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Reflect on the development of your communication and professionalism abilities across this module
(2,200 words). Create an Action Plan to identify four action plan goals to continue to develop your
communication and professionalism skills ready for your first clinical placement (300 words).
Essay Word Count: ***
Action Plan word count: ***
Total: ***
Student ID: ******
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Reflect on the development of your communication and professionalism abilities across this module
(2,200 words). Create an Action Plan to identify four action plan goals to continue to develop your
communication and professionalism skills ready for your first clinical placement (300 words).
Communication plays an important and vital role in successful health care provision. Upheld as one
of 6 Cs (Introducing the 6 Cs 2015) and a foundation of the NHS constitution, good communication
enables health care staff and service users to form trusting relationships to enable the best possible
health outcomes. The Nursing and Midwifery Council (NMC) pre-registration standards require all
nurses and midwives to use effective and ethical communication in order to ‘ensure people receive
all the information they need in a language and manner that allows them to make informed choices
and share decision making (Nursing and Midwifery Council England 2010)’. Demonstrating an
understanding of need for compassion, active listening, positive body language, team working, and
courage to communicate effectively is fundamental to forming a culture of best working practice and
people centred care. This reflective essay discusses the theory and significance behind paralanguage
and teamwork in healthcare and the importance of reflective practice to improve the quality of care
to service users.
Reflective practice is a fundamental skill within midwifery. The primary themes of the NMC Code are
to prioritise people, practice effectively, preserve safety and promote professionalism and trust in
order to provide public protection (Read The Code Online XXXXXXXXXXIn order to practice effectively
within their level of competency, all midwives must revalidate every three years. One of the
equirements to meet revalidation is providing a minimum of five reflective accounts within the
three year period. A research project lead by Linda Sweet et al. studying the importance of reflection
to enhance the learning for midwifery students found:
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‘Reflective practice is an essential component of one’s personal and professional
development as a midwife and learning to undertake critical reflection on practice is
considered the cornerstone of being an accountable and autonomous practitioner.’
(Sweet et al. 2019)
Reflection allows individuals to examine the actions, feelings and reactions to experiences by
themselves and others within a practice situation to identify opportunities to change their approach
and respond more effectively in the future. Reflective models provide a starting point and
framework for reflection; allowing the individual to focus on the process of self-awareness and
learning. It can be argued that reflective models can be restrictive due to the continuous process of
eflection and it may not always be possible to follow the structured steps, however, the study
conducted by Sweet et al XXXXXXXXXXconcluded that using a structured model of reflection improved
eflective writing components including self-awareness, critical reflection and evidence informed
practice.
I have undertaken a reflection of the development of my own communication skills using Driscoll’s
model of reflection XXXXXXXXXXwhich begins by asking what?; identifying my communication strengths
and weaknesses. So what?; what implications may these strengths and weaknesses have on my
progression in placement and training, the importance of addressing these to become a competent
healthcare practitioner and the implications of what may happen if I don’t develop these skills. Now
what?; how can future outcomes be modified, identify opportunities in my action plan to develop
these skills.
At the beginning of the course I undertook a SWOT analysis in order to establish my strengths,
weaknesses, opportunities and threats throughout training and placement. I have identified one of
my strengths as excellent communication skills however I lack in confidence within a team. I also
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undertook the Belbin questionnaire to learn more about my role within a team. As the ‘plant’ my
skills help to em
ace lateral thinking; forming new ideas and challenging the norm, however, plants
may also struggle to evaluate their ideas (Belbin 2019).
Driscoll challenges us to ask So What? What effect might my lack of confidence have on my
communication skills with both service users and multidisciplinary teams. Confident communication
is fundamental to providing excellent person-centred care, allowing service users to be involved
within the care pathway and make informed decisions which will help to build a therapeutic
elationship with healthcare professionals (Gault et al XXXXXXXXXXLacking in confidence may affect my
non-ve
al communication, particularly my use of paralanguage.
A 2013 review into NHS hospitals complaints systems Putting Patients Back in the Picture found that
a significant proportion of the complaints related to the lack of compassion and communication
within the care they received. The ve
atim comments regarding staff behaviour within the report
included ‘offhand, rude, impatient, callous (Clwyd 2013: 15-19)’. Highlighting the significance of a
compassionate discourse between staff and service user and the importance of this interaction in
ensuring a positive experience. The use of paralanguage; making adaptations to tone, volume, pitch
and rhythm of voice as well as using noises to indicate listening can dramatically improve
compassionate interaction. Hargie XXXXXXXXXXsays ‘how information is delivered paralinguistically has
important consequences for how much of the message is understood, recalled and acted on’.
Therefore, accurate information shared within the interaction is vital, but conveying the message
successfully relies heavily on paralanguage; the words used in the interaction may be polite,
informative and accurate, however, if paralanguage is used ineffectively responses may appear
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upt, curt or uninterested. This skill is significant due to the culture of language within midwifery.
Clinical language has the potential to isolate service users, ensuring they have understood the
information is vital to gain informed consent for them to make an informed decision on their care.
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Good communication does not arise purely from the practitioner, but their ability to listen to and
interpret the responses from service users. Understanding paralanguage allows the practitioner to
‘read between the lines’ and gather information on how the service user is feeling or thinking, for
example the use of “I’m fine”. The interpretation of the words would suggest that the person is well,
however, in the UK it is widely culturally understood that when the words “I‘m fine” are delivered in
a monotone, curt or aggressive manner means that the individual is angry, upset or hurt. Culture can
inform the use of paralanguage:
‘Speakers of British English use loudness only when they are angry, speakers of Indian English
use it to get the floor. So when an Indian speaker is trying to get the floor, the British speaker
thinks s/he is getting angry—and gets angry in response. The result, both agree, is a heated
interchange, but each thinks the other introduced the emotional tone into the conversation.’
(Tannen 1984: 193)
Understanding the presence cultural differences within linguistics allows healthcare professionals to
avoid such situations in Tannen’s research. The norms of culturally informed communication are
described as a pattern of internalised behaviours, hidden to the people that enact them (Roebuck,
2016). Acknowledging and reflecting on personal biases allows healthcare professionals to
understand and appreciate the individual backgrounds, cultures and experiences of service users
and use this to adapt their communication style effectively. In order to be an effective
communicator with vulnerable service users, it is important to understand cultural difference as well
as your own personal culture (Roebuck XXXXXXXXXXBy understanding bias and the culture that has
informed a communication style encourages an awareness of the potential impact individual cultural
communication has on those who communicate differently. Through working on the concept of
unconscious bias, I am aware that my own personal culture has the potential to influence my
thoughts or opinions on others. Within healthcare settings, there are dominant (staff) and non-
dominant (service users) cultural groups (Hall XXXXXXXXXXIn order to avoid the non-dominant group
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feeling negatively during and after an exchange, the healthcare professional must first acknowledge
any ethnocentrism, anxieties and prejudice and enact cultural sensitivity. If unaddressed, my
unconscious bias and lack of confidence has the potential to appear through paralanguage, which
may negatively impact on my interactions with service users, especially with those who may be
vulnerable due to a cultural difference or communication challenges and with other healthcare
professionals.
It is important to understand individual communication styles, cultures and skills in order to
communicate effectively with vulnerable service and is necessary to engage proactively within mutli-
professional teams. Using the Belbin questionnaire (1969), I found out more about my individual
style of communication and the role I play in teamwork scenarios. Knowing my strengths and
weaknesses within in a team has helped me to address my self-identified weakness of a loss of
confidence within my abilities and knowledge when in a teamwork situation. Identifying what
qualities I can offer a team will help to improve confidence in my role and empower me to seek
support where needed. Within healthcare settings a successful ‘team’ incorporates healthcare
professionals, the service user and their family to provide holistic care. Holistic care is the adaption
and deviation of pathways by combining a range of healthcare professional’s knowledge and
experience with the service user at the centre, playing an active role in their health (Dossey et al.
2005).
The production of Grandma Remember Me (Howard 2019) focused on the effects Dementia has on
families and individuals. Initially, I felt sceptical about the production as dementia has no direct
esonance with maternity services. The average age of primigravida women is 28.6 years and
multigravida 30.3 years (ons.gov.uk XXXXXXXXXXYoung onset dementia affects individuals between 30 and
65 years old, and accounts for 5% of people living with dementia (Young Dementia UK XXXXXXXXXXWhere
it is possible for women accessing maternity services to experience young onset dementia it is a very
are occu
ence. I decided to watch the performance from a holistic service point of view; how
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would I look after the family holistically, using an integrated approach to identify the individual
needs of the service user and their family and consider which other health and social care providers
would I refer the family to in order to improve their experiences and outcomes. It became clear that
the family