The literature describes various types of listening: directed, critical, empathic, reflexive, active, reflective.
Directed, critical listening. With this type of listening, the participant in communication first carries out a critical analysis of the message (often in advance, coming with an attitude towards critical perception of information), i.e. determines how true, reliable or probable the information can be, and only after that he understands whether he agrees with it and whether he wants to perceive and respond. Critical analysis requires an assessment of the quality and correctness of the interlocutor's conclusions, i.e. statements that are based on the study of facts but are not necessarily true. A fact is a verifiable statement, and a conclusion is a conclusion that follows from them. When listening critically, the interlocutor usually:
finds out whether there are significant facts that support the formulated conclusion, whether they are relevant;
evaluates whether the connection between the evidence and the conclusion seems logical;
defines, is there another known information, which reduces the quality of the conclusions.
In practice, such a hearing is useful in a specific situation where decisions are made, new experiences, projects are discussed, points of view are expressed (meeting, meeting or discussion). At the same time, critical listening is ineffective where new information is discussed, new knowledge is communicated (lesson, lecture, report). Setting on the rejection of information does not allow listening to it, requires focusing only on what confirms the undesirability of listening. As a result, everything of value seems to fly by, interest in information falls, time is lost, and dissatisfaction remains.
Empathic Listening. Empathy (from English - sympathy, empathy, the ability to put oneself in the place of another) is the ability of a person to emotionally respond to the experiences and feelings of other people. With empathic listening, the participant in communication pays more attention to “reading” feelings, rather than words, understanding what the interlocutor has to do with what he says. There are three types of empathy: empathic response, acceptance of a different point of view, and sympathetic response.
Empathic Response occurs when a person, using participant observation, experiences emotional reactions similar to the actual or expected manifestations of the emotions of another.
Taking a different point of view- imagining oneself in the place of another, in his role - as if "the ability to walk in other people's shoes."
Sympathetic response- this is a feeling of care, complicity, compassion directed at another person because of his circumstances or situation. The method of sympathetic response differs from the previous two mainly in that the partner does not try to empathize with the other person. Understanding what another person is really experiencing causes grief, concern for this person, pity for him or other feelings in a person.
Rules for Empathic Listening:
1) it is important to free the soul from one's own experiences and problems, to abandon prejudices regarding the interlocutor, to tune in to the perception of his feelings;
2) in your reaction to the partner’s words, it is necessary to accurately reflect his experience, feeling, to demonstrate not only their correct perception, but understanding and acceptance;
3) reflection of the partner's feelings should be carried out without interpreting his actions and hidden motives of behavior that led to specific actions, it is not worth explaining to him your opinion about the reasons for this feeling in him;
4) you need to pause. After your answer, the interlocutor usually needs to be silent, think, understand each other's feelings. Do not rush to additional considerations, explanations.
In empathic listening, as a rule, they do not give advice, do not seek to evaluate the interlocutor, do not moralize, do not criticize, do not teach.
Seeing the world from the point of view of another is a very complex skill, and it is developed in different ways in people, moreover, in some this ability is underdeveloped. Empathic skills allow you to increase the effectiveness of interaction, but they, like concentration, require additional efforts from the participant in the interaction. At the heart of such skills is respect for the interlocutor, which begins with a view of a person not only as an object, but also as a person with his own values. Respect allows you to focus your time and energy on others and not on yourself.
In communication empathic listening can be both effective if the speaker evokes positive emotions in the listener (joy, hope for the best, self-confidence, in the future, pleasure, satisfaction), and ineffective if the speaker in his own words evokes negative emotions in the listener (fear, anxiety, sadness, chagrin, disappointment, hopelessness, sense of impasse). Consciously observing the interlocutor and asking yourself questions, you will be able to focus on the verbal and non-verbal aspects of the information, through which the emotional state of a person is more expressed.
Non-reflective listening. This type of listening involves minimal interference with the speaker's speech with maximum focus on it. The ability to be attentively silent, without interfering with the speaker's speech with his remarks and remarks, facilitates the process of self-expression for the listener and helps him to better understand the meaning of the transmitted information, to grasp what is behind the words. An important signal of such listening is a non-verbal reaction, i.e. eye contact, nodding or shaking the head, etc.
In communication, sometimes you have to listen to a person who is in a state of emotional affect, strong emotional arousal (for example, in a conflict). This is where non-reflective listening techniques come into play. In such a situation, the interlocutor, as it were, is not in the literal sense of the interlocutor, he is now just a person who does not control his emotions, is “obsessed” with something, is not able to capture the content of the conversation. First of all, he needs to calm down, come to a state of normal self-control, only after that communication with him can be continued.
In such cases, it is important to simply listen to the person, letting him know that he is not alone, that you understand and are ready to support. Experts believe that the emotional state of a person is like a pendulum: having reached highest point emotional intensity, a person begins to “go down”, calm down; then the strength of his feelings increases again, but, having reached the highest point, it falls again, and so on. If you do not interfere in this process, i.e. not to “swing” the pendulum additionally, then, having spoken out, the person will calm down and be able to communicate normally. At the same time, one should not be silent at all either, because deaf silence causes irritation in any person, and in an excited person this irritation will be intensified. Best of all, a reaction like: “yes-yes”, “well, of course”, “agree”, a nod of the head, etc. works best. Sometimes in such cases it is useful to "adjust" to the interlocutor, i.e. behave like him: repeat his words, emotions, reflect his gestures, facial expressions. But if it’s naturally difficult to do this, then it’s better not to try to adapt, since the interlocutor, noticing insincerity, will evaluate the partner’s actions as a mockery of his feelings.
Non-reflexive listening during communication allows the interlocutor who has problems (for example: stuttering, limited vocabulary, shyness, self-doubt, etc.) to concentrate and speak out. It is also effective in communicating with a person who is preoccupied with a problem, he is eager to express his point of view, attitude to something (for example, he asks you: “Listen to me to the end, and then tell me what you think about it and advise, How do I deal with this situation?" Non-reflective listening is also appropriate with those interlocutors who experience negative emotions, feel the intensity of passions and verbally “discharge”.
Listening techniques at such a moment are usually the following: positive reactions:
- assent ("so", "yes", "well", nodding the head); - "echo reaction" (repetition last word interlocutor);
- "mirror" (repetition of the last phrase of the interlocutor with a change in word order);
- "paraphrase" (transmission of the partner's statements in other words);
- motivation ("Well, and ...", "And what's next?");
- emotions (“wow”, “ah”, “great”, “laughter”, “mournful mine”); - clarifying questions (“Repeat what you said?”); negative reactions:
- continuation or interruption of the speaker (when the listener breaks into speech and tries to complete the phrase, suggests words);
- logical consequences from the partner's statements, for example, an assumption about the cause of the event, assessments, advice;
- “rude reaction” (statements like: “nonsense”, “all this is nonsense”);
- questioning (the question follows the question, without specifying the purpose);
- neglect of the partner (the listener does not pay attention to his words, ignores the partner and what he wants to say).
A negative reaction during non-reflexive listening should not be used, you should also not ask clarifying questions and say: “Calm down, don’t worry, everything will be fine” - this can cause an outburst of indignation or frustration in a partner, in this state the interlocutor cannot adequately understand these words, they resent him, it seems to him that his problem is underestimated, that he is not understood. If the partner’s emotions are directed directly at you, then the main task is not to get infected with them, not to fall into the same state of anger that can lead to a violent conflict or “showdown”.
Active reflective listening. The type of listening in which the reflection of information comes to the fore is called active reflective listening. Reflective listening involves analyzing the information received in the process of listening and instantly responding to it with the help of questions or replicas. Reflection (from Lat ge/lex!o - reflection) is the process of self-knowledge by the subject of internal mental acts and states; the process of thinking a person about what is happening in his own mind; propensity for introspection. This type of listening in communication is considered the most constructive. Here, such an organization of interaction is carried out in which partners understand each other better: they speak out more and more meaningfully, check and clarify their understanding of information, the degree of mutual understanding.
The most common techniques that characterize active listening are constant clarification of the correct understanding of the information that the interlocutor wants to convey to you by asking questions like “Did I understand you correctly, what? ..”, paraphrases “So you want to say ...” or "In other words, you meant...".
The use of such simple communication techniques allows you to achieve two goals at once:
1) adequate feedback is provided, which allows to eliminate barriers, distortion of information, demonstrate empathy, sympathy, desire to help, there is confidence that the information transmitted by the interlocutor is correctly understood;
2) indirectly, the interlocutor is informed that he has an equal partner in front of him. Taking an equal partnership position means that both interlocutors must be responsible for their every word. This goal is usually achieved faster than the first, especially in those cases when you are dealing with an authoritarian, tough interlocutor who is used to communicating from a “pedestal” position. The use of active listening skills will greatly help someone who is characterized by the position of a “victim”: in this way, he not only knocks the authoritarian interlocutor from his usual position, but also raises him to the level of an equal conversation with a partner, makes it possible to focus on the essential points of the conversation, and not on his own experiences and fears.
In communication, not only words, but also gestures can have several meanings, and, accordingly, listeners can be understood differently. There are situations when the speaker, especially when excited, gets confused in words, gives too much vent to feelings that are expressed in confused gestures - all this can distort the meaning of statements so much that the speaker himself ceases to understand what he actually wanted to say.
Some people, afraid to speak out directly and openly or to be misunderstood, to seem ridiculous, stupid or strange, to face condemnation, disapproval, prefer to maneuver words, pile them up to confuse, hiding true motives their speech, and create incredible difficulties for the listener. Many prefer to talk about the information that is most important to them only when they are sure that they will be heard, tried to understand and will not be judged. This is especially true for young people who, having once opened up to someone, did not meet mutual understanding and stopped believing in adults, parents and teachers.
In order to ensure understanding, the listener must use the means to let the conveyor (the speaker) know exactly what is perceived accurately and what is distorted so that he can correct his message and make it even more understandable. It is this exchange of direct and feedback signals that constitutes the process of active reflective listening.
Listening style of each person depends on many factors: on gender and age, status, individual characteristics (character, temperament, interests, etc.), on a specific situation.
1. You need to tune in to the hearing: for a while
forget about your problems, get rid of your own
experiences, try to get rid of ready-made lips
novelties and prejudices about this person
ka. Only then will you be able to feel
what the interlocutor feels, to “see” his emotion.
2. In your reaction to your partner's words, you must
accurately reflect the experience, feeling, emotion, hundred
behind his statement, but do it in such a way that
demonstrate to the interlocutor that his feeling is not
only correctly understood, but also accepted by you.
3. It is necessary to keep pauses. After your reply
need to be silent. Remember that this is the time
belongs to the interlocutor, do not occupy him with your additional
nitial considerations, clarifications, clarifications
niami. The pause is necessary for your partner to
get into your experience.
4. Remember that empathic listening
nie - not an interpretation of hidden from the interlocutor, tai
nyh motives of his behavior. You just need to reflect
partner, but do not explain to him the reason for the
sense of this feeling. Comments like: "Actually
you would like to be looked at all the time
attention", as a rule, cannot cause anything
except for rejection and protection. Especially if these words
pronounced at the beginning of the conversation, when trust is not yet
arose.
In communication, it is important not only the ability to listen, but also the ability to build your speech in such a way as to be easier understood by the audience, not to provoke the interlocutor into a negative attitude towards yourself and what you say. Communication will bring positive results if the doctor and the patient are on the same wavelength. To do this, it is desirable to determine and take into account the individual characteristics of the patient (as well as colleagues, boss, etc.), tune in with him on the same wavelength, as well as:
Start with what you agree on (i.e. what
you both know and about what your opinions coincide);
Avoid overconfidence
their statements critically;
When persuading, use arguments (do
accurate and meaningful for the interlocutor, not for
you), not pressure;
Try to separate your views and impressions
from the objective characteristics of things and phenomena;
Use monologues as little as possible;
Do not label the interlocutor and you
sayings;
Before you object, make sure you are right.
understand the interlocutor with the help of technology
active listening, then agree with that cha
the quality of his statements, with which you can agree
and only then tactfully and argumentatively
bath object.
Sometimes there are situations in which you will be dissatisfied with something. How to express this dissatisfaction so that a person wants to change his behavior and
This was not offended by you. Use the "sandwich method": pack a nasty remark into praise. Before and after criticism, say something nice, something you like about the person or their behavior. In addition, instead of the form of comments, claims, use the form of wishes or constructive suggestions. With this form of presentation of information, one can avoid the automatic resistance that arises when accusations are made.
Let's consider what hinders the establishment of trusting relationships and full interaction, fruitful communication between the doctor and the patient.
BARRIERS OF COMMUNICATION
As mentioned above, a barrier to establishing trust can be personality traits- psychological features partners that make communication difficult. These include such personality traits of the interlocutor as egocentrism (inability to take the position of another person), authoritativeness, desire for dominance, categoricalness (“There are two opinions on any issue - one is mine, and the other is wrong!”), intolerance for shortcomings others, aggressiveness. Both inadequately high and low self-esteem, which sometimes occurs in both doctors and patients, has an extremely negative effect on the communication process. A person with low self-esteem is touchy: the most neutral situations can be perceived by him as an infringement of his rights; in human relations, he is looking for a subtext unfavorable for him. The seeming need to defend yourself can lead to aggressive reactions, outbursts of anger, irritation.
Laughter, a smile of the interlocutor - even they can be interpreted by the patient in a negative sense - as a mockery, a frivolous attitude of the doctor to his problem. Therefore, a smile, a joke, a compliment - these
the most powerful tools in establishing contact and further communication, should be used carefully by the dentist, as he may be faced with a person with low self-esteem, a patient with depression, a severe, incurable disease, etc.
There is a communication barrier negative emotions. A person who is overcome by anger or full of resentment is not capable of normal communication. He is not able to adequately perceive the interlocutor. Feeling in relation to the patient a feeling of disgust, irritation, fear, it is foolish to expect that he will be able to understand correctly. Meanwhile, some patients may cause such feelings “without habit”, as they may be poorly dressed, untidy, drunk, make unreasonable demands or accusations against you, etc. The resulting negative feelings are not always recognized by the doctor. Often, medical personnel experience fear of death, illness, deformity, poverty - and unconsciously try to isolate themselves, minimize contact with patients who cause these fears. By recognizing this fear in yourself, you can overcome it.
exist in communication perception barriers. The first moment of perception of a person by a person largely determines further interaction, creates an appropriate attitude, which can be positive or negative (in the latter case, after that you will have to apply a lot of effort to change it). Significant information about another person is carried by such elements as clothing, hairstyle, clothing accessories. Not only the form of clothing is important, but also the appropriateness of its given situation. A discrepancy between the doctor’s appearance and the patient’s expectations can negatively affect further interaction and form distrust.
Try to find out the expectations of your patients regarding the appearance of the doctor (office) and try
Try not to shock them with a bright tattoo or an extravagant hairstyle, etc. If you are very different tall, or you are a left-handed dentist, or you are allergic to perfume smells, try to ensure that patients who apply for the first time are properly prepared for this.
Human perception can also be influenced by stereotypes hinder further interaction. In this case, already the first moments of contact are colored by a positive or negative attitude. So the patient begins to be perceived by the doctor not on the basis of some of his real features and characteristics, but in the light of the doctor’s assumptions and assumptions that have arisen from the information previously received about the patient or on the basis of national, social, religious stereotypes.
Playing an important role in the formation of the first impression non-verbal(i.e. non-verbal, non-verbal) ways of communication that are not always recognized by partners - intonation and timbre of voice, postures and gestures, facial expressions, eye contact.
Non-verbal components (means) of communication. Non-verbal (non-verbal) means of communication include:
Facial expressions and pantomimes;
Distance in communication (distance between speaking
shchih);
Eye contact.
Psycholinguistic researcher Merobyan believes that only 7% of information is transmitted using the content of speech, 38% of information is transmitted by paralinguistic components, and the remaining 55% by facial expressions and pantomime.
The perception of a person by a person depends largely on from the voice- its intensity (loudness), pitch,
timbre, intonation. The loudness of the voice is associated with the individual manner of managing the space of communication. Ownership of the voice implies an intuitive choice of the volume that is needed for a given room, given the circumstances of the conversation. People who have a habit of speaking louder than they should, seem to capture the space in which not only they exist, but also other people. Increased volume is generally characteristic of excited, tense communication. Speakers of loud speech are perceived by others as dominant, wanting to attract attention to themselves (we should not forget about the possible hearing loss, in which a person's perception of the loudness of his own speech is disturbed).
The speed of speech can tell a lot about a person's temperament, his emotional state. An excited person speaks faster than usual, slightly not saying the words. A depressed, tired person speaks more slowly, more monotonously, reducing the speed and volume of speech towards the end of the phrase.
To establish good contact both interlocutors go towards each other. During a conversation, the doctor will more easily establish an atmosphere of trust by adjusting to the patient's speech, slightly changing the characteristics of his voice, adjusting, if possible, to his speech speed, but maintaining an adequate volume level.
To create a trusting, calm atmosphere among the non-verbal components of communication, a large place is occupied by pantomime - human postures and gestures. The posture of the interlocutor can be tense - signaling that the person is "collected" and ready to fight back in anticipation of an unpleasant message; “closed” - arms crossed on the chest, torso tilted away from the interlocutor; aggressive - hands clenched into fists; as well as calm, comfortable, relaxed, designed for long-term communication. To create an atmosphere
Cooperation, attentive listening, in which the interlocutor is usually not rushed, it is imperative that you yourself sit in a comfortable, calm, stable position.
If an anxious patient sits tensely in the dental chair, you can try to reduce his fears by provoking him to change his position. It is more effective in this case not just to say: “sit back,” but to invite him to rinse his mouth or perform some other action.
An important factor in communication distance, in which we are comfortable talking with a person. The distance we try to maintain when communicating with different people, most of all depends on the nature of communication (Hall) (intimate, personal, business or public communication), as well as on the individual characteristics of the interlocutors, their social status, national culture (more on this can be found in the book "Grandmaster of Communication").
A distance that is convenient for you when communicating with a patient may not always be acceptable for him: a chair that is too far away for the patient will make some people want to move it towards you, the other will feel insecure, because you are examining it, the third is quite comfortable condition.
At a dental appointment, as with some other medical procedures, there is a violation of the "intimate zone" of both the doctor and the patient, with a social level of communication. For the doctor, with experience, addiction comes, and for the patient, although he is theoretically ready for this situation, in practice this can increase tension and anxiety. Therefore, before proceeding with the examination, especially at the first appointment, it is necessary to establish a certain level of trusting relationship, giving the patient some time for this. You should not start contact with the interlocutor with an offer to sit in a special medical chair, lie down
for inspection, etc. In addition, if one of the interlocutors is sitting and the other is standing, this obviously provokes unequal relations and can cause a negative reaction that makes communication difficult.
Very great importance has in establishing good contact and further communication sight. He has long been credited with particular importance in establishing an emotional connection with the interlocutor and in conveying subtle semantic nuances. There are general patterns of perception of eye contact that are similar for all people and individual characteristics associated with the leading channel of perception in a particular person, national characteristics etc. So in the world, “contact” and “non-contact” cultures are distinguished, in which there are unspoken generally accepted norms, when it is possible and when it is impossible to look into the eyes of the interlocutor. In Russia, the "contact" cultural tradition prevails, therefore, persons who avoid eye contact are evaluated negatively. However, not everything is so unambiguous, and a long direct look is often perceived as a reduction in psychological distance, which is not always pleasant for another interlocutor, and can be perceived as dominance, challenge, aggression. It has been observed that people are more likely to look into each other's eyes if the distance between them is large, and try to avoid eye contact when the distance is close. Psychological research show that the average time during which a direct look into the eyes of a stranger is tolerated by them without discomfort is approximately 3 seconds. Thus, both the lack of eye contact and the abuse of it are dangerous for further communication.
Sometimes doctors have a "non-seeing" look, when the eyes are turned to the patient, but the look passes through him, as it were, or does not reach him. This is often the result of psychological fatigue, "emotional
Onal burnout *, the desire to isolate oneself from numerous contacts. Such a view completely destroys the possibility of full-fledged communication, only formal contact remains.
Conflictologists have developed a number of conditions for maintaining and developing cooperation that will help establish therapeutic communication and prevent the development of conflicts at a dental appointment:
Consent, consisting in the fact that the patient involved
participate in the treatment process (informed consent),
Practical empathy, involving the form
understanding of the situation on the part of the patient, understanding
his difficulties and fears, an expression of sympathy
Wii and desire to help;
Maintaining a reputation is a respectful attitude
relationship to the patient, even if your interests are different
walk;
The exclusion of discrimination, which prohibits
emphasizing differences in social status,
age, etc., any superiority;
Psychological "stroking", targeted
maintaining the positive emotions of the patient;
Non-sharing of merit - this is achieved by mutual
respect and remove such negative
emotions like envy and resentment (especially
important when interacting with colleagues);
Individual approach to the patient - taking into account his
personality traits and emotional
states.
In order to better understand patients, colleagues, management, you can use the new modern developments in such a psychological direction as NLP - Neuro-Linguistic Programming.
In the 1970s, R. Bandler and D. Grinder discovered priority ways for a person to perceive new information. L. Bradway explored the same features
individual perception in children of preschool and school age.
A person perceives the world around him with the help of all his senses, but at the same time unconsciously prefers one, and not the other. This innate feature dictates which method of cognition to choose - visual, auditory or tactile - and predetermines the choice of the object of attention, the speed of perception, the type of memory. This predominance does not exclude other sensations, but most affects the perception this person, and the significance of this circumstance has only recently been recognized.
In the psychotherapeutic direction of NLP (neuro-linguistic programming), 3 types of people are distinguished according to the leading channel of perception: kinesthetics - a sensory channel, visuals - a visual channel, audials - an auditory channel and the 4th type of people who do not have a leading channel - logicians. There are also polymodals - people in whom all channels are equally well developed (this can be achieved by special training).
The characteristic features of these types are presented in table 3.
Table 3 Types of people according to the leading channel of perception
| \ Manifestation Types \^ | visuals | kinesthetics | Audials | Digital |
| Memory | Visual memory | Memory for actions | auditory memory | logical memory |
| visual contact | Looking into the eyes of the interlocutor: looking to hear | Looking down, touching is more important than looking | Eyes lowered, not looking to better listen | Looking over head or forehead, avoiding eye contact |
| Voice | Voice high, sonorous | low, thick | Melodic, expressive, changing | Monotonous, intermittent, constricted |
| Speech | Speech and movement are fast | Speech and movement are slow | Very wordy | Little movement |
| &rather words | Beautiful, it seems, look, perspective ... | Comfortable, feel, grasp... | Harmoniously, sounds, echo, tone... | Smart, functional, I know, logical... |
Patients belonging to different types report their complaints in different ways, their attention is focused on different manifestations of the disease, they hear and remember the doctor's recommendations in different ways. In the speech of patients, the characteristic words "I see", "I feel", "I hear", "I think" will be used.
visual, when he comes to the appointment, he will sit far away and will carefully look into the eyes of the doctor when talking, but becomes silent if the doctor looks away to make an entry in the medical record. Such a patient will easily answer the question: “What does it look like?” *, and with difficulty the question: “What kind of pain?”. Convincing him of the need for treatment, try show him everything perspectives, “paint a clear picture* convalescence.
kinesthetic on the contrary, he will sit closer and easily describe his state of health in sensations. Ask him: "How do you feel right now?" and don't be afraid to move over and touch it. A kind touch can calm him down (this is often used by kinesthetic dentists). If such a patient stops you in the corridor to ask about something important, he will stand very close to you and may even hold you by the hem of your dressing gown. He, most likely, will gladly go to physical therapy or massage, but will remember only what he did himself. Recommendations “by ear” or from a book, he will remember much worse.
Audials ~ people with well-developed speech and auditory memory. They are happy to talk with a doctor and are offended and do not trust those doctors who cannot tell them in detail about their disease and the course of treatment.
digitalam it is also necessary to describe in detail and clearly the stage of their disease, the consequences and prospects, and to clearly and consistently explain the treatment plan.
(More details about kinesthetics, visuals, audials and digitals can be found in any book on NLP, for example, A. Lyubimov “Communication Mastery”)
In addition, using psychodiagnostic methods (observation, conversation or psychological testing), it is possible to determine such personal characteristics of patients as temperament or its individual properties, character accentuations, socionic type, anxiety level and build therapeutic interaction taking this knowledge into account.
OCCUPATIONAL RISK INSURANCE FOR DENTISTS
The study of the problem of the relationship between the doctor and the patient in the provision of medical services to dental patients is becoming increasingly relevant, which is primarily due to a significant increase in conflict situations with a steady upward trend.
It can be stated with a certain degree of certainty that the transition of a significant part of dental medicine to a reimbursable basis entails the application of the relevant legal relations governing these services. These legal relations acquire special significance in cases of improper provision of dental care. This dictates the need to develop a number of measures aimed at both resolving conflicts and improving control over the quality of dental services.
Numerous works are devoted to the issues of assessing the quality of dental care, however, they do not sufficiently show the role of the dental association in organizing pre-trial medical examination in resolving conflicts between the patient and the doctor in the provision of dental services. We want to acquaint readers with the experience of pro-
production of medical and dental examinations and examinations conducted by the Supreme Expert Council at the Dental Association of Russia (StAR).
The Supreme Expert Council for Dentistry (SEC) was established by the decision of the StAR Council in 1998. The basis for this decision was primarily the concept of developing and implementing the StAR dental insurance program, which provides for professional liability insurance for dentists. A significant impetus for the creation of the StAR dental insurance program was the numerous appeals to the association of doctors, who, under the conditions of modern legislation, have become virtually defenseless against legitimate, and often far-fetched claims of patients and court decisions, as a rule, resolving conflict situations in favor of patients.
To resolve conflicts in professional level The Supreme Expert Council for Dentistry was created, which began to consider claims from patients dissatisfied with the quality of the dental services provided to them, heads of dental organizations where a conflict situation arose, as well as insurance companies where the doctor is insured, with a request to give an objective assessment of the dental service. The decision to create a WEC was also facilitated by the order of the Ministry of Health of the Russian Federation No. 363 of October 24, 1996, which provides for the creation of departmental and non-departmental expert bodies, which were entrusted with the responsibility of monitoring the quality of dental care. Non-departmental examinations are carried out either by the chief specialists of professional dental associations, or by employees of various expert institutions or public organizations, such as consumer protection associations.
Teley. However, in these cases, expert conclusions from a legal point of view are not always correct.
The study of the issue of organizing a medical examination of the quality of the service provided showed the urgent need for such a specialization as an expert dentist who would have the appropriate special training and could legally participate in the examinations. Currently, when resolving conflict situations, only one medical institution acts as an arbiter - the bureau forensic medical examination, only the conclusions of which, according to the law, must be taken into account by the court, and are one of the types of evidence in the case. At the same time, the need for an expert dentist is dictated by life itself, since it often becomes necessary to promptly resolve the issue, while forensic medical examination does not have such capabilities, which is associated with the legislative procedure for its appointment (applying to the court, which, before examination is trying to resolve the conflict amicably, collecting documents, selecting appropriate specialists due to the lack of dental experts in the staff), and the experts of the forensic medical examination bureau do not have special knowledge in the field of dentistry.
When creating the EEC under the StAR, the leadership of the association proceeded from the fact that the doctors of the relevant profile included in the commission would perform expert functions on a voluntary basis. However, at the initial stages of the functioning of the expert council, certain difficulties of an organizational nature arose. First of all, the question of its legitimacy arose, and then the creation of such a structure that would clearly comply with the requirements of legislative and regulatory acts to the general principles of conducting
examination, registration of its conclusion with the construction of conclusions.
Our experience has shown that the most acceptable in this respect are general principles the work of the forensic medical expert commission, which provides for all stages of the organization of the examination: the peculiarities of studying the documents of patients (application, contract, medical records, etc.), the formation of a commission from the relevant specialists (therapist, orthodontist, orthopedist, surgeon), examining the patient, formulation of the conclusions of the expert opinion and its execution. Assessing the goals, objectives and functions of the Bureau of Forensic Medical Examination, we used its principle of work with certain adjustments.
Over the past four years, the EEC considered 59 cases related to the assessment of the quality of dental services, which were distributed by years as follows: 2000 - 15 cases, 2001 and 2002 - 9 each, 2003 - 12, and in 2004 - 14 cases. The given quantitative indicators testify to the growth trend of expertise.
Of all the examinations carried out, in 80% of cases, the commission revealed serious omissions in the diagnostic and treatment process, which served as the basis for declaring the service of poor quality. Moreover, in 34 conflict situations, insurance companies reimbursed patients for treatment costs. In 10 cases, the patients insisted on the consideration of the case in court, which also confirmed the conclusion of the VES and satisfied, in the main (9 cases), the claims of the patients.
On their own initiative, 7 patients applied to the Supreme Expert Council, and at the request of the heads of dental institutions - 18 cases. Among the plaintiffs, the largest share was made up of women (83.1%) and in a smaller number of men - 16.9%. Mostly residents applied for examination
Moscow (46 people), rarely residents of the Moscow region (5 people) and other regions of the country (8 people).
An analysis of the expert material made it possible to identify 5 main reasons that served as the basis for patients to apply to the commission, namely:
The presence of a continuing pain syndrome by
after endodontic treatment
and/or prosthetics - 24 cases;
Chewing dysfunction - 18 cases;
Combination of chewing dysfunction, pain
- 6 cases;
Aesthetic quality claims
work, despite the fact that the solution of these
issues are not covered by stoma insurance
medical insurance program StAR - b cases;
Rejection further treatment at the clinic or
this doctor after considering the claim
by the departmental commission that established the
solutions in the provision of dental services,
even if they were insignificant
nym and could be easily eliminated - 5 cases.
The largest number complaints about the quality of treatment were presented to orthopedic doctors (69.5%), in lesser degree- therapists - 20.5% and in isolated cases to orthodontists and surgeons - 5% of all cases.
Analyzing the defects in the provision of therapeutic care, it should be noted that we considered this activity not only as an independent type of service (12 cases), but also as one of the stages of preparing a patient for orthopedic treatment (7 cases), since improperly performed treatment may further affect on the results of prosthetics, as well as a violation of technology during prosthetics, can lead to therapeutic problems that sometimes come to the fore in patient complaints.
The main claims of patients to therapeutic treatment, considered by the BEC commissions, were related to:
Pain after endodontic treatment
due to perforation of the walls of the tooth root, removal
filling material for the top of the root,
ma endodontic instrument development inflamed
body process in periapical tissues;
Breaking off the thinned walls of the tooth after fasting
new fillings;
Violation of aesthetics in the treatment of frontal
groups of teeth
Conflict situations arising from the amounts
spent on treatment, which is caused by insufficient information
the formation of the patient by the doctor or misunderstanding
em of the provisions of the contract (for example, the cost of one
fillings are often perceived by the patient as one treatment
th tooth).
The study of medical documents, contracts and examination of patients allowed the commission to recognize these complaints as justified. At the same time, inconsistency was noted in the assessment of the causes of the conflicts given in the statements of the plaintiffs and the attending physicians and even the heads of structural divisions and the dental institution. Often, according to the doctor, the service is performed correctly, and he does not see any violations. As a rule, this point of view is also supported by the intra-departmental commission, which indicates bias, corporatism and an attempt to protect the doctor from the department.
Analysis of the results of examinations and examinations on conflict situations conducted by the Supreme Expert Council of the StAR made it possible to identify the main shortcomings, errors and omissions in the work of dentists in therapeutic treatment.
1. Errors in the conduct of the survey: incomplete or insufficiently thorough examination.
diagnostic errors.
3. Tactical mistakes(mistakes in writing
treatment plan).
4. Technical errors(execution errors
manual procedures).
Deontological errors.
6. Omissions in maintaining medical records.
The first three points are the treatment algorithm and
flow from one another.
The most common omissions in the examination of patients during the work of a general practitioner include the following points:
1. not performed before endodontic treatment
x-ray examination;
2. before a therapeutic intervention, do not
pulp viability was determined;
3. no additional examination methods were carried out
consultations or consultations of the patient with specialists in
identification of comorbidities.
Thus, insufficiently thorough examination, non-appointment of additional examination methods and consultations of specialists in related specialties leads to errors in diagnosis.
An incorrect diagnosis by a doctor leads to the fact that an inadequate plan of the proposed treatment is drawn up. From here it becomes clear the meaning and importance of a qualitative examination, which, unfortunately, is a rarity in therapeutic dentistry. The main attention should be paid to the collection of anamnesis and analysis of the patient's complaints, because. already at this stage it is possible to assume the nature of the pathological process or disease.
Technical errors are usually associated with manual procedures, and are often caused by deviations.
yami in the actions of a doctor from the standards adopted by the association and generally recognized norms and rules.
As our material shows, insufficient attention on the part of the doctor, the inability to listen to the patient, rescheduling the appointment time are the cause aggressive behavior patient, especially with an unstable emotional sphere.
Violation of the principles of deontology, to Unfortunately, this is also a common mistake. In particular, a doctor can afford not only to evaluate the work of another doctor, but also to criticize it. In this regard, I would like to emphasize once again that the assessment of the quality of the treatment performed is the prerogative of the expert. The general practitioner is obliged to ascertain the clinical situation of the oral cavity, the presence of a causal relationship between the previous treatment and the complications that have arisen, to issue such information to the patient in a delicate form, and to offer, if necessary, treatment.
An analysis of the examinations carried out showed that the medical records of dental patients are maintained with serious violations. Moreover, even those medical records that were obviously rewritten after the conflict situation arose are incorrectly drawn up, or they are poorly maintained even when the patient notifies the doctor that he is not satisfied with the quality of treatment and will complain to “higher authorities”. This suggests that the vast majority of practicing dentists either simply do not attach importance to record keeping, or are not aware of possible consequences negligence in its conduct, despite the fact that various publications indicate the role of the quality of medical records in resolving disputes at the pre-trial and judicial stages.
Our experience shows that the main omissions in record keeping are as follows:
The attending physicians, as a rule, are not included in
medical history information about the condition of the dentoalveolar
systems at the time of initial contact.
The dental formula is not filled out completely, as
as a rule, in the history of the disease there is a conditional designation
only the treated tooth.
Often there is no record of the x-ray
nological examination after filling
cash, which makes it impossible to carry out
monitoring the quality of treatment and, in case of disputes, is considered
like a defect.
There is no information about the proposed plan
treatment as an element of informing the patient, and
stages of its implementation.
X-ray data are not provided.
The timing of follow-up examinations after
completion of oral hygiene.
The existing omissions in record keeping and defects in the primary examination of patients do not always allow the commission to assess the dental status before treatment and are the reason for refusing to establish a causal relationship between the doctor's actions and the complication that has arisen.
It should be emphasized that in case of errors in maintaining outpatient cards or the absence of an entry in the medical history about the dynamics of treatment, everything is decided in favor of the patient. Therefore, if the doctor does not write a detailed medical history, he deliberately puts himself in the position of the accused.
At the same time, when the medical record contains details about the disease, additional methods of examination and consultations of specialists, it is not difficult for the expert commission to resolve the issue of the absence of a causal relationship between the occurrence, for example, of pain syndrome and the actions of doctors.
The teacher in his work is constantly faced with a wide variety of problems of interpersonal communication. The lack of a culture of communication or its low level often leads to the emergence of conflict situations, tension in relations between the teacher and children, their parents, colleagues.
Psychologically competent perception by the teacher of partners in communication will help to establish mutual understanding and effective interaction. This opportunity is largely provided to the teacher by the formed perceptual minds, i.e. the ability to correctly assess their emotional state by facial expressions, gestures, language, actions of partners. There are two interrelated types of social perception: proper perceptual (perception and understanding of a child or another person) and empathy (special sensitivity to a child, empathy and sympathy for another).
The process of social perception presupposes, first of all, the presence of listening skills. Numerous studies show that most educators lack listening skills
. Listening is a process during which connections are established between people, there is a feeling of mutual understanding, which makes any communication effective.
For both types of communication - first-time communication and long-term communication - are important. SKILL is reflexive. I. Non-reflective listening
psycho-emotional mechanisms that ensure the implementation of reflective and non-reflexive listening are reflection, empathy, identification
. Reflection- self-knowledge of internal states at a rational level (analysis)
. Empathy- self-knowledge of internal states on emotional level(sympathy, empathy)
. Identification- assimilation, attempts to become like a partner of interaction
To master the art of listening, the future teacher should form the appropriate listening skills and techniques, namely:
-maintaining attention focus and stability of attention, visual contact;
-use of elements non-verbal communication - gaze, posture, gestures, language of interpersonal space, change in voice pitch and intonation;
-remarks and questions;
-the presence of developed personal formations- understanding, sympathy, approval
Reflective listening is a type of listening when the reflection of information comes to the fore. It includes constant clarification of the information that the interlocutor wants to convey, by posing and clarifying questions.
Listening can take place in both reflexive and non-reflexive forms. Reflective listening is often called active listening, as it uses verbal form more actively.
. Productive Ways of Reflective Listening
. Reflection of feelings (empathy)
. The essence of the reception: emphasizing the speaker's perceptions, attitudes and emotional state
. the main objective - reflecting the feelings of the interlocutor, demonstrate understanding to him, provide psychological support for his personality, strengthen contact
. Possible verbal forms:. I think that. You feel. I understand. Your condition
Reflective listening is indispensable in conflict situations when the interlocutor behaves aggressively or demonstrates his superiority. This is very effective remedy calm down if there is a desire to develop a conflict that has begun.
A common mistake people make when using reflective listening is to formally follow the rules. In such cases, a person puts the “necessary” question: “Am I right. You understood that,” but, having not heard the answers, continues to develop arguments in favor of his own point of view, actually ignoring the point of view of the interlocutor. Then such a person is surprised that the active listening technique of non-working listening does not work.
Reflective listening can be used in all cases when the child is upset, offended, defeated, when she is hurt, ashamed, terribly. In such cases, it is important to let her know that. You felt her experiences "Voicing" the child's feelings helps to relieve conflict or tension or tension.
It happens that you have to listen to a person who is in a state of strong emotional arousal. In this case, the techniques of reflective listening do not work. In this state, a person does not control his emotions, is not able to catch the meaning of the conversation. She needs only one thing - to calm down, come to a state of self-control, and only then can you communicate with her. In such cases, the technique of non-reflexive hearing works effectively. Annannya.
. Paraphrasing (echo technique)
. The essence of the reception: return to the interlocutor his statements (one or several phrases), formulating them in your own words. You can start like this: "As I understand you", "In your opinion", "In other words,. You think"
. The main goal of "echo technology" is clarification of information. Essential ones are chosen for paraphrasing - moments are more important message. But when "returning" the remark, it is not necessary to add anything "from oneself", to interpret what was said. Luna-technician ka will allow you to give the interlocutor an idea of \u200b\u200bhow. You understood him, and prompt a conversation about what seems to you the most important in his words and the most important to you.
. Possible verbal forms:. As I understand you, in your opinion. You think
. clarification (clarification)
. The essence of the reception: an attempt to draw a logical conclusion from the partner’s statements, assumptions about the reasons for what was heard
. the main objective- clarify the meaning of what was said, quickly move forward in the conversation, the ability to get information without direct questions. But one should avoid haste in conclusions and use non-categorical formulations and soft tones.
. Possible verbal forms:. Please agree on whether to repeat this again. Don't explain your opinion
. Verbalization
. The essence of the reception: on the basis of what was heard from the communication partner, forecasting the possible factors that determined the situation that he spoke about
. The main goal of verbalization: forecasting and analysis of possible factors that determined the situation, which was told by the communication partner
. Possible verbal forms:. It seems to me that u. You have such a situation because. U. Your problem is that
. Summary
. The essence of the reception: reproducing the words of the partner in an abbreviated form, a brief formulation of the main thing, summarizing "If now to summarize what has been said. By you, then"
. The main purpose of summarizing is selection main idea. The reception helps in the discussion, consideration of claims, when it is necessary to solve any problems. It is especially effective if the discussion has dragged on, gone in circles, or reached a dead end. Summing up allows you to avoid wasting time on irrelevant conversations and can be a powerful and harmless way to end a conversation with a very talkative interlocutor.
. Possible verbal forms:. If we now summarize what has been said. By you, then. Your main idea was Like me. Understood you
. Situations in which it is appropriate to listen reflectively
Important situations of personal life;
Important professionally oriented situations;
Situations in which you need to evaluate another person (his knowledge, skills, behavior, etc.)
. Non-reflexive listening - the ability to make it clear to the interlocutor that he is not alone, that they listen to him, understand and are ready to support non-reflexive listening consists in the ability to be attentively silent, not to interfere with the speech of the interlocutor with your remarks, however, this silence is active, as it requires a lot of concentration on the subject of the conspiracy, showing understanding, approval and support for the speaker. Best of all, the so-called “yep-reactions” work best: “yes-yes”, “yes-yes”, “well, of course”, head nodding. Also, niche answers can be such similar answers as:
go on
This is interesting
Nice to hear
More
Need to think about this
Incorrect construction of a replica during non-reflexive listening can lead to disruption of contact with the interlocutor. It is not recommended to use such phrases: "Come on", "It can't be that way. Ogan", "Yes, you can't do it", etc. The emotional state is like a pendulum: having reached the highest limit of the emotional tension, the person begins to calm down, then the strength of his feelings increases again, bending to the highest limit, then subsides. If you do not interfere in this process, do not "swing" the pendulum additionally, by speaking, the person will calm down, and after that it will be possible to communicate with her calmly, you will be able to talk calmly with her.
The main thing in non-reflective listening:
o not be silent, because deaf silence causes irritation in any person, and even more so in an excited person;
o do not ask clarifying questions, because this will only cause a reciprocal outburst of indignation;
o do not tell the partner: "Calm down, don't worry, everything will get better" - he cannot adequately understand these words, they outrage him, it seems to him that his problem is underestimated, that he is not understood
Sometimes in such cases it is useful to "adapt" to a partner, repeat his words, emotions, movements, that is, behave the way he does, share his feelings. But this must be done sincerely, otherwise the repetition of actions will be assessed as a mockery of his feelings.
Non-reflexive listening, accompanied by non-verbal communication techniques, expresses understanding and sympathy much better than verbal. Non-reflective listening can be used in relation to soromyaza rain and insecure students, in situations where the student wants to express his opinion, emotional attitude, or if he has difficulty in expressing his sore problems. In the examples given, the use of non-reflective listening allows you to limit interference in the conversation as much as possible, which makes it easier for the speaker to express himself.
. Situations in which it is appropriate to listen to non-reflexive
In non-essential personal situations;
In unimportant and uncomplicated professionally oriented situations;
When the interlocutor is in a negative emotional dominant in order not to increase his emotional state
empathic listening allows you to experience the feelings that the interlocutor is experiencing, reflect them, understand the emotional state of the interlocutor and share it
During empathic listening, they do not give advice, do not seek to evaluate the interlocutor, do not criticize, do not teach. This is the secret of good listening - one that gives the other person relief and openness. Riva him new ways to understand himself.
. Empathic Listening Rules
1. It is necessary to tune in to listening: forget about your problems for a while, free your soul from your own experiences and try to move away from ready-made attitudes and prejudices regarding the interlocutor. Only in this case it is possible to understand what the interlocutor feels, to “see” his emotions and emotions.
2. In your reaction to the partner’s words, it is necessary to reflect exactly the experiences, feelings, emotions behind his statements, but do it in such a way as to demonstrate to the interlocutor that his feelings were not only correctly understood, but also accepted.
3. You need to pause. After. Of your answer, the interlocutor should usually be silent, think in order to understand his experience
4. It must be remembered that empathic listening is not an interpretation of the secret motives of his behavior hidden from the interlocutor. It is only necessary to reflect the feeling of the partner, but not to explain to him the reason for the occurrence of this feeling. Remarks like: "So it's so with you that you're just jealous of your friend" or "In fact, you would like to be paid attention to you all the time" cannot evoke anything in response, except for aggression and defense of aggression and outrage.
empathic listening provides a better understanding of the child by the teacher, helps to neutralize the teacher's tendency to evaluate. The desire of many teachers to listen to the student is not so much for the purpose of listening to it. The first thing she tells him, how much in order to appreciate him, often causes communication barriers. These include barriers to dialogic communication (prejudice, distrust, lack of a sense of humor, the ability to social contact). One of the varieties of dialogue between a teacher and a student is a discussion. Only high culture dialogue insures against the danger of turning it into a dispute, that is, into a "state of mutual hostility."
. Conflict Interaction Hearings
Listening shows our openness to what the other is saying. Does listening show this receptivity in dialogue?
Maintain constant eye contact;
Do not interrupt;
Don't give advice;
Summarize what. you heard;
Make reflective remarks showing that. You understand what the other feels
Only irreconcilable enemies do not listen. If. You will use these rules of listening, the interlocutor will feel that. You are not his implacable enemy and are ready to understand his needs and concerns. If he feels that his needs are being respected, he will be less aggressive in trying to bring him to. Your own consciousness. Gaki.
If a person feels irritated or fearful, she should get rid of these emotions, as they can be an obstacle in the relationship. Only after the person has been listened to and reassured can the usual conflict-free communication be restored. If a person is not allowed to speak out, then hostility and suspicion may arise on her part, and communication will be reduced to chaos and unrest.
An important element of listening technique is the ability to ask questions. They allow you to support the interlocutor, to help in the presentation of considerations. With the help of skillful and timely questions, the teacher can manage the dialogue with the student.
The tactics of formulating questions correctly chosen by the teacher contributes to the creation of a favorable psychological atmosphere of interaction with the student, the disclosure of his creative possibilities with sufficient completeness, and the identification of the level of assimilation of educational information.
5 Communicative culture of personality Training of communicative culture of a social teacher
. Communication culture training
. Communicative culture is a system of qualities, properties, traits and skills of a person that ensures high performance in communication. It consists of two groups of characteristics:
1. General human qualities and characteristics (to feel the need for communication and pleasure from communication; to feel the need to be among people long time, benevolence, sincerity, humanity; altruism; altruists and tendencies - the desire to bring joy and a positive charge to other people).
2. Personal and professional qualities and characteristics (reflection, empathy, the ability to listen reflexively and non-reflexively; self-regulation of psychophysical well-being; culture and technique of speech, the ability to convince you and inspire.
Communication training involves the following steps:
1) diagnostics (autodiagnosis) of sociability;
2) socio-psychological and professional communication training, the purpose of which is the development of two selected groups of characteristics in special training groups (TG) or intensive communication groups ((GIS.
. The task of socio-psychological and professional training
a) removal of clamps, tension, isolation in situations of communication;
b) organization of special situations requiring appropriate actions for self-expression;
c) development of skills and abilities of reflective and non-reflective listening;
d) auto-training and self-regulation of psychophysical well-being in situations of difficult communication;
d) development of individual sensitivity (perception, empathy, reflection, non-verbal means of expressing feelings);
e) teaching effective ways and techniques of communication
. Methods of socio-psychological and professional training of communication skills
1)imagotherapy- individual training of self-confidence, overcoming complexes, is carried out by self-hypnosis and group, role-playing training. Exercises: verbal formulas for self-hypnosis and. JSC ("Consignment shop", "Self-presentation", "Associative perception of the other") is more effective than accepting another");
2)functional behavior training- behavior training Everyday life. Exercises: "Compliments", "Nakhabnik", "Press Conference";
3)useful game method- a technique based on transactional analysis. E. Berna. Game - a system of transactions aimed at achieving a win and have hidden motivation. Similar to the game level of communication. Effective for training relationships in the family, with children. Exercise-situations: the child pretends to be sick, does not want to go to school, refuses to eat, does not want to go to bed in certain time hour;
4)psychodrama method- training of behavior in an extreme situation. Situation exercises: attacker, thief, fire, terrorists, natural disaster
Questions (answer in writing):
1. What active listening techniques can a teacher use in their work? Prove your point.
2. What are the key principles of persuasion that the teacher must apply in his work (select three main)? Explain why.
3. What strategy of behavior in a conflict situation do you consider the best? Explain your point of view.
4. What causes of pedagogical conflicts do you encounter most often in practice? (select three reasons and bring three examples)
5. What benefits does information about the conflict map give to the teacher? Why does the teacher need to know about the conflict map?
6.*(optional) Give an example of an intrapersonal conflict.
Empathy in communication, rules of listening.
Empathy(Greek ἐν - “in” + Greek πάθος - “passion”, “suffering”) - conscious empathy with the current emotional state of another person, without losing a sense of the external origin of this experience.
Active listening (Empathic listening) - a technique used in the practice of socio-psychological training, psychological counseling and psychotherapy, which allows you to more accurately understand psychological states, feelings, thoughts of the interlocutor with the help of special methods of participation in the conversation, implying the active expression of one's own experiences and considerations.
Active listening techniques
Allocate the following tricks active listening:
Pause- it's just a pause. It gives the interlocutor the opportunity to think. After a pause, the interlocutor may say something else that he would have kept silent about without it. The pause also gives the listener himself the opportunity to step back from himself (his thoughts, assessments, feelings), and focus on the interlocutor. The ability to detach from oneself and switch to internal process interlocutor - one of the main and difficult conditions for active listening, creating a trusting contact between the interlocutors.
Clarification is a request for clarification or clarification of something that has been said. In ordinary communication, minor understatements and inaccuracies are thought out by the interlocutors for each other. But when difficult, emotionally significant topics are discussed, interlocutors often involuntarily avoid explicitly raising sensitive issues. Clarification allows you to maintain an understanding of the feelings and thoughts of the interlocutor in such a situation.
Retelling (paraphrase)- this is an attempt by the listener to briefly and in his own words repeat what the interlocutor has just stated. At the same time, the listener should try to highlight and emphasize the main ideas and accents in his opinion. Retelling gives the interlocutor feedback, makes it possible to understand how his words sound from the outside. As a result, the interlocutor either receives confirmation that he was understood, or gets the opportunity to correct his words. In addition, retelling can be used as a way of summing up, including intermediate ones.
Development of thought- an attempt by the listener to pick up and advance further the course of the main thought of the interlocutor.
Perception message- the listener tells the interlocutor his impression of the interlocutor, formed in the course of communication. For example, "This topic is very important to you."
Self-perception message- the listener informs the interlocutor about changes in his own state as a result of listening. For example, "It hurts me to hear this."
Notes on the course of the conversation- the listener's attempt to communicate how, in his opinion, the conversation as a whole can be comprehended. For example, "Looks like we've reached a common understanding of the problem."
When reflecting feelings, the emphasis is not on the content of the message, but on the emotional state of the interlocutor. This distinction is not always easy to grasp, but it is of fundamental importance. Let's compare two phrases: "I feel offended" and "I think I'm offended."
Reflecting the feelings of the interlocutor, we must show him that we understand his condition: “I have a feeling that you are upset about something.” It is advisable to avoid categorical formulations such as: "I'm sure you're upset."
The intensity of the interlocutor’s feelings should also be taken into account: “You are a little upset!” (absolutely, very much, etc.).
by facial expression, gestures, intonation of the interlocutor;
according to him, reflecting feelings.
Rules for Empathic Listening #1.
Show full interest in his problems. Emphasize this interest with facial expressions, gestures, exclamations, etc. Do not use biased assessments given to the child by strangers.
Show your affection for him with a smile.
When listening to a child, do not be distracted. Concentrate all your attention on it.
Let the child speak. Do not rush, give him time to speak freely.
Do not emphasize with your whole appearance that the child is difficult to listen to.
Do not give advice and evaluations without his request.
Look for the true meaning of the child's words. Remember that the spoken word is complemented by shades that appear in the change in tone and color of the voice, facial expressions, gestures, movements, tilts of the head and body.
Show the child that he was heard and understood the meaning of what was said.
Rules for Empathic Listening #2:
1) it is important to free the soul from one's own experiences and problems, to abandon prejudices regarding the interlocutor, to tune in to the perception of his feelings;
2) in your reaction to the partner’s words, it is necessary to accurately reflect his experience, feeling, to demonstrate not only their correct perception, but understanding and acceptance;
3) reflection of the partner's feelings should be carried out without interpreting his actions and hidden motives of behavior that led to specific actions, it is not worth explaining to him your opinion about the reasons for this feeling in him;
4) you need to pause. After your answer, the interlocutor usually needs to be silent, think, understand each other's feelings. Do not rush to additional considerations, explanations.
In empathic listening, as a rule, they do not give advice, do not seek to evaluate the interlocutor, do not moralize, do not criticize, do not teach.
Conducting a conversation. Persuasion rules.
Skazhenik E.N. BUSINESS CONVERSATION Tutorial. Taganrog: TSURE Publishing House, 2006.
Rules of Persuasion
There is nothing more important than to win the listener over to the side of the speaker. After all, people judge much more often under the influence of spiritual movement than in accordance with the truth.
Cicero
1. The order of the arguments presented affects their persuasiveness. The following order of arguments is most convincing: strong - medium - one strongest.
2.To receive positive decision on a very important issue for you, put him in third place, giving him two short, simple ones for the interlocutor, on which he will easily say “yes” to you.
3. Do not drive the interlocutor into a corner. Give him a chance to save face. Do not belittle the status and image of the interlocutor.
4. The persuasiveness of arguments largely depends on the image and status of the persuasive.
5. Do not drive yourself into a corner, do not lower your status.
6. We are condescending to the arguments of a pleasant interlocutor, and critically to the arguments of an unpleasant one.
7.Wishing to convince the interlocutor, start not with the moments that separate you, but with what you agree with him.
8. Be an attentive listener.
9. Avoid conflicts. (Conflictogens are rudeness, threats, ridicule, peremptoryness, etc.)
10. Check if you understand each other correctly?
Conflicts. ways out of them. Behavior correction.
Conflict- the most acute way to resolve conflicts in interests, goals, views, arising in the process of social interaction, consisting in the opposition of the participants in this interaction and usually accompanied by negative emotions, going beyond the rules and norms. Conflicts are the subject of study of the science of conflictology.
A conflict is a situation in which each side seeks to take a position that is incompatible and opposite to the interests of the other side. Conflict is a special interaction of individuals, groups, associations that occurs when their views, positions and interests are incompatible. Conflict has both destructive and constructive functions.
Signs of Conflict
1. Bipolarity
Bipolarity, or opposition, represents confrontation and at the same time interconnectedness, contains an internal potential for contradiction, but in itself does not mean a clash or struggle.2.Activity
Activity is another sign of conflict, but only that activity that is synonymous with the concepts of "struggle" and "counteraction", activity is impossible without some impulse given by the awareness of the situation on the part of the subject of the conflict.
3. Subjects of the conflict
The presence of conflict subjects is another sign, the subject is an active party capable of creating a conflict situation and influencing the course of the conflict depending on its interests. As a rule, the subjects of the conflict have a special type of consciousness - conflict. The contradiction is a source of conflict situations only for the subjects-carriers of the conflict type of consciousness.
Types of conflicts
The number of participants in conflict interaction allows us to divide them into intrapersonal, interpersonal, intergroup .
Intrapersonal conflicts- represent a clash within the personality of equal in strength, but oppositely directed motives, needs, interests. A feature of this type of conflict is the choice between desire and possibilities, between the need to fulfill and compliance with the necessary norms.
interpersonal conflicts are a clash of individuals with a group, among themselves, a struggle for the interests of each of the parties. This is one of the most common types of conflicts.
Intergroup conflicts- conflicts between different groups, divisions, in which the interests of people are affected, united during the conflict into single cohesive communities.
Classification of conflicts
Strategies of behavior in a conflict situation
In modern conflictology, five strategies of behavior in a conflict situation are identified:
Adaptation - one side agrees with the other in everything, but has its own opinion, which is afraid to express.
Avoidance is avoidance of a conflict situation.
Compromise is a joint decision that satisfies both parties.
Rivalry - active opposition to the other side.
Collaboration is an attempt to arrive at a joint solution.
Conflict Management Strategies
There are five main strategies of behavior in conflict situations:
Strategies of behavior of participants in the conflict
Perseverance (resistance) When a participant in a conflict tries to force them to accept their point of view at all costs, they are not interested in the opinions and interests of others. Typically, such a strategy leads to a deterioration in relations between the conflicting parties. This strategy can be effective if it is used in a situation that threatens the existence of the organization or prevents it from achieving its goals.
Evasion (evasion) when a person seeks to get away from the conflict. Such behavior may be appropriate if the subject of the dispute is of little value, or if the conditions for a productive resolution of the conflict are not currently in place, and also when the conflict is not realistic.
Adaptation (compliance) when a person renounces his own interests, is ready to sacrifice them to another, to meet him halfway. Such a strategy may be appropriate when the subject of disagreement is of less value to a person than the relationship with the opposite side. However, if this strategy becomes dominant for the leader, then he most likely will not be able to effectively manage his subordinates.
Compromise. When one side accepts the point of view of the other, but only to a certain extent. At the same time, the search for an acceptable solution is carried out through mutual concessions.
Cooperation when the participants recognize each other's right to their own opinion and are ready to understand it, which gives them the opportunity to analyze the causes of disagreements and find a way out acceptable to everyone. This strategy is based on the participants' belief that differences of opinion are the inevitable result of smart people have their own ideas about what is right and what is not. At the same time, the attitude to cooperation is usually formulated as follows: "It's not you against me, but we are together against the problem."
TO pedagogical conflicts refer interpersonal conflicts between the educator and the pupil (teacher and student, parent and child), as well as intergroup conflicts , between the teacher and the class. Pedagogical conflicts are also part of the conflict of generations. Pedagogical conflicts are also distinguished by their specific features. home distinguishing feature pedagogical conflict consists in opposing social role positions. The position of the teacher can be conditionally expressed by the words "I am called to educate you!", The position of the student is reflected in the classic phrase: "I do not want to be educated."
S. Yu. Temina cites the following objective and subjective causes of pedagogical conflicts.
1. Objective causes of pedagogical conflicts:
Insufficient degree of satisfaction of the basic needs of the child.
Contrasting the functional-role positions of the teacher and the student (the task of the first is to teach, the task of the second is to learn; the teacher is a priori considered to be superior to the student in mind, knowledge, experience and endowed with power over him).
Significant limitation of degrees of freedom (requirements of strict discipline, subordination, lack of the ability to choose a teacher, subject, class, mandatory attendance at lessons, etc.).
Differences in ideas, values, life experience, belonging to different generations(the problem of fathers and children").
The dependence of the student on the teacher.
The need for teacher assessment.
Ignoring the personal problems of students in formalized educational systems.
The plurality of roles that a student is forced to play due to the different, sometimes opposite requirements placed on him in an educational institution, by parents, comrades, or any other significant people.
The difference between educational material and phenomena, objects of real life.
Social instability, etc.
Psychological incompatibility of teacher and student.
The presence of certain character traits in a teacher or student that determine the so-called "conflict personality" (aggressiveness, irritability, tactlessness, sarcasm, self-confidence, rudeness, rigidity, pickiness, skepticism, etc.).
Lack of communication culture in the teacher or student.
The need to study this subject by all students and the lack of interest in it from a particular student.
The discrepancy between the intellectual, physical capabilities of this student and the requirements placed on him.
Insufficient competence of the teacher (lack of experience, in-depth knowledge of the subject, readiness to resolve conflicts, low level of development of certain professional abilities).
The presence of a teacher or student of serious personal problems, strong nervous tension, stress.
Excessive workload of the teacher or student.
Forced inactivity of the student.
Lack of independence, creativity in the educational process.
The discrepancy between the student's self-esteem and the assessment given to him by the teacher, etc.
A. Menyaev in the article "Conflicts in training and education" highlights three objective reasons adult conflicts:
interaction of adult conservatism and new cultural values of children;
insufficient cultural level of adults (rudeness, tactlessness, etc.), its inconsistency with the level of culture of the people;
changes in the psyche of teachers or parents that arise in the process of accumulating experience in the systematic management of the child's behavior; these changes can be figuratively called "corruption by power" - the habit of constantly forbidding, ordering, correcting, forcing, reproaching, reprimanding, in a word, "educating" in severity, humility and discipline.
Types of pedagogical conflicts
Based on modern ideas about education as the most important social institution, an integral, multifaceted social phenomenon, three groups of conflicts can be distinguished that arise in different plans of education:
Systemic conflicts (conflicts based on contradictions that arise in the process of functioning of education as a system; they can be economic, organizational, political, ethnic, spiritual);
Procedural conflicts (pedagogical conflicts, which are based on contradictions that arise in the educational process);
Effective conflicts (arise on the basis of contradictions between the real and ideal results of the conflict).
Conflict map
For a more successful conflict resolution, it is desirable to draw up a conflict map developed by H. Cornelius and S. Fair. Its essence is as follows:
identify the problem of conflict in general terms. For example, in case of a conflict due to the amount of work performed, draw up a load distribution diagram;
find out who is involved in the conflict (individuals, groups, departments or organizations);
identify the true needs and concerns of each
Empathy (from English - sympathy, empathy, the ability to put oneself in the place of another) is the ability of a person to emotionally respond to the experiences and feelings of other people. With empathic listening, the participant in communication pays more attention to “reading” feelings, rather than words, understanding what the interlocutor has to do with what he says. There are three types of empathy: empathic response, acceptance of a different point of view, and sympathetic response.
Empathic response occurs when a person, using participant observation, experiences emotional reactions similar to the actual or expected manifestations of the emotions of another.
Acceptance of a different point of view - imagining oneself in the place of another, in his role - as if "the ability to walk in other people's shoes."
Sympathetic response is a feeling of caring, empathy, compassion directed towards another person because of his circumstances or situation. The method of sympathetic response differs from the previous two mainly in that the partner does not try to empathize with the other person. Understanding what another person is really experiencing causes grief, concern for this person, pity for him or other feelings in a person.
Rules for Empathic Listening:
- 1) it is important to free the soul from one's own experiences and problems, to abandon prejudices regarding the interlocutor, to tune in to the perception of his feelings;
- 2) in your reaction to the partner’s words, it is necessary to accurately reflect his experience, feeling, to demonstrate not only their correct perception, but understanding and acceptance;
- 3) reflection of the partner's feelings should be carried out without interpreting his actions and hidden motives of behavior that led to specific actions, it is not worth explaining to him your opinion about the reasons for this feeling in him;
- 4) you need to pause. After your answer, the interlocutor usually needs to be silent, think, understand each other's feelings. Do not rush to additional considerations, explanations.
In empathic listening, as a rule, they do not give advice, do not seek to evaluate the interlocutor, do not moralize, do not criticize, do not teach.
Seeing the world from the point of view of another is a very complex skill, and it is developed in different ways in people, moreover, in some this ability is underdeveloped. Empathic skills allow you to increase the effectiveness of interaction, but they, like concentration, require additional efforts from the participant in the interaction. At the heart of such skills is respect for the interlocutor, which begins with a view of a person not only as an object, but also as a person with his own values. Respect allows you to focus your time and energy on others and not on yourself.
In communication, empathic listening can be both effective if the speaker evokes positive emotions in the listener (joy, hope for the best, self-confidence, in the future, pleasure, satisfaction), and ineffective if the speaker in his own words evokes negative emotions in the listener ( fear, anxiety, sadness, chagrin, disappointment, hopelessness, sense of impasse). Consciously observing the interlocutor and asking yourself questions, you will be able to focus on the verbal and non-verbal aspects of the information, through which the emotional state of a person is expressed to a greater extent.
