There are five principles of verbal communication and a further five for nonverbal communication. These principles are important for the sender and receiver to achieve effective communication and establish a shared understanding (Cheesebro, O’Connor & Rios, 2010).
The first principle of verbal communication is to recognize that all languages have value. There is no language that is better than the other in terms of logic, ability to convey thought or complexity.
The second principle is to understand that everyone speaks a dialect. A dialect is a regional variation of language. It includes unique pronunciation, vocabulary and grammar. Despite the differences in dialects, one can still understand what is being said and should not let stereotypes attached to persons with these dialects negatively influence them.
The third principle of verbal communication is to understand that words do not have the same meaning to all people. Words could be misunderstood for other words with similar pronunciation. There same word that have different meaning based on the origin of the communicators. For instance, bird in British English is a lady, while in American English it is an insulting hand gesture.
The fourth principle is to recognize variations in how spoken language is used across cultures. According to Cheesebro, O’Connor and Rios (2010), there are some cultures who value the spoken message while others skeptical of language and value silence.
The fifth principle of verbal communication is to follow the suggestions for verbal communication as one way to move closer to a shared understanding. These suggestions include being willing to share and using specific language.
Nonverbal communication is present everywhere and makes up a large part of the message one communicates. Mehrabian’s research on communication in the 1960s revealed that only 7 per cent of the meaning is in the spoken word. 55 per cent of the meaning is in the facial expressions while the remaining 38 per cent is in the way the words are said (1981).
The second principle of nonverbal communication is that people do very little to learn and understand nonverbal communication. The lessons focus on speech and grammar, neglecting the nonverbal dimensions of communication. One requires a greater awareness and understanding of nonverbal communication in order to interpret these messages correctly and improve human interaction.
The third principle is that nonverbal messages are sent in advance of verbal messages. We send out communication using features such as our facial expressions, clothes, walking style, body posture and hairstyle, before we open our mouths to speak.
The fourth principle is that most people’s nonverbal messages are a reflection on their identities, emotions, relationships and trust level. The final principle is that nonverbal communication is culture bound. One should not assume that nonverbal communication is not universal. It is important to consider the various types of nonverbal communication across cultures.
On the basis of personal experience I have found the fifth verbal principle and the third and fourth nonverbal communication principles are the three most critical ones. I had once thoroughly prepared for a formal interview. Dressed appropriately, arriving in time and having revised on the potential interview I was ready for to face the panel. I walked into the interview room, full of confidence and greeted the interviewers in the customary manner. However, after two minutes into the interview, I could tell they were not interested in me. I later found out that my walking style, feeble handshake and lack of eye contact had spoken volumes about my character even before I had a chance to verbally express myself.
The third principle of verbal communication is critical for effective communication. Misunderstandings are a hindrance to effective communication. If the verbal messages conveyed are misinterpreted, then effective communication cannot be achieved. One should understand that words do not have the same meaning to all people. Furthermore, the sender should ensure that they use specific language in conveying their thoughts and ideas, since use of general language increases the likelihood of misunderstandings.
The second critical principle is that nonverbal messages are sent in advance of verbal messages. One’s emotional state is revealed in their nonverbal messages. The feelings the communicators have for each other may override the spoken word. A frown or smile will convey the emotional state of the sender before the verbal message is transmitted. Remember, light travels faster than sound!
Finally, the fourth principle of nonverbal communication is critical for effective communication. One should remember that nonverbal messages will reflect their trust level, identity, emotions and relationships. It is important to ensure that there is a match between ones verbal and nonverbal messages. When the verbal and nonverbal messages complement each other the trust between the communicators is increased. However, nonverbal behavior that contradicts the spoken message can create distrust and suspicion.
The patient-physician communication is crucial for quality health care to be delivered and to ensure the safety of the patient. Using the 10 principles, detailed above, one can be able to promote and improve communication in the health care workplace. The Four Habit Model is used to improve the verbal communicative process between the physician and patient. This model conceptualizes the basic communication tasks in the clinic encounter and how they relate to one another (Rao et al., 2010). The four habits are investing in the beginning, eliciting the patient’s perspective, demonstrating empathy and investing in the end. For effective nonverbal communication in health care, SURETY method is used. This allows for cultural variation and appropriate use of touch (Stickley, 2011).
The first habit in the Four Habit Model focuses on building a rapport between the patient and physician. The two will engage in social talk until they are comfortable in each other’s presence. The patient should then disclose all relevant concerns to the best of their knowledge in a detailed manner.
Using the second habit, one will get further details on the patient’s condition. The patient should state specific request, wishes and expectations; describing in detail how the illness affects their daily life. They will express personal beliefs and worries about the symptoms to which the physician will demonstrate respect. The physician will provide details on the symptoms, concerns and previous treatments and answer any questions in reasonable detail.
The third habit calls for feelings and concerns to be expressed. The communicators should talk openly about psychological issues. The physician should listen for understanding and responding with an expression of empathy.
In the last habit, the physician shall use the patient’s own language and terms to describe diagnosis and treatment plans. The opinions and concerns about the choices should be made known. The patient should ask questions and seek for clarification, restating the decisions made during the visit.
SURETY is an acronym for S – sit at an angle to the client, U – uncrosses legs and arms, R – relaxes, E- eye contact, T- touch and Y – your intuition.
According to Stickley, sitting at an angle creates a non-confrontational and comfortable seating arrangement that is ideal for one-to-one work. Crossing ones arms and legs is a nonverbal message for defensiveness. Uncrossing them will communicate that one is open and receptive. The physician should relax in the appropriately assumed position as they listen to the patient. They must ensure that they do not look overly relaxed or concerned. The perfect balance must be struck. Maintaining eye contact communicates respect and is an indicator that one is paying attention. Since appropriate use of touch is not universal the physician should display cultural sensitivity. Respectful use of touch can communicate compassion, empathy and understanding. Every human interaction is unique; therefore the medical practitioner should trust their intuition when implementing the components of SURETY (2011).
While and Dewsbury discuss the impact of technology on nursing in the International Journal of Nursing Studies (2011). Information and communication technology has had a positive impact on communication in health services. It has increased access to information and provided various forms of remote support.
Electronic records are available using technology. These electronic health records and electronic patient records are used to share patient information. They ensure that information that is communicated is credible and current as the records are updated after each visit.
Technology gives health care providers a channel to remotely access to patients. Using videoconferencing, telephones and various website and portals, professionals can communicate with their patients and peers. This has increased the reach and rate of communication. Nurses are able to interact with patients remotely allowing for the nurses to manage larger caseloads. These innovations have not improved communication in health care, but also reduced the time to travel and other health care related costs.
References
Chessebro, T., O’Connor, L., & Rios, F. (2010). Communicating in the workplace. Upper Saddle River, NJ: Prentice Hall.
Mehrabian, A. (1981). Silent messages: Implicit communication of emotion and attitudes. Belmont, CA: Wadsworth.
Rao et al. (2010). Engaging communication experts in a Delphi process to identify patient behaviors that could enhance communication in medical encounters. BMC Health Services Research, 10, 2-15. doi:10.1186/1472-6963-10-97
Stickley, T. (2011). From SOLER to SURETY for effective non-verbal communication. Nurse Education in Practice, 11, 395-398.
Whiles, A., & Dewsbury, G. (2011). Nursing and information and communication technology (ICT): A discussion of trends and future directions. International Journal of Nursing Studies, 48, 1302-1310
