Professional Communication in Clinical Environments

In a clinical environment, having the knowledge, understanding and ability to effectively implement professional communication styles and identify communication barriers is essential to creating and maintaining an operative and successful practice. While communication styles and techniques are developed by individuals throughout their lives and experiences, it is vital that managers in the workplace understand these styles and how they interact with each other. A comprehensive, coherent and deliberate communication strategy enables a workplace of individuals to function and communicate effectively.

The art of communication is described by Warnecke (2014) as the development and implementation of effective communication skills and finding a style of communication that benefits both the sender and receiver of a message. Communication can be divided into several different categories. Arnold and Underman Boggs (2019) describe intrapersonal communication as an introspective process to help one get in touch with their personal feelings and attitudes by critically examining their behaviours and the impact they have. Arnold and Underman Boggs go on to describe that interpersonal communication is an exchange of information between two or more people. It is an interactive and dynamic process with cognitive variables which impact its transmission and response.

Kiernan and Martyn (2015) emphasise that having an understanding of both intrapersonal and interpersonal communications enables individuals to improve and build self-awareness through the identification of how personal beliefs and biases may influence the way in which we communicate with others. Self-awareness and experience play an important role in effective communication skills. Being able to detect individual self-awareness is an important attribute in being able to identify and distinguish weaknesses and blind spots that may encroach on and impact an organisation. This understanding of self-awareness allows for continued improvement on a professional level in the art of effective communication.

Professional communication is the process of oral, written, visual, and digital forms of communication being delivered in a workplace environment. Perrin, Stanley and Taylor (2015) suggest that professional communication between patients/clients and healthcare professionals is imperative. Perrin et al., (2015) go on to distinguish professional communication into two categories: intra-professional and inter-professional. Intra-professional communication exemplified as communication between two professionals from within the same profession, ie. a nurse communicating with another nurse on a particular patient. Inter-professional communication is similar, yet subtly different and is exemplified as when different members of the health care team interact and communicate with each other, ie. a doctor, nurse and a pharmacist discussing a patient diagnosis and treatment plan. The important inference to draw from these different categories is that intra-professional communication becomes easier when an individual is comfortable in their professional environment and has developed a sound communication rapport with their colleagues, however, inter-professional communication can be challenging if key messages are not communicated or received by members of different professional teams.

Every individual is said to have their own communication style. According to (“4 Types of Communication”, 2018) there are four basic types of communication styles; passive, aggressive, passive-aggressive and assertive. Passive individuals are generally accepting and allow things to happen to them without resistance, lacking in outward communication. Aggressive communicators will speak loudly and intimidate others to get their point of view across. Passive-aggressive communicators tend to communicate with body language and prefer to internalise emotions rather that deal with conflict. Assertive communication is believed to be the most effective communication style as it aims for both sides to express themselves while being considerate of each other, a win, win situation. (“What Communication Style”, n.d.) describes other styles of communication such as analytical, intuitive, functional and personal. Analytical communicators rely on facts, real numbers and hard data and have a tendency to separate work life from private life. Intuitive communicators are ones to leave behind the finer details and focus on the bigger picture; getting the job done quickly by thinking on their feet. Functional communicators work with finesse, using detail and sequence; structure and organisation is important to functional communicators. Personal communicators like to communicate by talking things through with clients and colleagues; they are often very approachable, addressing and identifying problems openly and easily. Each communication style displays both strengths and weaknesses. Having an understanding and self-awareness of individual communication styles will assist in communicating effectively with others and their individual styles. Murphy (2015) summarises this in saying that by identifying your own communication style and that of others, messages are much more likely to be delivered clearly and concisely.

Communication techniques identified by (“Mastering Communication Techniques”, n.d.)  are vocabulary in the form of both written and verbal communication. Tone of voice, including the volume and the emphasis which is put on words should match the intended audience. Body language, including facial expressions like eye contact, posture and where hands and arms are positioned are all nonverbal communication indicators and can have a positive or negative effect on the intended messages attempting to be conveyed.

There are several barriers which can impede communication styles and techniques from being effective. Longest, Rakich, and Darr (2000) classify these barriers into two categories: environmental and personal. Environmental barriers are characteristic of the organisation and its environmental setting with examples including competition for attention and time between the message being sent from the sender and received by the receiver. Multiple messages being received simultaneously will likely cause messages to be incorrectly decoded by the receiver.  Personal barriers arise from the nature of individuals and their interaction with others with both of these types of barriers blocking, filtering, or distorting the intended message. Other communication barriers include; intrapersonal/psychological barriers within a person such as, differing expectations, bias and assumptions.  Interpersonal barriers such as culture, gender and hierarchy or physical/external barriers are all elements which may affect the physical comfort of people, and can ultimately weaken the ability to effectively and openly communicate (Kiernan, 2015). Effective communicators display empathy by demonstrating or attempting to demonstrate an understanding of another’s viewpoint. Acceptance of this view point as being valid not only improves the conversation flow but lays the foundation for relationships, trust and rapport to be built (Kiernan, 2015).

Listening is said to be the most effective form of nonverbal communication. According to Fibuch and Robertson (2019) the reception of a message is determined only 7 percent of the time by the actual words used, with the tone of the sender’s voice determining the meaning 38 percent of the time. Most importantly Fibuch and Robertson (2019) found that non-verbal communication influences message interpretation 55 percent of the time with eye contact making up to half of non-verbal communication. Delivery of a message is only part of the puzzle, communicating effectively relies on understanding the intended audience and knowing the tone and tact required to get the message to be listened to. Some barriers to effective listening may include preoccupation with own interests or worries, appearance and gender of the speaker and environmental noises, just to name a few (McGuire, 2001).  Johnson (2018) quotes George Bernard Shaw in that, “The single biggest problem with communication is the illusion it has taken place.” We listen to reply not to understand.  

Strategies to overcome communication barriers require recognising that barriers exist in the first instance. Having the ability to eliminate differences in perception, using simple language by removing jargon and slang, minimalising environmental barriers such as noise levels, listening with intent, identifying with emotional states, avoiding information overload and providing the sender useful feedback are all effective ways to assist with overcoming communication barriers. Ideally, individuals should posses efficient speaking and listening abilities, enabling the message receiver to have an understanding of viewpoints and concepts by using simple language in both written and oral communications, being respectful and polite so misinterpretation of the message is reduced (Kapur, 2018).

Communication is vital not only for an organisational structure to create and maintain a successful workplace but also for the individual as a whole. It is apparent that there are numerous barriers and obstacles that can occur during communications, some of which can be actively avoided or sufficiently reduced and others that are not avoidable. Effective communicators should possess knowledge and understanding of the ideas they are communicating, be resourceful with dialogue and listening abilities and have a desire to communicate, all to assist in competently overcoming communication barriers.

References

• 4 Types of Communication Styles, Alvernia University Online. (2018). Retrieved April 27, 2019, from https://online.alvernia.edu/articles/4-types-communication-styles/
• Arnold, E. C., & Underman Boggs, K. (2015). Interpersonal relationships: Professional communication skills for nurses (7th ed.). St Louis, Missouri: Elsevier Health Sciences.

         Arnold, E. C., & Underman Boggs, K. (2019). Interpersonal relationships: Professional communication skills for nurses (8th ed.). Retrieved April 27, 2019, from https://books.google.com.au/books?hl=en&lr=&id=XC2GDwAAQBAJ&oi=fnd&pg=PP1&dq=interpersonal+communication+in+healthcare+setting&ots=NpWl30-LIZ&sig=3wgmXhtV49OeNMDr115zuHpyolE#v=snippet&q=intrapersonal&f=false.

• Barriers of communication. (n.d.) Retrieved April 27, 2019, from https://www.toppr.com/guides/business-correspondence-and-reporting/communication/barriers-in-communication/
• Fibuch, E., & Robertson, J. J. (2019). Honing the fine art of communication. Physician Leadership Journal, 6(1), 64+. Retrieved April 29, 2019, from http://link.galegroup.com/apps/doc/A573714659/AONE?u=achw&sid=AONE&xid=ec6f732c
• Johnson, I. (2018). Communication huddles: The secret of team success. Journal of Continuing Education in Nursing, 49(10), 451-453. doi: http://dx.doi.org/10.3928/00220124-20180918-04
• Kapur, R. (2018). Barriers to effective communication. Retrieved May 1, 2019, from ResearchGate website: https://www.researchgate.net/publication/323794732_Barriers_to_Effective_Communication
• Kiernan, E. (2015). Communication theory and its applications in nursing and healthcare. In E. Kiernan, J. Lawrence & C. Perrin (Ed.), Building professional nursing communication (pp. 20-43). Port Melbourne, Australia: Cambridge University Press.
• Kiernan, E., & Martyn, J. (2015). Developing interpersonal capabilities for healthcare professionals. In E. Kiernan, J. Lawrence & C. Perrin (Ed.), Building professional nursing communication (p. 134). Port Melbourne, Australia: Cambridge University Press.
• Longest, B. B., Rakich, J. S., & Darr, K. (2000). Managing health services organisations and systems (4th ed.). Baltimore, Md: Health Professions.
• Mastering communication techniques. (n.d.) Retrieved April 27, 2019, from https://online.seu.edu/program-resources/mastering-communication-techniques/
• McGuire, R. (2001). Active listening. Student BMJ, 283. Retrieved from http://link.galegroup.com/apps/doc/A77756079/AONE?u=achw&sid=AONE&xid=a5b95638
• Murphy, M. (2015, August 6). Which of these communication styles are you? Retrieved April 27, 2019, from Forbes website: https://www.forbes.com/sites/markmurphy/2015/08/06/which-of-these-4-communication-styles-are-you/#2e7d5e53adb0
• Perrin, C., Stanley, D., & Taylor, M. (2015). Professional skills for nurses and other health professionals. In E. Kiernan, J. Lawrence & C. Perrin (Ed.), Building professional nursing communication (p. 188). Port Melbourne, Australia: Cambridge University Press.
• Warnecke, E. (2014). The art of communication: Australian Family Physician, 43(3), 156-158. Retrieved April 27, 2019, from https://search.proquest.com/docview/1527702740?accountid=174678
• What Communication Style Do You Use in the Workplace? (n.d.). Retrieved April 27, 2019, from https://ecic.online.adelaide.edu.au/blog/communication-styles