Communication Video – Self Evaluation

For this assignment we had to get patient consent to be filmed during an assessment appointment so that we could then go back and watch how we interacted with the patient. We were then instructed to write a reflection paper. As much as I don’t enjoy watching myself on camera, this assignment was really beneficial because it allowed me to see how I interact with patients from a new perspective.

Nonverbal Communication

After watching  back the video of this appointment I feel like I did a great job maintaining eye contact with my patient. At one point I stopped what I was doing for a moment to really engage with my patient and show her that I am actively listening to any comments or concerns. Eye contact is something that I personally value, because I know how much it helps make you feel like the other person cares about what you are saying. Since this is so important to me, I find it pretty easy to treat others with that same amount of respect just by simply looking them in the eyes.

Overall, I think my posture was good during the assessment, but there are some improvements that I can make. Some of those improvements may be paying attention to how straight my neck is and making sure my glasses are pushed up far enough that I’m not constantly trying to look over them rather than through them.

Early on in the perio assessment I could tell that my patient was a little anxious and that their gums were a bit sensitive. My patient jumped a little bit when I first started probing, so I stopped and let her know that if she is in a lot of pain that I could offer her some oraqix, and I explained what exactly that is. I also feel like you can tell how your patient is doing based on what they do with their hands and if they’re squeezing them together resulting in them appearing anxious or uneasy. I definitely do this when I’m the patient in a dental chair, so it’s something I try to pay attention to.

 

Protocol

            Normally I’m good about introducing both my patient and the faulty to each other, but I did notice that I just introduced my faculty by saying who my patient was and then I did not follow up and say “This is Ms. Grotheer, she’s going to be checking over what we’ve done today.” Looking back at this video though I know I was feeling super rushed and frustrated, because my patient was late and I wanted to make it through the initial check. That being said, I think my brain was a bit scattered and I just wanted the initial check to get going, so I neglected to fully introduce the faculty to my patient.

Considering the fact that my patient was late, I think I did a really good job at managing the appointment and timing things well enough to get through the initial check. Ideally I would have liked to get through the restorative exam, but I did a CMRS and still made it through the RDH check with my patient being over an hour and a half late, so I think I did pretty well.

 

Attitude

Going into this appointment I was feeling very overwhelmed with how much I wanted to get done and how little time I now had. Although I was feeling this way, I don’t think I gave off a negative vibe towards my patient. I played it cool and was kind, but still made note to my patient that I really needed her to be on time for her next appointment. She didn’t show up for her following appointment though, so I suppose my words were not very effective. I think my tone of voice had maybe been too lighthearted, because I was trying so hard not to sound annoyed with the situation. Overall, I do think I was very professional and kind. I think that having a good attitude towards my patients is never something I struggle with, despite how I may be really feeling on the inside.

 

Language Usage

This particular patient was around my age, and I find that it can be a bit easier to communicate with patients who are not much older or younger than me because it is easy for me to relate to them. I spoke very clearly and appropriately to this patient, but did so in a way that was relatable and positive. I thought in the moment that we both had a mutual understanding of how her lateness impacts a teaching clinic, but since she did not show for her following appointment I think I may have needed to be more stern and straight up with her. I would have done so by sitting down with her and telling her exactly why it’s so important to have patients arrive on time, then I would have asked her how I can help her arrive to her next appointment without any issues. I think that the way I addressed the topic may have been too passive or lighthearted.

 

Dialogue

            I explained each step of the assessment process to my patient clearly and since she had been screened the week prior, I think she had a better understanding of how things were going to be conducted. I think that when it comes to motivational interviewing I need to slow down and be more methodical about how I approach topics, but like I said earlier, I was feeling flustered this day, and I think I was just a bit off of my game compared to how I usually am with patients. With that though, we did pause and discuss her dental anxiety and how her dentist would previously help her out with calming those nerves, which lead to me talking to my faculty about her previous experiences with local anesthesia. This also lead to me explaining to my patient that we would likely only be doing one quadrant of scaling per appointment, which means fewer injections than she may have been thinking she would receive.

This particular patient had her tongue pierced, which opened the door for a great motivational interviewing opportunity. I did address the tongue piercing and ask some questions about when she got it, and then I did inform her that having a tongue piercing could cause damage to tissues and even sometimes cause teeth to break. I think I should have started off by asking when she got it and then follow up by asking if it was a plastic or glass ring, because I think that would have been a better segway into the possible negative effects tongue rings can have on your tissues and dentition. There is certainly room for improvement with my MI technique, but I’m glad I’m aware of that and know that I just need to slow down and think about how I want to approach things and still make sure that my patient is comfortable and receptive.

 

Periodontal Assessment Communication

            Prior to doing the perio assessment my patient and I had discussed what calculus is during her screening appointment and we reviewed it a bit at this appointment. This led me to explaining how calculus can affect probing measurements. I let her know what a healthy sulcus depth is and how that can turn into a pocket depth, i.e. a depth of 4mm or greater, and why it’s important to make note of those depths and work towards healing of that tissue. Although my patient had heavy sub-gingival calculus, she had no pockets and her bleeding was very minimal. I explained to her that this is good, but since there is still a lot of calculus we want to be sure to remove that so she doesn’t develop any pockets. I let her know that it’s important to avoid bacteria and calculus getting deep down into her gum tissue because that can start to affect the health of her bone, which may lead to more drastic oral health issues. I do think I could have explained the gingival conditions worksheet to my patient more than I did, so going forward that is something I want to improve on. I think making that improvement will open up more conversation about ones oral health, which gives me more of an opportunity for patient education.

 

Listening Skills

For this particular appointment I think I could have done a much better job with paraphrasing what my patient is telling me. I asked lots of questions to gain more information from my patient, but paraphrasing what she says back to me isn’t something that I have mastered. For instance, I asked more about her dental anxiety and let her know that I would talk to my faculty about her uneasiness towards receiving local anesthesia injections. I then let her know what my faculty said, but as far as paraphrasing what my patient is telling me directly, I think I have room for improvement. I think this is a life skill that I want to work on in general, because I want my patients, friends, family and acquaintances to feel heard and understood by me. I definitely ask questions and try to get more information from my patient though, so in that regard I think I’m doing well. Additionally, I think that when I don’t feel quite as rushed as I did during this appointment I do a better job at incorporating a bit of paraphrasing into the appointment. Regardless, this is something I want to work on.

 

Strengths

One of my strengths would be that I’m able to adapt to my patients and find ways to relate to them and be personable. I try to always make sure that they feel comfortable not only during the physical treatment, but also in the sense that they are comfortable with talking with me and giving me some insight on their true oral health routine. Also, it’s not shown in this video, but I took a CMRS and did so pretty quickly and with only two retakes, which I’m proud of. I think my time management skills are pretty good when I’m on the clinic floor, especially considering my patient was late and I at least made it to the initial check with an RDH. Furthermore, I think I did a great job at putting my best face forward despite the fact that I was certainly frustrated going into this appointment.

 

Final Section

As mentioned earlier, I want to improve things such as the posture of my neck, being sure that I introduce faculty adequately, making sure that my patient and I have an understanding and respect towards each others time, slowing down and having a methodical approach towards motivational interviewing opportunities, explaining what I chart on the gingival conditions worksheet, and finally, incorporating more paraphrasing into appointments so that my patients feel heard and understood. These are all things that I will do by having them on my mind during future appointments and by recognizing opportunities for more patient education. When those patient ed opportunites arise I want to slow down and approach them in a way that involves me checking in for understanding with my patient by paraphrasing and asking more questions. These are all things that I feel confident in being able to improve on relatively quickly, so I look forward to noticing myself becoming a better student hygienist.

 

Competency

Communication as a dental hygienist is important not only with patients but also with colleagues and other health professionals. We need to be able to respectfully and effectively communicate with others. My clinic experiences have required me to be able to communicate and deliver treatment plans and patient education to patients of all different ages and backgrounds. Clinic has also required me to be able to communicate with my faculty members and think critically about what I needed to prioritize that day. The communication video assignment allowed me to watch just how well I communicate with patients and also  notice my nonverbal communication skills that otherwise may go unnoticed throughout my day to day. That assignment was very eyeopening because it showed me how I can improve my communication skills.