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Communication strategies for interprofessional teams

This is an excerpt from Interprofessional Education and Collaboration by Jordan Utley,Cindy Mathena & Tina Gunaldo.

By Dee M. Lance and Kim C. McCullough

General Communication Strategies

The goal of interprofessional teams is to offer patients effective and efficient treatment, and communication is a factor that influences the ability to meet that goal. Klinzing and Klinzing¹¹ have identified some internal and external forces that interfere with the ability to engage in conversations or meetings:

• The mind processes words faster than they can be spoken, which can result in the formulation of responses before the message has been delivered.
• As people try to multitask, they experience divided attention, which can interfere with the ability to sustain attention during meetings.
• Environmental distractors, such as cell phones, noise in the hall, and shuffling feet, can interrupt attention.

If we allow things to compete for our attention when we are in a meeting, then we stop being communication collaborators.

Communication is a complex process, and both speakers and listeners carry responsibility for success. We have identified 9 actions (modified from Seery)²⁰ that can support interprofessional teams in their communication efforts.

1. Use Engaged Listening

We have all experienced talking to people and knowing they were not listening. The listeners may be physically distracted, checking their watch or looking at their phone. They may appear distracted, and it is evident they are thinking about something other than what you are saying.

Engaged listening is required for effective communication, and it involves actually hearing and trying to understand what the speaker intends for you to understand. When listening, you can gain clarification by asking questions or rephrasing what you are hearing so that you're sure you fully understand the message as intended. Lake and her colleagues⁶ remind us that listeners share responsibility for ensuring they have an accurate and complete understanding of the message. They suggest the following techniques for active listening:

• Resolve differences between verbal and nonverbal messages.
• Reflect your feelings about what is being said.
• Ask clarification questions.
• Restate the speaker's message.

Using these techniques helps make communication a process that is a partnership between speaker and listener.

2. Use Nonverbal Communication

As stated previously, the words we select for the sentences we say make up only 7% of the message being conveyed. For both speaker and listener, the conscious use of proxemics, kinesthetics, facial expression and eye behavior, and paralinguistics can reduce miscommunications. For example, your body language should help convey your words and should indicate your openness to the message being sent. Other nonverbal communication acts, such as standing or sitting (proxemics), hand gestures (kinesthetics), eye contact (facial expression and eye behavior), and voice tone (paralinguistics), can enhance communication. For example, a team member may be more likely to speak openly if you are relaxed, have a friendly tone, and use an open posture with uncrossed legs and arms. Eye contact is also important; too much can be intimidating and too little can indicate you are nervous or disengaged. Conscious use of nonverbal cues can help counteract some of the professional, cultural, and linguistic differences you are likely to encounter on interprofessional teams. You can also use your understanding of nonverbal cues to interpret how other team members are feeling.

3. Be Concise and Clear

Team members' time is important, so you should be as concise as possible. Understanding the purpose of your interaction can help you stay focused and convey only the relevant information, which in turn helps the team achieve its common goal efficiently. You should not sacrifice clarity for conciseness, however. Be mindful of shared meaning; group diversity (e.g., professional, cultural, dialectical) could make jargon, professional acronyms, and colloquialisms problematic. Failure to be both concise and clear can cause frustration and confusion.

4. Be Personable

Everyone likes to work with someone who is pleasant, agreeable, and kind. These are some of the characteristics that could be considered personable. Using both verbal and nonverbal communication can help convey information about yourself. This can be as simple as smiling and nodding when you agree with what is being said, managing your tone so that passion does not sound like aggression, allowing others to state their opinion first so that you appear receptive to other ideas, or adding a personal message to an email so that your communication is less abrupt.

5. Speak With Confidence

When you convey to other team members that you are up to the task, then effective communication can occur. If you sound tentative about your contribution to the team, the team will be cautious about your ability to help meet the goal. Using nonverbal cues such as tone and stance can help portray confidence. You should also listen to the message others are communicating and then use engaged listening to seek clarification.

6. Show Empathy

Empathy, the ability to take the perspective of another person or to understand what someone is feeling, is a foundational skill for successful interactions. You do not have to agree with what people are saying to show that you appreciate their perspective. By saying to your team members, “I understand where you are coming from,” you let them know that you have heard their message. Remember that people from low-context and high-context cultures will react differently to disagreements, so use other tools to ensure relationships among group members stay intact.

7. Stay Open-Minded

We have discussed cultural, dialectical, and gender differences, all of which can influence shared meaning, relationships, and decision making. Using all of your tools to project openness to others' opinions and ideas is necessary for honest and effective communication.

8. Give and Receive Feedback

When you ask for clarification or restate something that has been said, you are providing feedback about your understanding and potentially about the effectiveness of the interaction. This is an essential skill for communication and for the interprofessional team to be efficient and effective. There are other types of devices as well, such as praising someone's presentation or providing supportive, constructive feedback that can strengthen any team. How you give and receive feedback can affect team morale, so having a handle on the cultural differences within the group can help you frame your questions and feedback.

9. Consider the Medium

A large part of figuring out the medium (e.g., oral, written, electronic) for any communication is considering the audience and purpose. Remember, when contemplating a written format, only a small portion of any attempt to communicate is conveyed by the words selected. Sensitive information may best be handled in person. Some communication devices, such as humor and sarcasm, use paralinguistic features and can fall flat when using written language. Additionally, when selecting a communication medium, careful thought should be given to any content that is sensitive or confidential.

Lake and colleagues⁶ suggest that structured reflection is useful to monitor and increase self-awareness as you practice communication techniques within your interprofessional team. Self-reflection can take the form of journaling and checklists before or after meetings and interactions. Choosing good communication strategies, consciously using them in conversations and meetings, and evaluating both your successes and failures is important for your individual success as well as for doing your part to ensure that the interprofessional team is effective and efficient.

EBP of Teamship: Closed-Loop Communication

Closed-loop communication (CLC) is a well-known team communication technique that has been studied as a mechanism for providing feedback in health care settings when performing collaborative tasks. It is often used during medical procedures and is adaptable for other health care teams. CLC consists of 3 steps:

1. A team member calls out an observation or message.
2. The second team member confirms that the message was received.
3. The first team member confirms that original message was understood correctly.

For example, during a team meeting, a nurse states that the patient is NPO. The PT on the team confirms that the patient cannot be given any food or liquids by mouth. The nurse confirms by stating, “That is correct, the patient cannot be given any food or drink even if the patient requests it.”

In a case study, Johnson and colleagues²¹ investigated CLC along with two other communication techniques, shared mental model (SMM) and mutual trust (MT). SMM is based on the notion that, over time, team members develop a common context that facilitates understanding and the prediction of outcomes. MT is based on the shared belief that team members will do what they are supposed to do and that their actions will protect the team. The authors found that CLC was most helpful to team communication when used in conjunction with SMM.

Collaborative Corner: Self-Reflection

You may want to start your self-reflection with the following types of questions:

• What message am I sending?
• Who am I trying to convince and why?
• Is the purpose of my communication to achieve a group goal or a personal one?
• Am I open to the other ideas presented?
• How do I want my message received, or how was my message received?

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