Nine Principles of Human Communication

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“Generally, when verbal and non-verbal messages contradict each other, people tend to believe the non-verbal more than the verbal messages”

New Horizons

courtesy of De Gruyter publishing

 

In my previous blog, I looked at 7 Myths of Human Communication, and how they relate to leadership & management. In this blog, I will focus on 9 Principles that underpin effective communication.

The source of information for both of these blogs is an excellent book that I have recently read called “New Horizons in Patient Safety: Understanding Communication by, Hannawa, Wu & Juhasz (published by De Gruyter).

These principles remind us just how difficult it is to achieve a shared understanding with another person. One has to wonder if we ever really understand what is intended by another person.

Principle 1: Communication varies between thought, symbol and referent

According to Annegret Hannawa, human communication is “fundamentally an interactive meaning-making process”. Put simply, we use the joint creation and interpretation of symbols (words, gesture, images etc) to try to achieve shared understanding. So, our thoughts are encoded into symbols and behaviours (which have no intrinsic meaning of their own). This leads to the first challenge of “making meaning”, as there needs to be enough “common ground” for both parties to achieve a shared understanding.

Principle 2: Communication is a non-summative process

“Human communication is an interpersonal process that involves much more than the mere sum of its components” (Hannawa).

The assignment of symbols happens within an individual, but the meaning-making process (i.e. communication) happens between people. Because of this, communication cannot “breakdown” as it was not guaranteed in the first place. However, it can malfunction and the wrong meaning can be attributed to message being transmitted.

Principle 3: Communication is functional

Communication works best when it is purely factual but the nature of human relationships is such that often people are not interested in communicating purely factual information. The introduction of humour, sarcasm, persuasion etc. makes it more challenging for a true “shared meaning” to be achieved.

Principle 4: Communication is more than words

It is often said that “the meaning of the communication is the response it produces”.

Communication is more than just an exchange of words. We cannot “not” communicate. Silence can communicate just as much as words. In everyday interactions, we are interpreting both verbal and non-verbal symbols or signals. Generally, when verbal and non-verbal messages contradict each other, people tend to believe the non-verbal more than the verbal messages (Sellers & Beall, 2000)

Principle 5: Communication entails both factual and relational information

“In the same way that verbal messages are always accompanied by non-verbal messages, factual messages are always accompanied by relational messages” (Hannawa). The relationship between those communicating (social, status etc) plays a crucial part in how the communication is interpreted. It is not just what is said, and how  it is said, but the relationship between the individuals that will impact upon the “meaning” for the recipient

Principle 6: Communication is contextual

The meaning of a communicated message largely depends on the context in which it is encoded and received. This builds on Principles 4 & 5. Hannawa describes 5 different contexts that can come into play:

  • Functional (the goals of the interaction)
  • Relational (see Principle 5)
  • Environmental (the physical setting)
  • Chronological (the timing and sequencing as well as the timeliness)
  • Cultural (including beliefs)

These factors are particularly significant in interactions between line management and their reports

Principle 7: Preconceptions and perceptions vary among communicators

“Our individual life experiences contribute to idiosyncratic preconceptions and perceptions of communicated messages and behaviours” (Hannawa). Communication is an interactive negotiation to bridge these idiosyncrasies and establish “common ground”. This is the foundation for co-constructing a shared understanding.

Principle 8: Redundancy in content and directness in channel enhance accuracy

The appropriate repetition of content (see relevancy, primacy and recency) can enhance communication. Choice of communication channel can also have an impact, with direct face-to-face communication being superior to more indirect channels. It seems that having access from as many senses as possible can have an impact on achieving a shared understanding. this is un-surprising, given that we tend to trust non-verbal over verbal messages.

Principle 9: Communication is equifinal and multi-final

Reading principles 1-8 you might conclude that communication is random, but it is not. In fact, these principles tell us that there may be many different ways to achieve a shared understanding. With experience we can learn to choose the best route to achieve the desired result. For instance, sometime a person in authority needs to use that authority (tell assertive) to avert disaster (e.g. the chief surgeon in the operating theatre). However, in a different context a more persuasive (ask assertive) approach may be better (e.g. as a supervisor helping a junior with their career plan). No single tactic works all of the time.

There are many possible paths to the same outcome (equifinal) and many possible outcomes to the same path (multi-final).

Excellent communication requires us to be as aware of, and as open minded as possible to these 9 principles.

Mark De Cosemo is a Consultant, Trainer & Coach teaching influential communication across a variety of business sectors.

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Seven myths about human communication

Seven myths about human communication

If there is one thing that these 7 myths tell us, it is that as communication is a shared process, there is an onus on both parties to ensure they have the correct “shared understanding

New Horizons

courtesy of De Gruyter publishing

I recently read an excellent book called “New Horizons in Patient Safety: Understanding Communication (Hannawa, Wu & Juhasz, De Gruyter) which examines the role that communication plays in patient safety issues through 39 case studies. This excellent book  is essential reading for anyone involved in teaching or delivering health care. As a teacher of Leadership & Management and the role that communication plays in these skills, I cannot recommend this book enough.

One of the chapters (by Annegret F Hannawa, Ph.D.) explores common myths about communication. In this blog, I will discuss the 7 myths presented in the book, and add in a Leadership & Management perspective.

Myth 1: Communication is a simple and functional task

Communication is often, incorrectly,  conceptualised as a linear task of transferring a message. In fact, it is, as Hannawa describes it “interactive, error prone activity that often fails to accomplish its purpose of attaining a shared understanding”. This has implications not only for patient safety, but also in effective leadership & management, as leaders and managers often assume that “message sent is message received (and understood)”. The only way to confirm accurate communication is for the other person to be able to demonstrate a shared understanding by telling you their understanding. This is equally true in leadership and management situations, as well as HCP-patient communication.

Myth 2: Communication equals words

We’ve all played “Chinese whispers” where a message is passed along a “human chain” of several individuals. This sequential communication process often results in reduction in the quality and quantity of the information conveyed. This can be fun in a parlour game, but has serious consequences for patient safety and in leadership & management situations.

Then there is the impact of “non-verbal” communication. Language is often ambiguous and we “look” to body language and tone of voice to help us put a final interpretation on the meaning or significance of the message.

Myth 3: Communication equals information transfer

The case studies in the book illustrate how communication is more than just the conveying of factual information. The message recipient will have a set of personal filters through which the information must pass. These include personal experience, values, beliefs, cultural and social filters, as well as relationship filters. The relationship between the initiator and the receiver has a massage effect on the understanding (HCP – patient, manager-report)

Myth 4: Communication can be accessed, deposited and delegated

Written communication is subject to the same rules of (mis)understanding as verbal communication. Just because it is written down (deposited) does not guarantee communication. In fact, it may increase the risk of misunderstanding as shared understanding is not guaranteed. Whatever medium is used, it always pays to check that there is shared understanding, not assume that it is obvious.

Myth 5: Communication is not about individual understanding 

As Hannawa puts it “Communication is an interpersonal meaning-making process” which occurs between not within people.  Yet the assumption is often that everybody has the same understanding of terminology or jargon. This “common ground fallacy” can result not only in patient safety issues, but also management issues. Take the example of setting a timescale for a goal or objective. If I want to a achieve a goal “by December”  what date comes to mind? By when does the goal have to be achieved? Write it down. You can choose any date from 30 November to 31 December and be right! That can represent a difference of up to 32 days between two individuals. To ensure shared understanding we need both parties to verbalise and document a specific date.

Myth 6: More communication is better

People tend to assume that more communication is better communication. As Hannawa reminds us though “the truth, however, is that the functional form of the association between communication skills and competence is an inverted U, with both too little and too much of any given behaviour being perceived as inappropriate and ineffective in most healthcare interactions”. There is still a place for structure and repetition, especially in presentations  (see relevancy, primacy and recency) but remember; the only difference between a cure and a poison is the dosage!

Myth 7: Communication “breaks down”

Many people describe “failed communication” as a “breakdown” in communication. This perspective “mistakenly implies that communication failure equates to a mere lack  of communication rather than incomplete communication” (Hannawa). This has massive implications for organisations as it can perpetuate a “blame culture”, something that is very relevant to patient safety. As Hannawa states in the book “across the 39 case studies. poor outcomes were the result of no established shared understanding. What was never established cannot “break down”.

If there is one thing that these 7 myths tell us, it is that as communication is a shared process, there is an onus on both parties to ensure they have the correct “shared understanding“. For those in positions of responsibility (e.g managers to reports or HCPs to patients) there is increased onus on the initiator of the communication to confirm a shard understanding, not assume it

In the next part of this blog we will explore the Nine Core  Principles of Human Communication