Communication Interventions for the Management of Patients Who are Challenging or Resistant. Utilizing a Teaching for Understanding Framework

Abstract

Abstract Purpose of study: Communication programmes have become a part of mainstream education at all levels of dental training. As part of the Behavioural Science Programme as applied to Dentistry UCC, the teaching for understanding framework (TfU) was adopted to teach dental students how in clinical practice to manage patients who are challenging, or resistant. The key TfU goals are to understand and identify the types of challenging patients; to understand and develop communication skills, a core component of which is empathic concern; and to develop interpersonal and intrapersonal awareness. Method In order to assess the application of the TfU goals, dental students are required to engage in Objective Structured Clinical Evaluations (OSCE's) so that their ability to communicate with patients with challenging behaviour can be assessed. This requires the student to remain patient- centred and to manage the clinical encounter by using a selection of clinical interventions to dissipate the patient's emotional response to the medical or clinical situation. Conclusion & Recommendations: If the interaction is managed effectively the student will address the patient's concerns, acknowledge the patient's affective state, and refocus the patient on the decision(s) to be made with regard to their dental treatment plan. The value of using the TfU framework is ultimately to bridge the gap between the theories learnt in class and their application in clinical practice.