Communication in Pharmacy Practice: An Overview

COMMUNICATIONS CENTRE NATIONAL CONTINUING EDUCATION PROGRAM JUNE 2006C E N T R E C EObjectivesAfter reading this lessonpharmacists will be able to:1. Describe different learning stylesand how this may influencepatient teaching.2. Describe elements of verbal andnon-verbal communication.3. Identify barriers in your practicethat influence communication.4. Explain the importance of empathyin patient communication.5. Evaluate their communication style.Instructions1. After carefully reading this lesson,study each question and select theone answer you believe to be correct.Circle the appropriate letteron the attached reply card.2. To pass this lesson, a grade of70% (14 out of 20) is required. Ifyou pass, your CEU(s) will berecorded with the relevant provincialauthority(ies). (Note: someprovinces require individual pharmaciststo notify them.)Answering optionsA. For immediate results, answer onlineat www.pharmacygateway.ca.B. Mail or fax the printed answercard to (416) 764-3937. Your replycard will be marked and you willbe advised of your results withinsix to eight weeks in a letter fromRogers Publishing.Disclosure: The author, expert reviewers andPharmacy Practice magazine have each declaredthat there is no real or potential conflict ofinterest with the sponsor of this lesson.Communication inPharmacy Practice:An OverviewBy Nora MacLeod-Glover, BSc PhmProgram OverviewEffective patient communication is centralto being able to provide pharmaceuticalcare: identifying patient issues and needs,developing and communicating solutionsand ensuring patient agreement andunderstanding are essential skills for pharmaciststoday. Effective communicationskills are necessary for practitioners toreceive accurate and comprehensive informationfrom the patient as well as successfullyeducate the patient. Additionally,strong communications skills will enable apharmacist to:• Establish the necessary rapport to buildinga trusting relationship; and• Ensure an effective exchange of informationnecessary for the pharmacist toappreciate patient needs and for thepatient to understand and accept pharmacistrecommendations.The purpose of this lesson is to providepharmacists with the fundamentals of communicatingeffectively so that they can ultimatelyprovide better patient care. Some ofthe more tangible benefits patients experiencewhen pharmacists use effective communicationstrategies: 1• Improved adherence with medication use• Increased satisfaction with their relationshipwith the pharmacistApproved for 1 CE unit by the Canadian Council on Continuing Education in Pharmacy.File # 336-1105. Lesson expires November 30, 2008.• Greater likelihood that patients will askfor help when it is needed, resulting infewer unaddressed side effects andadverse effects.• Improve patient trust in pharmacistadvice and education.Background/IntroductionCommunicating–knowing versus doingKnowing how to communicate and beingan effective communicator are different. Itis important to understand how to communicatein order to be an effective communicator.This lesson will provide informationabout communication theory along withhow and why it is important. Just as weneed to understand the rules of golf or tennisbefore we can play, so must we appreciatethe elements of communication. Andlike learning to play tennis or golf, being aneffective communicator takes practice andrequires a deliberate effort to manage ourinteractions with others.A skill we can all learnWe can all learn how to become more successfulcommunicators. In this lesson youwill encounter reflective exercises to enableyou to think about how you can apply theinformation to increase your effectivenessas a communicator.1 CEU

2 Communication in Pharmacy Practice: An OverviewCOMMUNICATIONS CENTRE CE • JUNE 2006How we communicateCommunication involves several activities.We communicate verbally (throughwords), visually (through the use of picturesor printed materials), kinesthetically(through body language), interpersonally(through social interaction) and intrapersonally(within our self). The structure ofcommunication can be described as a systemmade up of several elements. Theintended message is put into words by thesender, who transmits it (through speechor writing) to the receiver, who must thendecode the message to understand theintended message. Along the way, thereare several opportunities for communicationto fail, and so the pharmacist’s taskis two-fold. When communicating withpatients and other health-care providers,pharmacists can manage how they conveythe intended message through verbaland non-verbal communication. There is aneed to also be aware of the verbal andnon-verbal responses of the receiver ofour communication so that the pharmacistcan identify when confusion or misunderstandinghas occurred and take steps toclarify. 2Communication StylesUnderstanding ourselvesas communicatorsBeing self-aware is essential for effectivecommunication. Appreciating the breadthof styles both for how we learn and howwe interact with the world is necessary tobe able to tailor our care to best meetpatient needs. Kolb’s Learning StylesInventory (LSI) and Myers-Briggs TypeIndicator are two tests that can help usappreciate our strengths in how we learnand how we interact with the world. Onceyou understand and appreciate how yourespond to others naturally, you can learnto become intentional in managing yourinteractions with others. 3Reflective Exercise:Which learning style most closely appliesto you? How would you tailor the way youteach others about their medications orhealth conditions when their learningpreferences may be different from yourown?TABLE 1Kolb’s Learning Styles InventoryKolb’s theory of learning styles discusses preferences for how individuals learn. Understanding thedifferent learning styles can help the pharmacist be more effective in how he or she approachesthe aspect of patient education. Because the tendency is to teach from one’s preferred style, it ishelpful to know what that style is so that one can consciously incorporate other teachingapproaches when educating patients about their medications and their health. Free on-lineresources for Kolb’s Learning Styles inventory are not readily available; the test and workbook areavailable for a fee from http://www.learningfromexperience.com/assessment-tools/#LSI. Kolb’s 4learning styles are presented below along with characteristics that influence our learning style. 4,5Divergers• Prefer doing and experiencing.• Tend to focus on generating ideas or solutions.• Value harmony, listening with an open mindAssimilators• Prefer observing and reflection.• Tend to focus on ideas and concepts over individual needs; require time to reflect beforeresponding to questions or situations.• Value logic and have strong organizational skills.Convergers• Prefer to begin by understanding reasons and concepts.• Tend to focus on finding practical solutions; can be unemotional.• Value quick decision-making and leadership.Accommodators• Prefer to “dive in” and try things out for themselves.• Tend to focus on efficient use of time and energy; enjoy finding useful, convenient solutions.• Value a direct approach when dealing with people and situations.Pharmacists need to be flexible in their teaching to accommodate the various learning stylesof their patients. For example, when teaching a patient how to use an inhaler for the firsttime, the pharmacist will likely demonstrate how to use it and offer an explanation of whyeach step is important. A diverger will likely be eager to try it out which will offer the pharmacistan opportunity to assess technique and offer corrective feedback. An assimilator maybe reluctant to try it himself/herself in front of the pharmacist as they may wish to have timeto reflect on the process. A converger may need more information about the why and how ofthe device. An accommodator may not listen to the pharmacist as they will be eager to learnfor themselves through experience how it works.Reflective Exercise:Which of the personality traits in each pairof preferences most closely applies to you?How would you communicate with apatient who may have a different preferencethan you for how they gather data ormake a decision?Adjusting our communicationsstyle to fit patient needsDespite inherent preferences for learning orinteracting with others, to provide patientfocusedhealth-care, effort is needed toadapt messages and responses to enablepatients to understand and accept theinformation provided. Learning styles andType preferences are not inflexible.Depending on the situation, an individualmay engage in non-preferred learningactivities (a converger may attend expertlectures, or an assimilator may participatein a hands-on activity) or use either Myers-Briggs preference (an introverted individualmay learn to behave in a more extrovertedmanner when interacting with patients).This flexibility means that as pharmacistsgain comfort and confidence with howthey like to learn or teach and who theyGET YOUR CE RESULTS INSTANTLY! Online answering and accreditation now available at www.pharmacygateway.ca

4 Communication in Pharmacy Practice: An OverviewCOMMUNICATIONS CENTRE CE • JUNE 2006way. Open-ended questions are ones thatcannot be answered “yes” or “no.” Anexample of an open-ended question mightbe: “Describe how you have been takingyour medication?” compared to one that isclosed-ended: “Have you been taking onetablet twice daily?” Further into the conversation,closed-ended questions may beappropriate to gain more precise information.For example: “Do you have difficultyswallowing the tablet?”Active participation by patients, throughthe use of effective questioning, can influencepatient satisfaction and their decisionsregarding treatment adherence. 8 Whilemost patient counselling sessions are similarin structure, it is important that thepharmacist be flexible and adjust theircounselling routine depending on theresponses given by the patient. 9A few tips:• The rate of questioning is important.If the pharmacist moves through thequestions or instructions too quickly, thepatient may become confused, tune-outor misunderstand what is asked. This canresult in inaccurate information beinggathered or inappropriate use of medicationonce the patient returns home.• Never make the mistake of asking morethan one question at a time. Allowpatients to respond to each question attheir own pace.Active listeningEffective communication is built on activelistening. Active listening is a form of therapeuticlistening which focuses fully onthe patient in order to accurately see theworld as they see it. Active listening ishard work. It takes effort. 1 The act of listeningimplies providing conscious, completeand undivided attention to thepatient. It requires that you not be distracted,interrupted or hurried. Active listeningalso requires participation by thepharmacist: it is necessary to respond tothe patient in a manner that demonstratesthat you have both heard and understoodwhat they have said.Active listening responses help thepatient feel heard and understood;responses can also serve to clarify the accuracyof understanding. There are threetypes of active listening responses: 3• A restatement response repeats thewords of the patient as you have heardthem. Best used early in the patientinteraction, restating phrases reassuresthe patient that you are listening and willencourage them to continue.• A reflective response verbalizes both thecontent and the feelings of the patient.This shows the pharmacist is hearing boththe words and the emotions behind them.These responses often begin with phrasessuch as “It sounds like you…”, or “Youseem to be feeling…”• A clarifying response verbalizes bothcontent and feelings and also summarizesor simplifies the patient’s statementsinto clear, concise statements. Thistype of response may begin with aphrase such as: “As I understand it,you…” These statements also invite thepatient to correct or re-frame yourunderstanding if necessary.Managing personal spaceWhen a pharmacist is providing care to apatient, it is important that the physicaldistance between the pharmacist andpatient reflect the degree of immediacy.The distance needs to create some privacy(standing too far from a patient may allowothers to overhear) while at the same timenot making the patient uncomfortable.The more intimate the content of the conversation,the closer a pharmacist willwant to stand or sit to a patient. A goodrule of thumb is to stand an arm’s lengthaway from the patient. Patients will providenon-verbal cues if the pharmacist istoo close. They may appear to fidget oreven step backward to create their desiredspace.Body languageMost of what we communicate happensthrough our body language. 1 For communicationto be perceived as genuine or sincerethere needs to be congruency between ourwords and our body language. For thepharmacist, being sensitive to body languageduring patient communicationmeans being able to manage their ownbody language and at the same time belooking for and responding to body languagecues from the patient.There are a number of ways a pharmacistcan use body language to increase theeffectiveness of their communication anddisplay interest and concern. Establishingeye contact while talking to patients, leaningtoward them and having a relaxed postureall help to put the patient at ease.Pharmacists may want to come out frombehind the counter or remove any physicalbarriers, such as a desk, to create a morepersonal space with the patient. A relaxedposture includes uncrossing arms andremoving hands from pockets, facing thepatient directly with feet facing forward.Head nods and smiling are all ways pharmacistscan encourage patients to listenand respond to what we are saying.Patients tell us a lot about what theyare thinking and feeling through theirbody language. Whether they make eyecontact or the intensity of their eye contactcan help the pharmacist gauge thepatient’s understanding or emotionalresponse. Facial expressions in general canconvey emotions such as worry, confusion,sadness or excitement simplythrough movements in eyebrows, smilesor frowns, or angle of the head. Body languagehas cultural implications. Somebody movements mean one thing in oneculture, and may convey a totally differentmessage in another culture. When a pharmacistuses body language to identify apatient’s feelings or understanding, theyneed to use words to clarify whether theirassumptions are correct.Reflective Exercise:After interacting with a patient, considerthe following checklist to determine howwell you applied verbal and non-verbalcommunication elements.❏ I gathered information and provided carein a logical and organized manner.❏ I used a variety of open-ended and closedendedquestions.❏ My questioning pace provided the patientsufficient time to respond.❏ I spoke clearly using words that would beunderstood.❏ My tone conveyed both respect and concernfor the patient.❏ My volume of speech was loud enoughGET YOUR CE RESULTS INSTANTLY! Online answering and accreditation now available at www.pharmacygateway.ca

COMMUNICATIONS CENTRE CE • JUNE 2006Communication in Pharmacy Practice: An Overview5for the patient to hear while respectingthe patient’s privacy.❏ I actively listened while the patient respondedto questions or provided information.❏ My tone and body language were congruentwith the words I used.EmpathyEmpathy is the process of communicatingto patients the feeling of being understood;it is putting yourself in the patient’ssituation. 10 It requires that the pharmacistidentify the affective experience of thepatient. 1 Demonstrating an understandingof the patient’s feelings establishes the necessaryrapport for creating a caring, trustingrelationship with the patient. 11 Empathycan be learned, although using empatheticresponses may feel awkward at first.Learning to be empathic requires that thepharmacist place importance on developinga caring therapeutic relationship withthe patient. 11We demonstrate empathy by how werespond to patients, both verbally and nonverbally.It is not necessary to have experiencedthe patient’s incident to display empathy.Empathy takes courage (particularlywhen the experience is sad, such as the lossof a spouse) because it means the pharmacistmust be open to and able to acknowledgethe feelings experienced by thepatient. In this regard, empathy is differentfrom sympathy in that when we are sympatheticwe “feel” the patient’s emotions.Pharmacists display empathy nonverballyby reflecting the patient’s facialexpressions or body language. Demonstratingempathy through a verbal responsemeans choosing words that don’t judge,give advice, quiz or placate. Rather thesewords should demonstrate understandingand acceptance of ‘what is’ for the patient.Giving patients a safe environment inwhich to express themselves will give thema sense of control of their lives and empowerthem to take greater responsibility forparticipating in solutions for managingtheir health.Reflective Exercise:Empathy can be in response to others’ joyor happiness as well. Think about a timewhen someone you cared about sharedsome excellent news. Did your face light upas you shared their joy? Did your wordsconvey your excitement and offer encouragementand congratulations?Communication BarriersPharmacists are confronted by many barrierswhen trying to make effective communicationa part of their daily activities.Identifying these barriers is the first step toovercoming them. The most commonlyencountered barriers are those related tothe pharmacist’s environment, themselvesand their patients. Once barriers are identified,the pharmacist will be better able tocreate and implement solutions to overcomethem.11, 12Environmental barriers may includeaccessibility to the pharmacist, lack of aquiet, private space in which to speak withpatients, or lack of time to engage inmeaningful discussion with patients. Oneway for the pharmacist to identify environmentalbarriers is to place him- or herself inthe patient’s shoes. Suggestions to overcomeenvironmental barriers affectingcommunication include:• Reduce the number of products for salenear the counselling area to reduce thenumber of customers nearby andincrease the sense of privacy for patientswho are being counselled.• Place a computer terminal near thepatient counselling area to reduce walkingand increase access to needed information.• Reduce the number of items on thecounter where you will be engaged in apatient interview to reduce the distractionsand create a professional atmosphere.• Use support staff, such as techniciansand assistants effectively to free-up timeto speak with patients.Reflective Exercise:Stand in various areas near the dispensaryto see whether the pharmacy staff is visible.Are you able to tell the difference betweenstaff members who are pharmacists andthose who are not pharmacists? Listen tothe volume of noise to see whether it is tooloud for easy hearing or too quiet with noprovision for privacy.Patient barriers preventing effectivecommunication may include lack of awarenessof or respect for the pharmacist’s role,difficulty in speaking English, or feelinguncomfortable asking questions abouttheir medication or health issue. In addition,many patients are anxious about theirhealth and do not concentrate on whatthey are being told. As a result, they mayforget at least a part of what the pharmacistsaid to them. Suggestions to overcomepatient barriers to communication include:• Supplement patient counselling withprint materials to increase patient understandingof the information.• Maintain eye contact with the patientwhen you are speaking. This will helpkeep them engaged with you during theconversation. The pharmacist will also beable to watch for non-verbal cues thatindicate lack of understanding or concernon the patient’s part.• Encourage patients to ask questions andtake time to respond to questions in athoughtful manner.Personal barriers influencing a pharmacist’sability to communicate effectivelyinclude lack of confidence in their leadershipor advisory role (and the very nature ofeliciting personal, potentially sensitive,information from the patient), lack ofknowledge (about the drugs or the patienthistory), inability to respond to patient cues(either verbal or non-verbal), shyness, orlack of awareness of cultural differencesthat hinder patient response to pharmacycare. Suggestions to overcome personalbarriers to communication include:• Ensure you are easily identifiable to thepatient as the pharmacist.• Wear clothing that is reflective of yourhealth-care professional status toincrease patient respect for your role inhealth care.• Develop an effective patient interviewstyle to ensure you gather all necessaryinformation about a patient before providingcare.• Ensure that your non-verbal communicationcommunicates the desire to spendtime focusing on the patient’s issues.Reflective Exercise:What barriers exist in your environment,GET YOUR CE RESULTS INSTANTLY! Online answering and accreditation now available at www.pharmacygateway.ca

6 Communication in Pharmacy Practice: An OverviewCOMMUNICATIONS CENTRE CE • JUNE 2006within yourself or within your patients thatmay prevent you from communicating aseffectively as you would like?Building ConfidenceAs with any new skill, it takes time andpractice to become comfortable and proficient.Taking time to reflect after a positiveinteraction about what went well and whatcontributed to the success of the communicationcan help the pharmacist identifystrengths that can be developed further.Likewise, reflecting after less positiveinteractions about what did not go welland how communication might be moreeffective in the future can be a powerfuldevelopmental exercise.Learning to change existing patterns ofbehaviour is difficult—it may feel awkwardor forced. Practice is necessary beforechanges become a natural part of how wecommunicate with our patients. A pharmacistmay want to practice new skills withincomfortable relationships, such as withfamily or friends, before applying them totheir patients. However, with time andeffort, change is possible and well worth itgiven the importance of establishing strongtherapeutic relationships with patients andtheir caregivers.11. Tindall, W., R. Beardsley, and C. Kimberlin.Communication Skills in Pharmacy Practice. 4th ed, ed. D. Troy.2003: Lippincott Williams & Wilkins. 203.12. Rantucci, M. Pharmacists talking with patients: A guideto patient counselling. 1st ed. 1997:Williams & Wilkins.References1. Berger, B. Communication Skills for Pharmacists: BuildingRelationships, Improving Care. 1st ed. 2002, Washington:American Pharmaceutical Association. 166.2. Quintrell, N. Communication Skills: A Handbook forPharmacists. 1st ed. 1994: Pharmaceutical Society of Australia. 95.3. Davis, C. Patient Practitioner Interaction: An ExperientialManual for Developing the Art of Health Care. Third ed. 1998:SLACK Incorporated. 305.4. Kolb, D. Experiential Learning: Experience as The Sourceof Learning and Development. 235 ed. 1976, New Jersey:Prentice-Hall, Inc.5. Kolb, D. (2005) David A. Kolb on experiential learning.www.infed.org/biblio/b-explrn.htm.6. Lowenthal,W. Myers-Briggs Type Inventory Preferences ofPharmacy Students and Practitioners. Evaluation & the HealthProfessions, 1994. 17(1):22-42.7. Meldrum, H. Interpersonal Communication in PharmaceuticalCare. 1st ed. 1994: Pharmaceutical Products Press. 154.8. Skoglund, P., D. Isacson, and K. Kjellgre. Analgesic medication–communicationat pharmacies. Patient Education andCounselling, 2003. 51:155-61.9. Dyck, A., M. Deschamps, and J. Taylor. Pharmacists’ discussionsof medication side effects: A descriptive study. PatientEducation and Counselling, 2005. 56:21-7.10. Cipolle, R., L. Strand, and P. Morley. Pharmaceutical CareProcess: The Clinician’s Guide. 2 ed, ed. C.N. Michael Brown.2004: The McGraw-Hill Companies, Inc. 394.GET YOUR CE RESULTS INSTANTLY! Online answering and accreditation now available at www.pharmacygateway.ca

COMMUNICATIONS CENTRE CE • JUNE 2006QuestionsCommunication in Pharmacy Practice: An Overview71. One reason a pharmacist may wantto work to improve communicationskills is to:a) Increase the number of prescriptionsfilled.b) Improve patient adherence with medications.c) Improve the patient-physician relationship.d) Increase personal job satisfaction.2. It is important to understand ourown learning style so that we can:a) Tailor the way we educate patients tobest meet their needs.b) Ensure that we provide comprehensivecare to patients.c) Persuade patients to follow advicegiven.d) Encourage patients to learn in the sameway that we do.3. Which statement is TRUE aboutMyers-Briggs Type Inventory personalitytraits?a) Introverts are too shy to provide effectivepatient care.b) People with judging preferences arecritical of others.c) Knowing your Type means you can fixyour weaknesses.d) Preferences are flexible and behaviourcan be modified.4. Keeping the five ‘Ss’ of communicationin mind when counsellingpatients will help to:a) Provide structure to the counselling session.b) Ensure counselling information is completeand accurate.c) Increase patient understanding of theinformation provided.d) Provide opportunities for the patient toask questions.5. Which question is open-ended?a) Do you take your medication withbreakfast or dinner?b) What did your doctor tell you about thismedication?c) Do you have difficulty remembering totake your medication?d) Have you been taking your medicationwith meals?6. Which statement is an active listeningresponse?a) Don’t worry, we can find another medicationfor you to try.b) I’m sure your doctor thought the medicationwould be right for you.c) This medication works well for mostindividuals.d) I guess you’re pretty frustrated that themedication didn’t work.7. The best approach to managing personalspace when interacting withpatients is to:a) Stand away from the patient and letthem choose how close they want to beto you.b) Stay behind the counter and leantoward the patient to show howinterested you are in them.c) Remove physical barriers between youand the patient and watch for cues thatyou are too close.d) Ensure the counselling area in thepharmacy is large.8. Most communication occursthrough:a) The words we choose.b) The pamphlets we provide.c) The body language we use.d) The actions we take.9. Which statement about body languageis TRUE?a) Standing with arms crossed makes youlook authoritative.b) Making eye contact helps patients knowyou are listening to them.c) Moving and speaking quickly will conveyhow busy you are.d) Avoiding eye contact will help you put apatient at ease.10. One of the problems with readingpatients’ body language is that:a) It is not fair to try to guess what thepatient is feeling.b) It is culturally sensitive and may be misinterpreted.c) Patients usually try to hide their truefeelings.d) Not all patients use body language tocommunicate.11. Which statement is TRUE about apharmacist’s verbal and non-verbalcommunication?a) It is important that they communicatethe same message.b) It is not possible to control non-verbalcommunication.c) Our focus should be on accurate verbalcommunication.d) Non-verbal communication is too unreliableto be useful.12. Which statement best describesempathy?a) Empathy is about listening to patientscomplain about their health problems.b) Empathy is about being sympatheticwhen things go wrong for a patient.c) Empathy is about agreeing with apatient when they express their feelings.d) Empathy is about being open to,accepting and acknowledging feelings.13. Which statement is TRUE aboutcommunication barriers?a) Using a counselling area will preventthem.b) We can’t change them so we have toaccept them.c) If we ignore them they usually go awayon their own.d) We need to identify them before wecan change them.14. One way to identify environmentalcommunication barriers is to:a) Draw a picture of the pharmacy floorplan.b) Ask staff for feedback from patients.c) Stand where the patient stands andobserve.d) Ask patients if they can find you easily.15. Environmental communicationbarriers include:a) Having products for sale in your patientcounselling area.b) Poor lighting and lack of seating in theGET YOUR CE RESULTS INSTANTLY! Online answering and accreditation now available at www.pharmacygateway.ca

8 Communication in Pharmacy Practice: An OverviewCOMMUNICATIONS CENTRE CE • JUNE 2006Questions continued…counselling area.c) Patients who don’t wish to use your privatecounselling room.d) Ineffective temperature control in thepharmacy.16. Which statement is TRUE aboutpatient-related communicationbarriers?a) It is not possible to overcome beliefsthat patients have about pharmacistsand pharmacy care.b) It is the pharmacist’s responsibility tofind ways to ensure patients have theinformation they need.c) Patients will always ask questions if theyhave not understood what the pharmacisthas said.d) Speaking clearly and slowly will ensurethe patient will understand what we tellthem.17. Which statement about activelistening is FALSE?a) Active listening requires participation bythe pharmacist.b) Active listening implies providing conscious,complete and undivided attentionto the patient.c) Active listening skills help to ensure thepatient feels heard and understood.d) It is important to remain quiet whenengaged in active listening.Case # 1: A teary-eyed, middle-agedwoman enters your pharmacy and is shakyas she fumbles through her purse for theprescription. She provides you with a prescriptionfor a 78-year-old man whom youhave on file. The prescription is for morphinelong-acting oral tablets (100 mg) andmorphine instant-release tablets (10 mg).She says she will wait for the prescriptionas the patient needs it right away.18. What is this customer’s bodylanguage telling you?a) She is impatient.b) She is angry.c) She is worried.d) She is annoyed.19. How could the pharmacist communicateconcern for this patient?a) Fill the prescription quickly to get herhome fast.b) Provide written material to avoid theneed to counsel.c) Use a soft, calm tone to help her relax.d) Avoid asking questions in case she cries.Case #2: A 50-year-old man who is a regularpatient of yours comes to your pharmacycounter with a new prescription. Hisshoulders appear tense and his eyebrowsare knit tightly. He says to you, “I can’tbelieve I have to fill another prescriptiontoday, I was just in three weeks ago andspent $100 dollars on some fancy newmedication that didn’t do a darn thing!”20. What might be an appropriateactive listening response to thispatient?a) It must be very frustrating to have to trysomething new.b) It’s too bad we can’t take a prescriptionback for a refund.c) I can provide you with a smaller quantitythis time.d) Your doctor is trying to find the bestmedication for you.FACULTYCommunication in Pharmacy Practice: An OverviewAbout the authorNora MacLeod-Glover has developed andfacilitated pharmacy education programsand is currently the Interim Executive Directorfor the Canadian Council on ContinuingEducation in Pharmacy. As ProfessionalDevelopment Advisor for the ContinuingCompetency Department for the OntarioCollege of Pharmacists, Nora supports theremediation efforts of pharmacists who havepractice weaknesses identified when theyare randomly selected to participate in thePractice Review. Her work includes supportingthe development of skills related to knowledgemanagement, patient interviewing andcommunication. Nora is currently enrolled inUniversity of Toronto PharmD program.ReviewersAll lessons are reviewed by pharmacists foraccuracy, currency and relevance to currentpharmacy practice.CE CoordinatorHeather Howie, Toronto, Ont.Missed something?Previous Novopharm CE lessons are availableat www.pharmacygateway.ca andwww.novopharm.com.For information about CE marking, pleasecontact Mayra Ramos at (416) 764-3879,fax (416) 764-3937 or mayra.ramos@rci.rogers.com. All other inquiries aboutCE Compliance Centre should be directedto Karen Welds at (416) 764-3922 orkaren.welds@pharmacygroup.rogers.com.This CE lesson is published by RogersPublishing Limited, One Mount Pleasant Rd.,Toronto, Ont. M4Y 2Y5. Tel.: (416) 764-3916Fax: (416) 764-3931. No part of this CElesson may be reproduced, in whole or inpart, without the written permission of thepublisher.GET YOUR CE RESULTS INSTANTLY! Online answering and accreditation now available at www.pharmacygateway.ca

TO ANSWER THIS CE LESSON ONLINEIf currently logged into our ONLINE CE PROGRAM, please return to the "Lessons Available Online"Page and click on "Link to questions" for this CE Lesson.If not logged in but already registered to our ONLINE CE PROGRAM, please click here:http://ce.pharmacygateway.com/Pharmacy/login/index.aspIf you have not registered for our ONLINE CE PROGRAM and wish to answer online, please clickhere:http://ce.pharmacygateway.com/Pharmacy/login/adduser.aspIf you have any questions. Please contact:Pharmacy Practice, Pharmacy Post, Novopharm CE Compliance Centre, More CCCEP-approved CE’s, or TechTalk (English and French CE's)Mayra RamosFax: (416) 764-3937 oremail: mayra.ramos@rci.rogers.comQuebec Pharmacie and L'actualite PharmaceutiqueStephane ParadisFax: (514) 843-2183email: stephane.paradis@rci.rogers.com