Üsküdar University’s Faculty of Health Sciences organized the 1st Clinical Communication Symposium: Violence in Healthcare and Communication in Healthcare. Speaking at the symposium, President of Üsküdar University and Psychiatrist Prof. Nevzat Tarhan emphasized that an issue cannot be managed unless it is tracked with statistics. He noted that clinical communication serves as a buffer that prevents violence, helps build trust, and reduces anxiety. In this context, experts in the field came together with participants during various sessions.
The symposium was held at the NP Health Campus İbni Sina Auditorium. The opening speeches were delivered by Prof. Nevzat Tarhan, Dean of the Faculty of Health Sciences Prof. Arif Aktuğ Ertekin, and Dean of the Faculty of Medicine Prof. Haydar Sur.
The symposium was also attended by faculty members and students.
Prof. Nevzat Tarhan: “If we do not track a topic with statistics, we cannot manage it”
In his opening presentation titled “Effective Methods in Clinical Communication,” Prof. Nevzat Tarhan said that There are global data from the World Health Organization (WHO) regarding violence in healthcare. According to WHO, 62 percent of healthcare workers experience some form of violence at least once during their professional life. The most common forms of violence include verbal abuse and threats (33 percent) and sexual harassment (13 percent). Between 8 percent and 32 percent of healthcare workers experience physical violence at some point in their careers. This rate is particularly high among young and inexperienced workers. When compared by sector, healthcare professionals are five times more likely to face violence than those in other sectors. A staggering 73 percent of all workplace violence occurs in the healthcare sector. This figure comes directly from WHO’s latest records. In Türkiye, data from the White Code system were not shared in 2022. In 2021, however, the data for the first six months showed 9,035 reported cases. Legal support was provided in 78 percent of them, with an average of two cases reported per day. In the 450 documented cases of violence in healthcare identified in 2021, 43 percent of the victims were nurses and 48 percent were physicians. The 2023 White Code data were shared 16 months later. If we do not track a subject through data and statistics, we cannot manage it. The most important element here is the data itself, proper analysis of that data, and then tailoring training and policies accordingly.”
“They were called heroes during covid, now they are forgotten”
Highlighting that healthy communication increases patient satisfaction, Tarhan said that Depression, anxiety, and insomnia are common psychological problems among healthcare workers. During the COVID-19 pandemic, 27 percent of healthcare professionals experienced depression, 33 percent experienced anxiety, and many suffered from insomnia. During the pandemic, healthcare workers were hailed as heroes, but now they have been forgotten. Violence lowers the quality of healthcare services and compromises patient safety. When violence occurs, the quality of care declines, the likelihood of medical errors increases, and ultimately the patient suffers. This is why populist policies in this area should be questioned. What is clinical communication? It refers to the interaction between the patient and healthcare provider. Only 20 percent of this communication is verbal; the remaining 80 percent is nonverbal. Its components include listening, empathy, open dialogue, and body language. There is a strong correlation between clinical communication and patient satisfaction. When communication is healthy, satisfaction is high. In clinical communication, a relationship of trust is established, anxiety is reduced, misunderstandings are avoided, and aggressive reactions from patients or their relatives decrease. It functions as a buffer that prevents violence. For instance, in one documented case, an empathetic explanation during a delay in the emergency department helped calm a patient’s relatives. This is related to mirror neurons in the brain. It is not an abstract concept. Our mirror neurons communicate with the mirror neurons of the person across from us. Emotions such as anger, fear, hatred, and love activate the mirror neurons in the other person’s brain.”
“Proper communication requires investment”
Noting that value systems enhance compassion in communication and increase social capital, Tarhan said that “Communication errors can trigger violence. These include dismissive behavior, avoiding eye contact, performing procedures without explanation, and failing to listen to the patient. Effective communication requires investment. This is because communication is a form of social capital. We often approach things from the perspective of financial capital, that is, aiming for optimal benefit. In social capital, we also need to expand the ‘pool’ by strengthening relationships. The broader the social capital, the more effective our power becomes. Investing in this means building a stronger generation — just as a master shoemaker creates the best shoes. Competent individuals excel at using their talents. In communication, these talents are expressed as human values. These values, described by Howard Gardner in 1982, now have neurobiological correlates. According to Lawrence Kohlberg, rational brain functions include logical analysis, reasoning, and calculating ability. Meanwhile, intuition, emotions, actions, artistic sense, and aesthetic preferences are related more to the right hemisphere of the brain. If we approach communication only with left-brain thinking — with sharp logic or an engineer’s mindset — we will not succeed. We must also engage with the right brain, the emotional brain. That is where wisdom resides. There are six core virtues: courage, humanity, justice, temperance, transcendence (self-transcendence), and wisdom. And there are 24 values to cultivate. The more we develop these values in our brain, the more compassionate our communication becomes, and the stronger our social capital grows. These abilities are developed through education, and they are not innate.”
Prof. Arif Aktuğ Ertekin: "Violence exists everywhere, not just in health"
Üsküdar University Faculty of Health Sciences Dean Prof. Arif Aktuğ Ertekin evaluated the issue of violence in health. Ertekin stated that "Violence exists everywhere, not just in healthcare. It is in our religion, in politics, in education, on the road, on the street. Violence everywhere you greet. In an environment where there is such widespread violence, I think it is not easy to purify certain professional groups from violence. A lot of good work has been done in the field of health in the last 20 years, but has anything great been done about violence? No. People's expectations are very different. Raising people's expectations is a good thing in the field of health, but it is also very important to create facts that are grounded and compatible with reality. While we are doing the health side of the business, some issues are taking place outside of us. Unfortunately, we are not the decision-makers here."
Prof. Haydar Sur: "It will be on our agenda every year"
Mentioning that violence is the responsibility of everyone who is interested in social psychology, Üsküdar University Faculty of Medicine Dean Prof. Haydar Sur said that "In an environment like Türkiye, where violence constantly gnaws at itself and the morality of society in daily life, everyone who deals with social psychology automatically falls under the responsibility of everyone. Since there is violence in health, it is also on our agenda because we are health professionals. Many activities related to this have been carried out for a long time. A new one will be made every year and different aspects of the work will be the subject of discussion on our agenda every year. Hopefully, we think it will continue like this until this country gets rid of the issue of violence."
'The Growing Problem in Health Services: Violence' was discussed
The first session titled "The Growing Problem in Health Services: Violence" was chaired by Prof. Mehmet Zelka, Advisor to the Rector of Üsküdar University. In this context, the following presentations were made:
-Marmara University faculty member Prof. Gürkan Sert: "Refusal to care for the patient in case of violence in health (legislation and medical ethics),
-Üsküdar University Faculty of Medicine, Department of Mental Health and Diseases, Prof. Cemal Onur Noyan "Anatomy of the White Code: 5W 1H",
-Üsküdar University Faculty of Communication Public Relations and Publicity Department Head Assoc. Prof. Özge Uğurlu: "Crisis Management in Combating Violence in Health Institutions: Risk or Solution?)"
After the question-and-answer session, the first session ended.
"What Needs to Be Done to Prevent Violence in Health" was discussed
In the second session of the event titled "What Needs to Be Done to Prevent Violence in Health", Kocaeli University faculty member Prof. Ayşe Günsel chaired the session. In this context, the following presentations were made:
- Üsküdar University Faculty of Medicine Dean Prof. Haydar Sur: "The Issue of Violence in Health Services",
- Mehmet Salih Yıldırım, Chairman of the Board of Directors of ISSCA: "Communication in Health: The Cleveland Clinic model",
- Üsküdar University Asst. Prof. Gamze Kağan: "The Importance of Communication Skills in Violence in Health Services".
The symposium ended with the presentation of a certificate of appreciation and a group photo.
Üsküdar News Agency (ÜNA)