B991 Health And Social Care Assessment Answers

Answer:

Introduction:

Communication in the domain of learning and teaching in health and social is considered to be one of the most crucial elements since it enables the favourable interlinking between the patient and healthcare providers. The essay presents the two case scenarios including the clinical communication encounter and a learning encounter which highlights the significance of communication in the clinical set-up. Generally, the profession of healthcare requires the providers to have recognizable competence in the terms of skills such as communication apart from other mandatory and critical skills required in healthcare [1].

Various institutions have developed formal assessment frameworks to compare the effectiveness of the healthcare service providers which can be termed explicitly as Clinical Skills Assessment (CSA). A notable implication that can be drawn with respect to health encounters and learning encounters is the apprehension of the emotional context. This essay aims to derive critical reflection into two different case scenarios characterized distinctly by a learning encounter and a clinical encounter in which communication plays a key role. The critical reflection on the two case scenarios has been comparatively analysed with explicit references to theory and evidence [2]. The connection that is formed due to communication between the patient and healthcare provider, and between student and teaching personnel in healthcare profession has been presented here. The findings can also be collated to obtain valid recommendations for inducing a transformative change in individual practices pertaining to healthcare environment and individual practices which could further contribute to the potential improvements in outcomes of health and learning [4].

Clinical encounter:

A proper and healthy clinical encounter is a necessity to improve the health conditions of the patients. There is need to establish a strong inter-professional bond in the healthcare backdrop so that shared decisions can be taken and the best available medical knowledge and skills can be used to cure the ultimate service user. The cardiac catheter lab refers to the special hospital room where the physicians perform tests and procedures for the purpose of diagnosing and treating cardiovascular ailments. Any delicate clinical encounter in this space can make a significant difference in the life and death situation of the patients [10].  

The clinical encounter that has been considered for analysis in this essay comprises of references to the case of a patient named Robin. Last year, a pregnant patient had been admitted to the hospital and her case was considered to be delicate since she was having some cardiovascular diseases (CVD) that could be risky for her and her unborn child [29]. Robin was taken to the cardiac catheter lab where all the necessary tests and diagnosis were conducted to assess her health condition. The test was pretty challenging since she was undergoing pain during the entire time. Her health condition had worsened since her delivery date was fast approaching. After the test, her husband was explained the gravity of the situation and the test results [13]. This communication helped him to understand that his wife’s body was in a poor state so it could be risky for her to give birth to the child. The entire episode was challenging for all the involved people in terms of emotions and medical knowledge. 

During her stay in the hospital all the proper cardiology procedure was followed and special treatment was provided to her since she was pregnant. The medical team could notice a positive change in her health since she was able to endure her pre-labour ordeal. She gave birth to her child just after the 7^th month of pregnancy. The baby was very tiny and underweight but he was healthy. Both mother and son stayed in the hospital for some time until her health condition improved [14].  The diagnosis of Robin’s health revealed that her heart condition had strengthened and her son was also fit. Since an effective treatment model was followed in the healthcare set-up, the maternal and fetal health was proper and sound. Robin was discharged from the hospital along with her baby within a few days and they did not experience any kind of health issues after the particular pregnancy complication that had aroused in the initial stage [27].

This clinical encounter shows that a simple and effective communication between patient, his or her guardian and the medical professionals is necessary to offer the best possible treatment to the patient. Even though Robin’s condition was quite bad in the initial stage, the necessary changes were introduced in the medical treatment that minimised the impact of CVD. She still comes to the hospital for regular check-up along with her son to where necessary health checks are conducted [28]. 

Communication in clinical encounters:

Communication in form of listening, and having a conversation is an integral part of healthcare set-up. Listening is a formidable interpersonal communication skill and in the clinical scenario, this tool needs to be effectively used since it can bring about significant changes in the life and death situations of the patients [5]. Listening can be associated with the urgent requirement on behalf of the receiver to have perceptive capabilities. Some of the prominent characteristics of effective listeners include establishing eye contact, appropriate communication with patients through gestures and explicitly calm posture. Similarly establishing transparent communication in the clinical environment is necessary for the patient so that he can share his health-related concerns with the professionals [3]. 

The healthcare providers need to facilitate flexible opportunities for patients to communicate their ideas and feelings through depicting attentive behaviour. Theoretical references to the skills of listening in clinical communication encounters are largely reflective of the significance of paraphrasing which enables the identification of any ambiguities in the message communicated by patients. A simple yet understandable communication medium must be adopted in clinical encounters so that the physicians are able to understand the complex health condition of a patient.  There should be no scope of doubt in the process and necessary clarifications must be made in case of any confusion. A health exchange of feedback with patients can help in the overall improvement of the communication process [6].

In the case of Robin, since I was the cardiac catheter lab nurse there I had an open conversation with her relating to her physical health. She described her pain in the chest during the pregnancy phase, and the focused listening skills played a crucial role to monitor her issues [8]. Furthermore, I also depicted favourable body posture which helped Robin to be more comfortable while talking to me and she understood that I was interested in everything she had to say. An open communication model and comforting attitude play a key role in the medical sector since it allows patients to open up about their health condition [12]. Healthcare providers are often required to anticipate the thoughts of a patient in order to lead them and incite a conversation. One of the common examples of showing positive communication skill in the domain of health and social care is observed in the use of open questions with binary responses which comprise of relevant questions that could help in anticipating the thoughts of the patient. Direct leadership that is depicted by healthcare providers in clinical encounters has been accounted for notable benefits for elaboration, clarification and illustration of the intentions of the patient. Direct leadership could be considered effective in scenarios where patients are subject to a multitude of issues wherein the issue of utmost concern can be emphasized for guiding the process of communication. Another notable indication of the use of leadership in clinical communication could be observed in the example of indirect leading. Indirect leading comprises of prominent references to the outcomes of providing essential privileges for patients to control the direction of communication alongside preserving their ideas [17]. In case of Robin, I was able to apprehend that developing open questions could contribute to the development of leading skills gradually with the acquisition of capabilities to frame relevant questions that can provide a viable impression of the patient’s condition and ideas. Reflecting on the feelings, message and experience of patients enable the nurse to anticipate the world from the perspective of the patient. The identification of feelings of the patients in verbal and non-verbal form could be assumed as profound benefits that could be facilitated by the reflective practices of healthcare service providers. Reflective content pertaining to clinical communication could also be accounted as an entity similar to paraphrasing since it involves the summarizing of important highlights conveyed by patients [18]. The reflective practices in communication enable healthcare service providers to obtain a credible impression of the patient’s thoughts in case he is unable to communicate his feelings expressively. My initiatives for communication in the case of the concerned clinical encounter case study in context of reflective practices in communication suggest the use of monotonous words and the use of certain words which were inappropriate for Robin. Therefore, it is imperative to consider the remedial measures such as communicating intended parts from the reflective outcomes to patients and using lesser monotonous words thereby depicting sincerity in communication.

The healthcare service providers must understand the significance of timing the feedback communication. In the concerned clinical encounter case study of Robin, an open communication model was adopted since the delicate physical health of Rabin was shared with her husband [19].  The health condition of Robin and the prevalence of the heart condition were elaborately explained to him so that he would understand the health condition of his wife and his unborn child in advance.  The communication that was carried out with Robin was also positive and friendly but the delicacy of her health was not revealed till her since it could lead to stress [22]. 

Communication in clinical encounters could be enhanced on the grounds of the patient’s flexible understanding of the novel frame of reference communicated to them. The interpretation aspect in clinical communication has been associated with profound benefits of expanding the scope of the patient’s perception of their feelings and ideas. The interpretation was a cognizable communication skill that was used by me in the concerned clinical encounter case study of Robin. Her initial frame of reference was directed towards her assumption of the nurses in the hospital as angels that are helping her in a difficult situation and motivating her. I suggested her to join the nursing profession. Interestingly, Robin stated that she would think about joining a Licensed Practical Nurses program after her baby grows up and she receives the pre-requisite qualification [26]. The other necessary aspects of communication in clinical encounters as validated by theory and evidence refer to the sharing of information and summarizing of skills. The process of information sharing could be accountable for the provision of flexible advice to patients in healthcare. Sharing of information enables the patient to get acquainted with the approach followed by nurses in the delivery of healthcare thereby obtaining a promising impression of the probable courses of action that should be taken by the patient. The applications of information sharing and advice can be explicitly observed in the case of patients that are experiencing crisis scenarios. In the concerned case study of the clinical encounter with Robin, she was motivated throughout her stay in the hospital by all the healthcare members. This was done so that she would not feel depressed or worried for her unborn baby [30]. This communication model had a positive impact on her and she was able to relax better in the hospital environment. Summarizing skills have also been accounted as promising contributors to communication in the context of healthcare. The summary of patient communication would enable to find the details and effects of the message communicated by patients. Summarizing is a viable resource in clinical communication for healthcare service providers which enables them to convey the progress in identification of patient feelings and ideas alongside the problem-solving approaches intended for them. Summarizing could be very well assumed as the concluding stage of communication wherein new ideas are explored alongside the organization of the existing ideas which are vague in nature. Furthermore, summarizing enables the patient to perceive the effectiveness of healthcare service providers in understanding the messages and ideas conveyed by them. Understanding Robin’s delicate health state helped the medical staff to summarize the same to her husband at the right time. It was surely a very challenging thing to do but it helped to make him prepared for the worst outcome [31].  Robin’s summarizing skills during the cardiac catheter lab tests also played a significant role in this clinical encounter since the medical team was able to design the treatment plan accordingly. Thus utilizing patient ideas and views can enhance the communication model that is used in the healthcare set-up. 

Observation of the case scenario of clinical encounter involving Robin and reflecting on it critically from the perspective of theory and evidence provides an impression of the possible promoters and impediments that are observed in clinical communication. Since I was one of the nurses that took care of the cardiac catheter lab I was in constant touch with Robin. This close proximity allowed me to minutely observe the changes in her medical aspects. This aspect of communication played a key role to improve her health condition since the minute changes in the health behaviour were communicated to the doctor so that necessary diagnosis could be carried out. It could also be observed that my positive thoughts helped me to be strong for Robin and her child [32]. I was able to communicate with her on various aspects such as heart-related discomfort, and pregnancy complications. I never tried to postpone discussion with her relating to her health condition. On the other hand, the hospital environment was good and friendly for the patients including Robin. The profound enablers for communication that could be observed in the concerned case scenario refer to the lack of cultural and social barriers to communication and the provision of a friendly attitude towards Robin upon arrival and departure in the hospital [25]. The initiatives taken by me for ensuring that Robin was perceptive of my thorough involvement in the communication process and willingness to listen to her ideas and feelings were also reflective of enablers for the communication process.

Learning encounter:

The student nurses significant amount of time to receive theoretical knowledge on important medical subjects. This learning encounter is crucial for them since they are able to grasp all the theoretical knowledge that is covered in books. The learning and teaching aspect in the healthcare set-up plays an important role since it could have a vital impact on the ultimate encounter between the patients and students that dictate the clinical settings [24]. Learning to effectively treat patients and adopting key approaches for their care is assumed to be crucial for the learning and education of healthcare service providers. The following section reflects on the case scenario of my encounter with a patient, Jane, as a student in the domain of healthcare. Such experiences play a vital part to expose students to the actual clinical scenarios. This experience helped me to understand the advantages and pitfalls that are associated with communication in the healthcare context. Involving patients in the learning experience of students is regarded to be a solid learning tool in the healthcare setting [16]. 

The patient under concern, Jane, who aged 26, was diagnosed with uterine fibroids which are a unique case of benign tumors affecting the uterine tract of victims. She was admitted in the hospital and was subjected to vaginal hysterectomy treatment for resolving the issue of uterine fibroids. Recovery from the disease was considerably intensive in terms of impact on Jane which was complemented further by the complication arising from the surgery. Jane complained about stinging pain in her abdomen while urinating which existed in her condition prior to the surgery [20]. Therefore, she was admitted to the clinical education ward where the doctors were able to communicate with her and obtain favourable outcomes in terms of developing my healthcare skills. Since I was just a student then, I was pretty apprehensive to ask her about her health condition. I thought that she would be offended since I was not her concerned doctor but later on I showed confidence and started communicating with her so that she could open up about her medical condition in person [21]. However, it was imperative to reflect on the profound elements that promote the communication among the patient and students which could be related to the profession as well as beyond the scope of the profession of healthcare. Research studies have indicated profoundly that learning encounters between patient and students have been characterized by the lack of precise interpretation of the learning processes that are involved.

Referring to the critical reflection on the concerned case scenario of Jane and her interaction with me should be supported by references to the role of patients and the impact of relationship on learning outcomes. The impact of communication on patients could be observed in the form of their self-empowerment which enables them to engage in open communication with students. Students could be able to apprehend the profound implications of practical experiences pertaining to illness and care alongside providing opportunities for students to train in practical skills [22]. However, it is also imperative to consider the possibilities of negative outcomes in the case of communication with patients for learning purposes. The negative outcomes could be attributed to the ill perception of patients regarding the aspects of student access to patient records as well as the concerns of discussion on personal matters of patients. Furthermore, the learning communication could be hampered by the factors of uncertainty and disinterest among students alongside excluding communication between supervisor and students. The communication between Jane and me was pretty casual at first and she was willing to share details o the first symptoms of her health condition.  I would say that a health patient-student relationship was formed in this encounter since Jane was a young lady who wanted to share details on her condition so that the diagnosis and treatment process of benign tumors affecting the uterine tract of patients could be improved [23]. 

The conventional guidelines provided by supervisors for students to perform the task relating to healthcare helped me to focus on the subject. In case I deviated from the topic, soon I focused on the medical aspects so that I could collect as many relevant details about vaginal hysterectomy treatment. This practical learning experience was beneficial for me and I believe that it would also add value for other students as well since they could get to understand the healthcare set-up.  The learning encounter would additionally allow them to observe the functional aspects of the clinical environment [15].  The mutual relationship between a student and a patient is responsible for dictating the performance of the overall student learning. The existence of a mutual relationship between patient and student could be observed as a viable indicator of improvement in the learning communication process.

This sort of a learning experience would allow students to garner promising insights into the authenticity of the learning process from internal as well as external contextual perspectives. While external authenticity is realized by students through participating in real world care of patients, internal authenticity is characterized by the perception of an inherent association with the patient and contribution to their care. In the concerned case of Jane, the elements of external and internal authenticity were observed profoundly. Pertaining to my practice as a student, I got the opportunity to participate in the clinical set-up and care for real patients. I was also able to apprehend internal authenticity through my communication with Jane. I was not only able to perceive that Jane could provide me material information regarding the prior and post conditions of uterine fibroids but I also committed myself to the care of Jane in the clinical education ward. My interest for learning ensured my frequent visits to Jane which convinced her that I was interested in taking her care.

Theory and research studies suggest that communication between patients and students as well as the outcomes of learning that can be derived from the encounters has been largely associated with the implications of cognitive, emotional and socio-cultural aspects. Learning is assumed to be a dynamic construction process that depends highly on the action, comprehension, interaction and thinking of an individual. The use of communication in the learning process could be apprehended in terms of the option for accomplishing precise meaning-making. The outcomes of learning in the domain of healthcare can be subject to limitations when the implications of knowledge construction do not include references to the practical interactions with other people and the external environment in which the learners or students have to perform their assigned tasks in the future. The relationship between role of patient and learner in student learning in healthcare could be described as learning relationship and attending relationship [11]. The implications of these sorts of relationship on the outcomes of communication between students and patients could be apprehended cognizably in different scenarios. The learning relationship is characterized by the mutual relationship between patient and student which create opportunities for active participation of patient in the learning process. On the other hand, attending relationship is characterized by a one-way relationship that depends on characterizing patients as passive participants and subjects for training of students. Attending relationship could be accounted as a formidable contributor to improvement in clinical communication. However, the dimensions of attending relationship could not be capable of delivering the desired outcomes of learning encounters particularly due to the lack of interactive communication. Learning relationship is characterized by the development of mutual relationship between patient and student. The mutual relationship could facilitate reasonable opportunities for promoting communication between patients and students which is another profound motivator for learning communication in a healthcare context. In the case of Jane, there was a mutual relationship that had developed between me and her over time. The bond led to the promotion of valid prospects to acquire beneficial communication outcomes that would add value for both of us. Jane would be benefited since she would get knowledge on her condition post treatment of uterine fibroids and the knowledge on her medical condition would act as a key source of knowledge for students in the medical facility. This factor played a crucial role in motivating Jane to actively participate in the learning process [9]. Her active participation was observed in her willingness to provide comprehensive details regarding the symptoms she experienced prior to the diagnosis, medications provided to her prior to the surgery and the conditions recommended by physicians in charge of her treatment.

The nature of the relationship could be discussed further on the grounds of varying types of interaction between students and patients. However, research studies have provided substantial evidence regarding the importance of a good atmosphere for interaction that would pave the path for a productive communication. In Jane’s case a good atmosphere was established that made the learning process effective and fruitful. The favourable communication model helped to improve the learning process and ultimate learning outcome. I visited Jane on a frequent basis along with her family members [7]. I later found that Jane and her family members were keenly waiting for my arrival on certain occasions. I also ensured that my learning encounter with Jane was not limited to single visits in a day and so I visited her on different occasions so that I could enquire about her present condition as compared to that during the previous visit. This factor was responsible for invoking a certain bit of inclination towards development of a mutual relationship between her and me. The mutual relationship between Jane and me could also be associated with the profound highlights of two way communication. In the case of Jane, I was able to reflect on the positive outcomes from our communication that involved not only discussions on the medical condition of Jane but also on other issues beyond the scope of the medical profession. These interactive communications enabled me to realize feasible opportunities in terms of the patient’s understanding of the necessity of students to engage in practical studies rather than rely on the instructions of supervisors. Some of the essential outcomes which I was able to obtain from the learning encounter with Jane and other patients in the clinical education ward included practical performance of various kinds of medical procedures which involved examples of vital controls, wound care and taking blood samples. The communication with Jane enabled me to accomplish a credible impression of the impact of disease on the life of Jane. This factor could be accounted as a major attribute for ensuring my motivation to involve myself comprehensively in the profession of a healthcare service provider. An effective learning communication played a key role to enhance the learning encounter between me and Jane in the healthcare setting [9]. 

Conclusion:

The role of healthcare service providers such as nurses and physicians plays a key role to enhance the communication model that they adopt with patients. Since they always remain in close contact with the patients, a thorough interactive model can help to accurately identify the progress in their health condition.  The essay presented here highlights the reflective accounts of two distinct case scenarios which are characterized by clinical encounter and learning encounter. The comparison between the reflection outcomes on individual case scenarios presents the key differences in the same clinical setting. In the case of clinical encounters, communication is a key since it largely focuses on the skills required for communicating with patients. On the other hand, learning encounters were characterized by the association of positive communication with the cognitive, emotional and socio-cultural aspects validated through research studies and theory.

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