Communication

Communication, or the exchange of information, is a critical component of relationships. There are three major elements to communication:  a sender, a message, and a receiver. Today, communication can be achieved in numerous ways, including verbally, non-verbally, visually, and with the use of a variety of technological tools. Communication is often complex and can include the use of several types to convey a message. 

Nursing faculty who lead courageous, challenging, or difficult conversations are encouraged to first engage in personal reflection about the topic and purpose, establish ground rules or guidelines for having the conversation, and do some preparatory work prior to teaching about or engaging with others in these types of communication.

Life Coach and Blogger Sarah Godfrey and others identify the following ingredients for initiating and engaging in courageous conversations:

1. Be clear about the issue
2. Be truthful throughout 
3. Know your objective
4. Adopt a mindset of inquiry
5. Manage the emotions
6. Be comfortable with silence
7. Preserve the relationship
8. Be consistent
9. Develop conflict resolution skills
10. Choose the right place to have the conversation
11. Know (and practice) how to begin. What is the framework for the conversation? 
12. Be compassionate
13. Stay calm (breathe)
14. Don’t single anyone out
15. Assist all in identifying personal blind spots, preconceived views, biases
16. Listen to all perspectives
17. Be curious about drivers of perspectives
18. Don’t avoid tough questions or comments
19. Don’t tolerate any type of bullying behaviors that can intimidate others or impact participation
20. Summarize what was discussed and solicit feedback/input on any missing elements
21. Reflect on next steps or additional needs / actions
22. Check in with how people are feeling and how they experienced the conversation

Reflection:

Questions and exercises to consider with classmates and/or colleagues:

• Think about a time when you found yourself trying to communicate about a challenging or controversial matter. What happened? What did you learn about yourself and about your personal communication skills? What would you do differently today?
• Reflect on why you think nurses may need to engage in difficult conversations. Are there benefits to patient care?
• Reflect on your comfort level in communicating with others. If you believe that you need to be more proficient in communicating with others, what specifically do you need to do to increase your comfort and proficiency?

Helpful Resources

Navigating Courageous Conversations 
California State University, Northridge Faculty Development Teaching Toolkit

Dare to Dialogue: Creating Safe Spaces to Talk About Race
Sphinx (YouTube)

The Power of Vulnerability
Brene Brown TED Talk (YouTube)

Managing Difficult Classroom Discussions
Indiana University Bloomington Center for Innovative Teaching and Learning:

Teaching Tolerance in Higher Education
Kate Shuster, Learning for Justice

Recommended Readings

Chou, C. & Cooley, L. (2017). Communication Rx: Transforming Healthcare through Relationship-centered Communication. McGraw Hill Publishers.

Clancy, C. (2018). Critical Conversations in Healthcare: Scripts & Techniques for Effective Interprofessional and Patient Communication. Sigma, 2^nd edition.