Abstract

Holding the correct posture, maintaining the eye contact, assessing the patient’s feeling correctly, responding appropriately with student’s face, saying thepatient’s feelings in student’s own words can improvecommunication and empathy4. Interpersonal skillsdevelopment is considered as an essential prerequisite to demonstrate empathic behavior5, 6. Empathycan be enhanced by educational programmes to improve students' interpersonal skills that implicitly imply enhancement of the capacity for empathy7-9.Suchman et al10,11 identified three basic communication skills namely, "recognition" of patient's negativeemotions, concerns, and inner experiences(cognition); "exploration" of these emotions, concerns, and experiences (understanding); and"acknowledging" them to generate a feeling in thepatient of being understood (communicating). Thesethree skills have been usedto identify and promoteempathy hence ust nodding or saying: "I understandyour concern; let's work on it together" can improvethe communication process12.Hence nonverbal cues includeing: changes in tone ofvoice, eye contact, gaze and aversion of gaze, silence, laughter, teary eyes, facial expressions, handand body movements, trembling, touch, physical distance, leaning forward or backward, sighs, or othersigns of distress or uncomfortableness can help inestablishing an empathic clinician-patient relationship13-15.Psychological effects of nonverbal cues suchas folded arms (more likely to indicate defensiveeness, coldness, rejection, or inaccessibility) or moderately open arms (more likely to convey acceptanceand warmth) can also be taught in interpersonal skillstraining programs16. Also, teaching clinicians to try tomirror patients' postures, gestures, respiration rates,tempo and pitch of speech, and language pattern cancontribute to forming an empathic engagement17.

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