Andersen, J. (2008). Developing active listening skills: can you hear me now? How effective communication will enhance your career. IDEA Fitness Journal, 5(5), 85-88.

Browning, S., & Waite, R. (2010). The gift of listening: Just listening strategies. Nursing forum, 45(3). doi: 10.1111/j.1744-6198.2010.00179.x

Dawson, S., King, L., & Grantham, H. (2013). Review article: Improving the hospital clinical handover between paramedics and emergency department staff in the deteriorating patient. Emergency Medicine Australasia, 25(5). doi: 10.1111/1742-6723.12120

Levinson, W., Lesser, C. S., & Epstein, R. M. (2010). Developing physician communication skills for patient-centered care. Health affairs, 29(7). doi: 10.1377/hlthaff.2009.0450

Lord, B. (2009). Paramedic assessment of pain in the cognitively impaired adult patient. BMC Emergency Medicine, 9(20). doi: 10.1186_1471-227X-9-20

Jensen, S.M., Lippert, A., & Stergaard,, D. (2013). Handover of patients: a topical review of ambulance crew to emergency department handover. Acta Anaesthesiologica Scandinavica, 57(8). doi: 10.1111/aas.12125

Spencer, C., & Archer, F. (2006). Paramedic education and training on cultural diversity: Conventions underpinning practice. Journal of Emergency Primary Health Care, 4(3). doi: 10.33151/ajp.4.3.382

Williams, B., Boyle, M., Brightwell, R., Devenish, S., Hartley, P., Mccall, M., McMullen, P., Munro, G., O’Meara, P., & Webb, V. (2012). An assessment of undergraduate paramedic students’ empathy levels. International Journal of Medical Education, 3. doi: 10.5116/ijme.4fba.9190                                                                                       

Williams, B., Boyle, M., & Earl, T. (2013). Measurement of empathy levels in undergraduate paramedic students. Prehospital and Disaster Medicine, 28(2). doi: 10.1017/S1049023X1300006X

It is important to constantly reflect on one’s ability to communicate in order to improve. This is challenging in itself as you must try and identify what you know and actively seek out knowledge to challenge yourself. It can be hard to find information that does not agree with your world view and it is hard to practice some of these communication techniques. Communication is not easy, which is why we must reflect. It is also challenging to understand how communication may not be the same in each professional field. Paramedics do not experience much time with their patients so their way of communicating can contrast with another profession such as a psychologist who may have more clinical time with the patient.

Throughout this unit, I have started to understand how effective communication is in improving health care outcomes. Specifically with this ePortfolio, I have found studies that have stated how better communication does have clinical results. If I had three takeaways from this unit, they would be the use of active listening, empathy, and knowledge of non-verbal communication. I plan to practice active listening in my own life in order to improve my skill in retaining and understanding as much information as possible. If I can utilize it in normal conversation, hopefully this means I will be effective in using it with patients. I plan to practice empathy in order to understand an individual’s framework and hopefully understand their circumstances better in order to facilitate conversation with future patients. And overall, I plan to pay attention to more than just verbal communication. There is so many ways to communicate and it is important to not just limit yourself to one.

Understanding barriers and enablers to communication will facilitate better communication in the paramedic’s work life. It is important to understand how certain factors can prohibit effective communication and by understanding these factors, a paramedic can try and circumvent these barriers. Conversely, by understanding the enablers of communication, a paramedic can use this knowledge to streamline the communication process. Use of knowledge of these communication factors will help the paramedic communicate more effectively, as they become essentially solutions to the communication problem. Though Levinson, Lesser, & Epstein (2010) do not explore the use of communication techniques in paramedicine, they do explore it within the health field. They state that there is a growing recognition for the education and training of health care professionals in non-technical skills such as communication. They identified what the patients understood to be barriers in the communication during their treatment and stress that it is important for health care professionals to be aware of these barriers in order to overcome them. Teaching health care professionals these communication skills will give them the knowledge to improve their communication. This is important as effective communication does improve clinical outcomes (Levinson, Lesser, & Epstein, 2010). Reflecting and teaching one’s self about communication factors will help improve your knowledge and help improve communication.

Empathy plays an important role in communicating with patients. Paramedics need to establish a health provider-patient relationship that promotes two-way communication and use of empathy can help develop a successful relationship. There are several barriers that may prevent a patient disclosing all the information, embarrassment being one of them. The use of empathy can help a patient open up and encourage this provider-patient relationship. Through this, the paramedic is able to work with the patient in order to facilitate better communication and therefore, better health outcomes due to the information being provided that may not have been disclosed before. This is explored by Williams, Boyle, & Earl (2013) who attempted to measure the level of empathy in paramedic students. This study, along with Williams et al. (2012) helped me understand how improved empathy behaviors among healthcare professionals directly impacts on healthcare outcomes. They stress the importance of paramedics and empathy, stating that in this highly emotional pre-hospital environment, basic empathy is crucial in the avoidance of inadequate communication and misunderstanding which characterizes poor health care. Understanding this has prompted me to try and actively attempt to practice my empathy. This is through trying to understand a patient’s circumstances and feelings and understand how this can frame their current situation. Hopefully by considering the patient’s mindset, it will allow me to understand them and enable better communication.

Communication with patients who have disability can be hindered by a variety of barriers. Cognitively impaired patients for example may have a limited ability to report their pain experience. As such, it is important to explore alternative communication strategies in order to try and get as much information from the patient as possible. Practicing this skill can lead to better health care outcomes due to the paramedic getting as much information as possible from a patient with limited communication ability. Lord (2009) explores communication with disabled patients and the effectiveness of pain management. He states that paramedics have an important role in the assessment and management of pain but effective management depends on the paramedic’s ability to gather relevant clinical information. Lord continues to explore communication strategies such as using number scales or simply observing nonverbal cues such as facial expressions and changes in body language and behavior. This study explores how verbal communication may fail in cases of individuals with disability so it is important to recognize other forms of communication. Though it is not 100% effective, relying on more than simple verbal cues can help the paramedic gather more information and improve pain management translating to better health outcomes. It is important to be aware of an individual’s overreliance on verbal communication which may fail in cases where a patient’s ability is limited.

Active listening is a communication skill that is extremely important in the interviewing process. It is essentially, listening for meaning as what someone says and what you hear can be different. Personal beliefs and assumptions can distort what you hear (Andersen, 2008). Active listening uses restatement to ensure understanding, and means the listener is not only paying attending to what is said but how it is said. It helps eliminate barriers that keep you from hearing accurately (Browning & Waite, 2010). This is important in understanding patients but several academic papers have identified a problem of active listening in handover, targeting the lack of communication between the paramedic handing a patient over in the emergency department (ED). Poor active listening in handover leads to patient safety issues and vital information being lost. This lack of active listening is often due to the conflict between listening and performing practical work which prevents an individual from practicing their active listening skills (Dawson, King, & Grantham, 2013). Jensen, Lippert, & Stergaard (2013) suggest that improving active listening skills and strategies, such as delivering information in two phases, the essential information and then the supplementary information, when initial treatment has been undertaken. These articles have highlighted to myself the importance of active listening on patient outcomes. In order to reflect this, I will try to practice my active listening skills, particularly in high paced environments.

In an increasingly multicultural landscape, a paramedic will treat individuals with a variety of cultural backgrounds and therefore will need to communicate with a variety of different individuals. However, communication does not necessarily mean understanding. The same scenario may have different interpretations based on an individual’s cultural background. And it is understanding this problem that will help a paramedic receive information better from the patient. Having a basic understanding of the barriers inherit in communicating with others from a different cultural background will help an individual overcome these challenges. By having this basic understanding of the barriers, the paramedic will learn how to better understand the patient and relate this knowledge to understanding the problem being presented resulting in more effective and satisfying treatment. Spencer & Archer (2006) demonstrates how health outcomes deteriorate when health professionals do not provide care that is culturally appropriate. It also explores how cultural misunderstandings may occur through failing to recognize the link between language and culture which could compromise patient safety. This helped me recognize how important understanding the cultural backgrounds in trying to communicate with individuals. As a result, I will try and increase my empathy and patience towards those with a different cultural background and try and improve my knowledge whenever I can.

Communication is essential in every professional domain but is extremely important in the health care field. If communication is blocked in-between patient and health care professional, or in-between health care professionals, this can lead to poor health care outcomes. Promoting communication skills and practicing and reflecting on these skills is important in providing optimal health care. This is especially important in the paramedicine field. Paramedics work in a fast-paced environment where information must be communicated clearer and effectively in order to successfully treat the patient in the pre-hospital environment. Poor communication leads to poor understanding of the patient and poor understanding in-between health professionals and coworkers. This means that vital information can be missed, and the patient may suffer the brunt of the consequences, through situations such as delayed times or simply wrong health care treatments. Improving communication skills and constantly reflecting on these skills will improve patient experience. It will lead to more effective treatment and a more satisfying health care experience. As such, a reflective exercise such as an ePortfolio is helpful in learning about communication because it means that the paramedic must identify all they know about the skills and challenge this knowledge. This leads to improved knowledge and more effective use of the skills being explored. The ePortolio is also effective as it invites others to offer their perspective of the communication skills, allow the individual to further challenge their knowledge and uncover more skills that can improve their abilities.