Print Media

The power of the press arises from its ability of appealing to the minds of the people and being
capable of moving their hearts. Despite the fast growth of the electronic media, the printed word
continues to play a crucial role in disseminating information and mobilizing people. However, it has been noticed that the Press have not evinced the requisite interest in developmental communication. In order to correct the imbalance noticed in the media coverage of Rural Development Programmes and to ensure that these Programmes are portrayed in proper perspective, several steps were taken during the year to sensitize the media about issues relating to rural development.

The interaction of the Ministry with the Press is mainly through the Press Information Bureau.
During the year under review, press conferences, press tours and workshops were organized
through PIB, with the financial assistance from the Ministry, so as to sensitize press persons about Rural Development Programmes. An Editor’s Conference on Social Sector Issues was also
organized (through PIB) during the year. For the purpose of creating awareness in
respect of rural development programmes among the general public and opinion makers and for
disseminating information about new initiatives, the Ministry issued advertisements at regular intervals in National and Regional Press through the Directorate of Advertising and Visual Publicity. To enable people in rural areas to access information on Rural Development Programmes, a booklet ‘Gram Vikas – Programmes at a Glance’ was brought out in simple language in Hindi, English and Regional languages. In order to ensure easy accessibility of the booklet 10 million copies were printed and distributed in rural areas through DRDAs. The leaflets on the Programmes of the Ministry in Hindi, English and Regional languages
were also printed and distributed upto Panchayat level across the country.

The Ministry prepared a Wall Calendar for the year 2002 with each sheet depicting its major
schemes, for distribution upto the Panchayat level all over the country. Desk Calendars were also brought out during the year and efforts were made to improve the quality of communication through ‘Kurukshetra’ a monthly journal devoted to rural development issues, which is brought out on behalf of the Ministry by the Publications Division, Ministry of Information and Broadcasting. In addition to serving as a forum of free, frank and serious discussion on problems related with rural development (with focus on rural uplift), the journal projects the programmes and policies of the Ministry.

Needs and Possibilities for Communication Education in Seminaries

If the purpose of a seminary is to educate people for ministry one might first look into this
purpose a little bit deeper. The word “educare” has as its roots the Latin word “ducere’ which
means “to lead”, to give direction. “E-ducare” might therefore be interpreted as to “lead out”, to
give direction. It would mean to lead out of ignorance to knowledge and understanding.
Education thus might be interpreted as to prepare people for life and to equip them with the
knowledge and means necessary for life. It means for the Seminary to enable the students to
know where to go and what to do in their future work as ministers to the Word of God.

Education includes from elementary years reading and writing and other communication skills as essential for understanding and mastering life. When we talk about communication education in the Seminary and theological schools it is good to keep these basics in mind. Usually when we talk about “Communication Education” in the Seminary we think immediately of mass media or the modern means of communication which includes especially technical tools. Most media courses or even those more general on communication aim at equipping the seminarian in the use and technique of the modern means of communication for his/her ministry.

This, however, should not be the first purpose in the seminary. It should have been done already
at the college level before entering the seminary for graduate studies. Today it should be part of
any educational program to enable every student to critically judge and use the modern means of communication. This is part of the Communication/media education which in turn should be part of any school curriculum. It includes having a general knowledge about the ways and means
modern media operate like e.g the essential criteria to judge the quality of a news item, a TV
program or a film. It is to enable people to become informed and responsible recipients. Communication Education in the seminary should be already on a more advanced level and
should be able to build on the general media education in college and elementary.

Programs in the seminary should slowly lead the seminarian to the proper and active use of communication for ministry because s/he is part and parcel of the modern communication world. This, however,
includes not only modern means and technology. Proper communication preparation for ministry starts already long before and is based on the essentials of human communication.

Electronic Media

An intensive IEC campaign over the Electronic Media (Radio and TV) was
undertaken through Prasar Bharati for optimum dissemination of information
on rural development programmes. In order to meet the area and region
specific communication needs of Rural Development Programmes, half an hour
audio and video programmes were produced and broadcast/telecast over local and primary stations of All Programmes of the Ministry, workshops at the national level in Delhi and also at regional levels were held during the year before the production of audio visual software. In addition to the Programmes and spots produced and broadcast through Prasar Bharati during the year, the Ministry continued to sponsor a weekly magazine format radio Programme ‘Jage Jan Jan Jage Gaon’ over Vividh Bharati Stations of AIR. The Programme is produced in Hindi and 12 regional languages and broadcast every Friday from 7.45 to 8.00 PM over 39 Commercial Broadcasting Stations. The broadcast of another weekly radio Programme of
thirty minute duration based on folk music over Primary and Local Radio Stations of AIR is also to start shortly. The Programme would be field based and produced in regional languages besides major dialects of Hindi, to meet the region specific communication needs relating to Rural Development Programmes.


The broadcast of Programmes and spots over regional kendras of Doordarshan and
primary and local radio stations of AIR is largely intended to meet the communication needs of the target groups in rural areas. In order to sensitize the opinion makers, urban elites and corporate bodies etc about issues relating to rural development and to facilitate their participation in the development process, weekly Programmes to be telecast over News and Current Affairs channel of Doordarshan were produced. Also to address the international community and to project the resurgent rural India in proper perspective, weekly Programmes were produced and telecast over DD (International).

In addition to the intensive IEC campaign through the print and electronic media , the Action
Plan also envisages utilization of the other modes of conventional and non conventional
Communication for disseminating information on Rural Development
Programmes. The Song & Drama Division, media unit of Ministry of Information and
Broadcasting, disseminates information on evelopment issues, among target groups
through the medium of performing arts, raditional arts, puppet shows, folk media,
mythological recitals and the like. As the edium of transmission is rooted in the
local ethos and traditions, the evelopmental messages are more easily rasped by the target groups. During the ear, from the financial assistance provided
by the Ministry, the Song & Drama Division resented Programmes through their field
units on the themes of the Programmes of he Ministry.

During the year Ministry participated in the epublic Day Parade 2002 with a tableau on the
theme of the Sampoorna Grameen Rozgar Yojana. he Ministry also took part in the India International rade Fair and set up a pavilion ‘Saras’ where poducts made by rural artisans from all over the ountry were displayed to provide them with maketing support and exposure to national andinternational buyers.

For meeting expenditure on IEC activities, the IEC Division utilizes budgetary allocations provided under the Communication Cell in the Department of Rural Development. In addition, the allocations provided for IEC activities under different Programmes in all the three Departments viz Department of Rural Development, Department of Drinking Water and Department of Land Resources are pooled together and utilized by the IEC Division for undertaking IEC activities in respect of all the Programmes in a holistic manner. Though as per BE 2001-2002, the total allocations available for IEC activities is only Rs.22.50 crore, the expenditure likely to be incurred on IEC activities during the year, on account of intensive IEC campaign, would be around Rs.75 crore. The expenditure in excess of the budgetary allocations are proposed to be met out of the savings available under different Programmes.

Using Cinemeducation (Film) To Teach Interpersonal and Communication Skills

Goal:

To raise awareness and stimulate reflection and discussion among residents and faculty about such issues as breaking bad news, medical interviewing, and the psychosocial impact of terminal illness

Objectives:

1. Residents will be able to reflect on the importance of physician-patient communication skills
2. Residents will be able to apply good methods of delivering bad news
3. Residents will be able to describe the impact of terminal illness on the patient and the family.


Learning Activity:

Cinemeducation is an excellent way to promote discussion on a wide range of topics in Interpersonal and Communication Skills. This article describes the use of “The Doctor,” to teach communication skills such as interviewing, breaking bad news, and the psychosocial impact of terminal illness. Initially, the film is introduced to residents and they are asked to view the video clip. Discussion questions are provided in the article for residents to discuss in a group format.
Program Directors also should encourage residents to bring forth their own cases or experiences in order to encourage application of information. Small group or large group discussion format can be used with the following types of questions:

• What are might the physicians have done differently to more successfully deliver the bad news to the patient and his wife?
• How can you be of assistance to patients and their families in facilitating open discussion about serious illness?
• What are challenges faced by physicians in balancing work and home lives?

For a broader list of topics, please see the resource guide Cinemeducation. Ideas for teaching communication skills, specific time counters for the film clips and specific discussion questions are included for a wide range of films and topic areas.

Resource Guide:

Alexander M, Lenahan P, Pavlov A. Cinemeducation. Radcliffe Publishers. Dallas, Texas. 2005.

Using the ILS (Invite-Listen-Summarize) Model to Teach and Assess Patient Centered Communication

Goal:

To improve a resident’s communication skills with patients in the ambulatory clinic and inpatient settings.

Learning Objectives:

1. Residents will be able to identify the components of the ILS model
2. Residents will be able to apply the ILS model to interactions with patients

Learning Activity:

The ILS model encourages residents to establish rapport with the patient (Invite), engage in active listening (Listen), and summarize the patient’s story throughout the interview (Summarize). These skills are part of a patient-centered interviewing technique that seeks to elicit the patient’s perspective. The authors of this model used standardized patients to provide feedback to learners on their ability to apply the model. This is a longitudinal curriculum and scenarios of graded difficulty are used throughout the year. Learners in small groups, working
with a standardized patient, are instructed to apply this model to the medical interview. Feedback from peers and standardized patients is used to improve communication skills.

A number of specialties could use this model in a variety of ways, depending on the resources of the program. This model is a more compressed version of the communications model developed by the Kalamazoo Consensus Statement.

Use of Standardized Patients:

Many academic medical centers have standardized patient programs and are happy to help construct specialty specific scenarios that reflect typical communication issues. The model could be presented in a short didactic form followed by resident interaction with a standardized patient who was instructed to give feedback regarding the resident’s application of this model. The advantage of this activity is that it provides residents with excellent feedback on their
interviewing skills. Standardized patients can also perform formative and summative assessment. Many standardized patient assessment centers have developed scenarios with high reliability and validity.

Role Play:

Role-play is another method that can be used to teach this model. A short didactic could be presented on the model. Ideally, one resident might take the role of the physician while one resident plays the role of the patient. The resident playing the patient could provide feedback to the “physician” on his/her ability to find it easier to do this activity if cases are chosen eforehand and are relevant to their specialty.

Video/Audio tape:

Videotaping and/or audiotaping allows the resident to self reflect on their communication style with a patient. Faculty review allows for significant discussion and formative feedback designed to improve a resident’s communication skills and enhance the development of an individualized learning plan. Residents and faculty should review the tape with an evaluation tool using
behavioral anchors.

Cinemeducation:

A fourth way to teach this model, which is fun for residents, is to present a short didactic on the model. Video clips of popular movies can be used to stimulate discussion about the model and about communication skills in general. For an extensive list of video clips, including discussion items, please see the resource guide section under Cinemeducation. For issues related to copyright, please consult this book as well.

Many of these strategies can be used to teach a variety of topics in Interpersonal and Communications Skills. Please see the bibliography at the end of this booklet for more excellent ideas.

Assessment:

Many of the assessment tools for patient-centered communication skills involve focused observation of the resident interacting with a patient. Program Directors should consider using a focused observation tool about twice a year. A focused observation tool allows faculty to identify a resident’s strengths and weaknesses in patient centered communication and helps residents develop a learning plan for improvement. There are many excellent focused observation tools, such as the Harvard Medical Schools Communication Skills Form or the SEGUE (see assessment section).

Using the Griev-ing Model to Teach and Assess Interpersonal

Goal:

To improve residents ability to notify family members and significant others following the death of a patient

Objectives:

1. Residents will be able to articulate the stages of the “GRIEV-ING” Model
2. Residents will be able to apply this model during various role plays

Learning Activity (2-hour workshop):

1. Short didactic on why death notification is an important skill and the significant verbal and nonverbal characteristics of empathic communication (20 minutes)
2. Small group activity facilitated by program faculty, hospital chaplain or hospital social worker. The focus of this small group activity is to ask residents to share personal experiences about the death of a patient and share communication skills that individuals felt were effective or ineffective for interacting with the family. Discussion questions are included in the appendix to the article.
3. Mini-lecture introducing the GRIEV-ING mnemonic. This mnemonic helps residents remember the appropriate steps to take when notifying family members or significant others about death.
4. Paired role-play – In these role-play residents received and delivered a death notification using the GRIEV-ING mnemonic. They were encouraged to provide helpful feedback to their colleagues
5. Simulated survivor encounter – Residents provided death notification in each of three scenarios portrayed by the simulated survivors. .Residents received feedback on their performance. Example scenarios and checklists for the simulated survivors are included in the article

Assessment:

The assessment for this activity is contained in the simulated survivor feedback and assessment tool included as an appendix to the article.

Comment:

While this model was used within an Emergency Medicine program, it would be equally valuable for other specialties in which notifying families and significant others of a patient’s death are required.

Using the Humanities to Teach Interpersonal and Communication Skills and Professionalism

Goal:

To improve resident’s interpersonal and communication skills and professionalism

Objectives:

1. Residents will develop a deeper understanding of professional and communication issues.
2. Residents will begin to explore their own feelings regarding their practice of medicine using narratives.

Learning Activity:

The authors describe weekly case based small group discussions focusing on such topics as medical errors, ethical issues, medical malpractice, and racism. Examples of discussion questions are given in the article. Specific readings designed to deepen the reflections of the discussion group are given throughout the year; these include novels, essays, and journal articles by physicians. Residents are also encouraged to write about their experiences with patients.
Active participation and discussion by senior faculty help residents reflect on and integrate this experience into their daily activity. Senior faculty were trained in problem based learning and group facilitation through the medical school in order to develop their skills in small group facilitation. As an alternative, behavioral science faculty or social workers might also be helpful in facilitating the discussions.

Assessment:

The authors present a theoretical model for assessment of this curriculum. Currently, they assess this module through required attendance and participation. Interpersonal and communication skills are assessed via a 360 evaluation from physicians, nurses, and patients.
A reflective narrative delineating their experiences and summarizing key individual learning points might be an additional method of assessment. These reflective narratives could become part of the resident’s portfolio. The narratives could be assessed by the Program Director using a standard checklist or rubric.