending and receiving messages, which allowed me and Helen the turn-taking pattern of speaking and listening.

Whilst communicating with Helen It was important for me to convey a feeling of warmth, by using the following methods:

Smiling- to show that I was happy and enjoying Helen’s company
Eye contact-to show that I was paying attention and respected Helen
Gestures- to emphasise meaning and to express emotion
Open postures- to show I was relaxed and comfortable
Open questions- to encourage and provide an opportunity for a broad-ranging response
Tone- I kept the tone of my voice soft and slow at all times.
Pace- spoke slowly so Helen was able to understand me
Used her first name- as a sign of respect for Helen

Effective communication in care settings depends on the ability of being able to listen well, through active listening. This involves the linguistic, or spoken aspects of what the person says and the paralinguistic aspects through the quality and features of a person’s voice when speaking.

During the interaction, I thought that it was vital for Helen to know that I was listening to her, which I achieved by:

Good eye contact- to show I was paying attention
Active listening through paralinguistic and non- verbal aspects
Facial expressions- by smiling and frowning at the right time
Checking understanding by clarifying what Helen had said and by repeating some of the spoken words back to her
Nodding my head to show I understood what she was saying.

Group Interaction

On the 4th week of my work placement, I was asked by Ms. William to assist her class’ science activities. It was 2 teachers, 2 adult students and 28 children in year 2 and 3. The interaction was taken place in the assembly room, where the instruction was given by Ms. William and we four adults were to lead a group of 7 children to do different forms of science experiment. The children had to swap between 4 adults to try all of them, which meant that I had 4 group interactions within 1 and half hour.

The first 3 groups went on smoothly without major problems but the last group I could not take control and had to stop the experiment several times. I would like to present this particular group interaction because I have learnt a lot about effective communication and interpersonal interaction with this group. I had 3 girls and 4 boys with me and I had them sit in a circular fashion as other groups did for easy communication so that everyone can see each other.

I also sat down on the floor, explaining what we need to do, as I want them to feel relax and comfortable within the environment as well as not to feel over powered or threatened by me. One of the first things that I noticed before we even started the interaction was the behaviour of two boys. (Jason and Jack – not real name) They appeared to be very domineering and seemed to try to dictate the starting of the activity. I told them to sit down but was ignored. The two boys went on kicking ball and run around the place, which created another problem, as other children sitting with me started to join them.

At first I was very confused about what I should do to regain my leadership within the group, then a girl (Emily – not real name) came up to me, she raised her hand up, saying if I did the same the whole group would be quite again and listen to me. I realised later on that this gesture was often used in the class by the teacher to control the class. I was surprised to learn that everyone automatically stopped what they were doing and return where I want them to sit. I restarted the interaction by giving them the instruction. Before I could have finished, I noticed Jason and Jack was talking to each other. I didn’t want the interruption to continue so I rose up my hand and told them that we would not start the activity until everyone was sitting quiet.

This therefore gave the impression to the children that the activity would only start under my command rather than these two boys. I felt that this communication was very effective because Jack and Jason did not try to dictate the group after I made it clear that I was the leader of the group. After I had given my instruction, I asked everyone if they have any questions about the experiment. Sam and Sunny (not real name) could not understand, so I decided to have Emily to help me to show everyone what they should do.

I then asked them to work in pair. Our experiment is about the way how we can change the direction of a moving object. The first experiment they did very well as they all communicated and interacted effectively. The objects were passing from one to another and the pairs were far from each other so that non-verbal communication is used as well. However, when I asked them to stop what they were doing as I need them to change different object experiment. The boys went on, shouting and kicking the balls. Again I used this technique I just learnt (Hand up), but failed to control them.

I had not choice, but had to end the experiment, so I asked the girls to help me. The girl were very helpful, they got the balls back to me from the boys. This took a while because the boys were running around to get away from the girls. As a result of these constant interruptions by Jason and jack, I could not have completed the science experiment with this group, but I am sure that they all have good fun.

Here I have included a transcript of some of the conversation between the group and myself:

Me: Can I have you all sit down on the floor in a circle around me, please.

Children: they were talking to each other

Me: waited until they stop talking (about 10 seconds), Ok! We were going to do a science experiment. I wanted you to find out how you can change the direction of a moving object.

Me: (I placed a ball in front of me) Could anyone of you tell me how you can change its direction if it is moving?

Jack and Jason: standing up, kicking the ball to each other (at first I thought they were showing me)

Me: boys please come back here and sit down (I did not know their name)

Jack and Jason: continued and ignored me and the children sitting with started to join them.

Me: Confused, don’t know what to do

Emily: Mr. you can raise up you hand and everyone would listen to you (she raise up her hand).

Me: everyone come back here and sit down, (raise up my hand)

Children: they all come back and sit down in a circle around me.

Me: OK! You can push or pull the ball if you want to change its direction, when it is moving. Any questions?

Sam and Sunny: Mr. We don’t understand (They don’t know my name).

Me: Emily can you help me to show them?

Emily: OK!

Overall, I think my communication skill in group interaction was not so effective but it was fun and I learnt a lot from my mistakes. For example, I should have introduced myself to the group and asked them their name so the barrier as me a stranger to them can be broken. Also, the constant interruption and background noisy are barriers to the communication and interaction. However, I learnt to use hand gesture to get their attention. I also used silence technique to maintain the situation under control. My verbal communication was OK as I tried to speak slowly and clearly to them.

However, looking back at what my aim and purpose as of my interaction I feel that I was successful in achieving this because, at the end of the day all the children had fun, and the interaction was full of surprised and laughter. I truly believe that by the end of interaction all of the children felt very comfortable around me and were able to ask me questions without feeling intimidated. Along with this the children seemed to be able to interact with each other very well which I think was enhanced by some of the methods I used to try and include them all together.

I must admit that at the beginning of interaction there was a lack of trust between me and the children but as we continued the activities, I learnt their name and so I win their trust in a short space of time.

Chapter Six

M3 Reflect on, and explain how you think your own communication skills could have been used to make the interactions more effective.

If I had the chance to repeat the group interaction, I would break the “me as a stranger” barrier as I was asked to help in someone else class. I can introduce myself, find out their name and ask some questions to ease the tension before we start the task. I think this barrier has created another problem too as 2 boys in the group started to interrupt the interaction. Also I should be more assertive and take the group leader role when the interruption began. I should speak slowly, clearly and loud enough as the noisy level in the background were too high to hear from each other.

I had to repeat twice to make myself understood which was mainly due to my foreign accent. I think this could be improved by practice, and just making sure that I remain as calm as I possibly can. Being aware of my body language too is essential too.

I also feel that to improve the quality of the interaction I would need to find out ways in which I could include other group members, which were lacking in joining in. I can ask teacher and find out information about how to make clients feel valued and belonged within the group more than what I know already.

My one-to-one interaction with Helen was very successful as I have known her for a while and has interaction with her before. However, I think I still need to work on my foreign accent as I had to repeat twice to Helen sometimes. The second problem I had is that I tried to write down the conversation, which has affected my interaction a bit as I have to break eye contact from Helen and the conversation has to stop from time to time. Next time if I am going to have another one-to-one interaction I should use a tape recorder.

I felt I could improve interaction with Helen by using phrases such as "let me say it again", "what I mean is", "what else can I say", "is something wrong", "do you want me to go on" etc Using this phrases I can easily break the silence.

Chapter Seven

D1. Consider the factors – both positive and negative – that you think may have influenced the interactions undertaken, and analyse their relative importance / influence on the success of the interactions.

Chapter Eight

D2 Analyse how communication in health and social care settings assists service users / patients and other key people.

Effective communication in care work is essential in order to improve the quality of people’s lives by addressing a range of needs, to create a safe, welcoming and valuing environment. Effective communication is vital if staff are to foster peoples equality, diversity and rights. Health and care work involves constant communication with others. Even when staff are not taking, their body language will be influencing other around them, this is called informal interaction. The way care staff undertake informal communication is very important, they should make their clients feel respected and valued. Formal interactions require care workers to work within appropriate verbal and non-verbal skills. Some situations also require emotional skills or special skills in working with people with communication differences.

Abraham Maslow built a theory in which the goal of life was personal growth, this helps us to understand the different types of personal needs. For each person to develop his/hers personal ability and potential, they will have to successfully meet Maslow's levels of needs as shown in this pyramid, (Heinemann AVCE, Advanced Health and Social Care, Page 74, Figure 2.1 'Communication within Maslow's levels of need'):

Examples of situations in my work placement which refers to each of Maslow's levels of needs and also which type of interaction is required to meet their need:

Personal growth - A child has problems sounding out words of objects. To overcome this issue conversation skills are essential, the speech and language therapist at school helps by pronouncing the name of the object very slowly (articulate) and then allowing the child to repeat afterwards several times. This is so that the pronounciation of the word will stay in his mind when next asked the name of the object. Resulting in his potential developing.

Self-esteem needs - A child has problems talking to the rest of the class as she becomes very shy when asked to tell the class what she did over the weekend. The best way is for the teacher to use communication to encourage her not to threaten her self-esteem. To do this first talk to only a few children instead of the whole class. Also the teacher should continue to ask open-ended questions and become enthusiastic by using interventions e.g. "Wow!" This will help the child to continue to talk as she feels you are interested.

Belonging and affection needs - A child who gets upset when no other child in the class is interested in playing with her. Communication skills are essential to resolve this problem. If the staff see that the girl is playing with something, they should make it obvious to the class that they want to play with the girl, as it looks like fun. This will attract others attention, as not only do the children like playing with other children, but they also like playing with staff. Other children will become intrigued of what the staff are making all the fuss about. Resulting in the girl feeling a sense of belonging.

Emotional and physical safety - A new girl starts attending Ms. Morse’s class, her parents come with her and talks to the teacher. When her parents leave she begins to cry because she knows no one and everyone looks like a stranger to her as they all stand there staring at the new girl. The new girl feels threatened by the other children and lonely. In order to overcome Ms. Morse needs to first introduce the girl to the class so that she feels welcomed and then use her conversational skills to help her feel safe and welcome.

Physical needs – Some children needed help to undo their buttons on their uniform, the teacher used her good communication skills by telling the children to try and undo the buttons themselves, if they couldn’t do it then they could go to her, she said this in a very calm and relaxed manner without even slightly raising her voice, she also said it by making use of good eye contact, use of good eye contact helps regulate the flow of communication and signals interest and respect in others.