Communication and Interpersonal Skills
Therapeutic communication
Effective communication is a clinical skill, not a personality trait. It requires active listening, appropriate eye contact and open posture, open questions, reflection, paraphrasing, summarising, and the deliberate use of silence. Empathy - recognising and naming the patient's feeling - differs from sympathy, which centres on your own emotion. Adapt to health literacy, sensory impairment, cognitive change, language and culture; use professional interpreters rather than family members for clinical conversations, and confirm understanding with teach-back.
Structured tools
Know ISBAR (identify, situation, background, assessment, recommendation) for handover and escalation, and how to structure a difficult conversation: prepare, explore the patient's understanding, share information in plain language, respond to emotion, agree a plan. Documentation must be contemporaneous, factual, objective and free of speculation or judgemental language.
Traps
- "Why" questions, which invite defensiveness and imply blame.
- False reassurance ("don't worry, you'll be fine"), which blocks further disclosure.
- Giving advice or solving the problem instead of exploring it.
- Premature reassurance, changing the subject, or filling silence with your own story.
- Assuming consent because the patient signed a form, or assuming understanding because they nodded.
Rule of thumb
When a question asks for the best response, choose the option that seeks the patient's perspective and feeling before providing information or advice. Exploration first, explanation second.
Worked example
A patient says, "I don't think I can go through with the operation." Best response: "Tell me more about what is worrying you." This invites the patient's concerns without judgement. Explaining the procedure's benefits, or saying there is nothing to worry about, closes the conversation.