Effective Communication Skills

We spend 80 percent or more of our waking hours on the four basic communication skills of listening, speaking, writing and reading. Yet, how often do we think of the importance of these skills in our personal and professional lives? The process of human communication is so complex that scientists have yet to unravel its mysteries. Plus, we learned to communicate so early in our lives that we take it for granted.

The Early Years
Communication actually began in the first few days of our lives, when crying brought food, comfort and companionship. By the end of the first year, we had learned the power of a few simple words, such as "No!" At age 2, we were putting words together in short sentences, such as "More juice," and we learned that words symbolized or represented objects, actions and thoughts. Ages 3, 4 and 5 brought a rapidly increasing vocabulary of up to 2,000 words and a mastery of the rules of language. All this developed without any conscious thought of the miraculous process of communication!

In subsequent years, we honed our communication skills at home and school, and in the community. By the time we entered the workforce and began to practice in health care, we had a twenty years or more of communication experience, both academic and social, to bring to a job.

For Success, Communication Skills Rank #1
In today's workplace, communication skills are rated first in order of importance for job success, yet most of us in health care have little or no practical training on how to communicate effectively with others.

Can your communication skills in the workplace be improved? The answer is a resounding yes! Let's start by defining communication, listing the seven points at which communication can falter from speaker to listener, and finally identifying some of the specific barriers to effective communication.

To define communication, the key word is "symbols." Symbols are things that stand for other things. Words are symbols, not the real objects they represent. So communication is the transmission of thoughts, ideas and feelings through the process of "symbol-using."

Pathway to Proper Communication
There are three primary phases of symbol-using: Preparing a message in the brain of the sender, transmitting the message from the brain of the sender to the brain of the receiver, and translating the message in the brain of the receiver.

Potential disruptions in this communication pathway can occur at seven points:

1. When the sender decides the key ideas of the intended message;

2. When the sender codes these ideas into words;

3. When the sender speaks or writes the words to be transmitted;

4. When the message is transmitted through whatever media apply - airwaves, paper or devices such as telephones, computers or even hearing aids;

5. When the symbols are received by the senses of the receiver, primarily through the eyes or ears;

6. When the symbols are conveyed from the sense receptors to the brain; and

7. When the symbols are decoded in the brain of the listener.

How closely do the messages received by your patients resemble your original, intended messages? We need to check the seven possible points of message disruption by asking questions corresponding to each:

1. Is the content and arrangement of the message clear and orderly in your own mind? Common barriers to achieving this are not staying with one key idea per comment and not determining the special goals of each verbal exchange.

2. Has your intended message been coded into words familiar to the intended listener? If you are not using words the listener knows, or not defining new or technical terms clearly, a breakdown may occur.

3. Are your words articulated clearly? Be sure you are speaking directly to the listener with appropriate volume and pronunciation.

4. Have you reduced or eliminated noises and distractions that might interfere with the transmission of the message? When other people are talking or interrupting your session, or telephones are ringing or air conditioners are humming in the background, your conversation partner may have trouble receiving your message.

5. Are the hearing and vision abilities of your patient adequate to hear and see the symbols used in transmitting the message? If your patient has reduced hearing or vision, segments of your messages may be missed.

6. Are there any physical or mental barriers to the transmission of the sound and sight stimulus from the sense organs to the brain of your listener? Consider that the listener may be preoccupied with other concerns, under stress, sleep deprived, or have cognitive or perceptual problems, such as dementia or an auditory processing disorder.

7. Is your patient familiar enough with the words and phrases in the message to translate them into the meanings you intended? Common barriers to comprehension at this stage include the patient not being fluent in your language, not understanding health care jargon, or not knowing the implied specifics of general terms used.

Troubleshooting Conversation
An important communication tool for checking the accuracy of the message received, in comparison with the intention of the message sent, is for you to ask the patient to briefly summarize the main points of what was understood. You can then alter or add to any distorted or missing parts by briefly restating or correcting the ideas received from the other person. In this way, the output and input of messages can be continuously monitored.

When misunderstanding occurs, review the seven points along the communication pathway to see where any breakdowns took place. You can then take steps to remedy these problems in subsequent communication.

Allan Ward is professor emeritus of speech communication at the University of Arkansas at Little Rock. He can be reached at alward@ualr.edu via e-mail.

Jess Dancer is professor emeritus of audiology at the University of Arkansas at Little Rock. He can be reached at jedancer@ualr.edu via e-mail.

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