Interpersonal and Interprofessional Communication: Structure, Safety and Openness
Structured communication is the core skill
The exam rewards candidates who can show a structure. Use ISBAR for every handover and escalation: Identify (yourself, the patient, the ward), Situation, Background, Assessment (your clinical impression, not a second data dump), Recommendation (what you want and by when). Close the loop on verbal orders by reading back and being acknowledged. When you feel unheard, use graded assertiveness - PACE (Probe, Alert, Challenge, Escalate) or CUS (Concerned, Uncomfortable, Safety issue).
Consumers, whanau and health literacy
Effective communication is a Code right, not a courtesy. Match language and format to the person; use a professional interpreter, never a child; check understanding with teach-back ("tell me how you will take this medicine at home"). Whanau involvement is normal and expected in New Zealand practice - confirm the consumer's wishes about who is present and who is told what, and record those wishes.
Open disclosure
When something goes wrong, acknowledge it early, apologise, explain what happened and what happens next, and document it. Open disclosure is an ethical duty, not an admission of legal liability, and it should not wait for an investigation to finish.
The traps
- In ISBAR, "Assessment" is your interpretation - reciting observations again is a common wrong option.
- Vague escalation ("someone should look at her") earns a vague response. State the concern and the timeframe.
- Documentation written hours later is a red flag; write it as the event occurs.
- Corridor conversations and social media posts are privacy breaches, not team bonding.
- Saying "I told them" is not handover; handover requires confirmation of receipt.
Rule of thumb
Communicate as though the next person has no context and a very busy night: complete, specific, and closed-loop.