SKILLED INTERPERSONAL COMMUNICATION

The importance for health care professionals of having a "good bedside manner" has long been realized. In 400 BC, Hippocrates noted how the patient "may recover his health simply through his contentment with the goodness of the physician". In recent years, this belief in the power of communication to contribute to the healing process has been borne out by research.

Rider and Keefer (2006) and Tallman et al. (2007) have shown that high levels of practitioner interpersonal skill are positively correlated with increases in the quality of care and effective health outcomes, while ineffective skills are associated with decreased patient satisfaction, increased medication errors and malpractice claims. These findings are corroborated in the field of nursing, where effective interpersonal communication has been shown to be related to improved health outcomes, such as greater patient satisfaction and quality of life (Klakovich and dela Cruz, 2006).

The nature of interpersonal skills

Hargie (2006a: 13) defined interpersonal skill as "a process in which the individual implements a set of goal-directed, inter-related, situationally appropriate social behaviours, which are learned and controlled", it emphasises seven separate components of skill:

1. Skilled performance is part of a transactional process which involves: formulating appropriate goals, devising and implementing related action plans, monitoring the effects of behaviour, being aware of and interpreting the responses of others, taking into account the context in which interaction occurs and adjusting, adapting or abandoning goals and responses in the light of outcomes.

2. Skilled behaviours are goal directed: goals both motivate and navigate the interpersonal process (Berger, 2002; Oettingen et al., 2004).

3. Skilled behaviours are interrelated and synchronised.

4. Skills should be appropriate to the situation.

5. Skills are defined in terms of identifiable units of behaviour: verbal and nonverbal.

6. Skilled behaviours are learned.

7. Skills are under the cognitive control of the individual: learning when to employ behaviours is just as crucial as learning what these behaviours are and how to use them.

Zimmerman (2000) identified four key stages in the learning of skills:

-Observation
-Emulation
-Self-control
-Self-regulation: the person learns to use the skill appropriately across different personal and contextual conditions.

Communication and interpersonal communication

Communication is a transactional process, inevitable, purposeful, multidimensional and irreversible.

Conceptual model of skilled interpersonal communication 

This model builds upon skill models developed, inter alia, by Dickson et al. (1997), Bull (2006) and Hargie (2006c), based upon early theorising by Argyle (1983). It identifies six elements of skilled interpersonal interaction:

1. Person-situation context: personal characteristics, knowledge, motives, attitudes, personality, emotion, age, gender, situational factors and culture.

2. Goals: 

-Task and relational goals

-Instrumental and consummatory goals

-Implicit and explicit goals

Goals are hierarchically structured and have a temporal dimension (short or long term). They differ in their level of concreteness and compatibility, goals may be similar, complementary or opposed.

3. Mediating processes: these processes mediate between the goal being pursued, our perceptions of events and what we decide to do about them.

-cognitive processes: Nelson-Jones (1996) recommended a seven-stage framework for rational decision making: confront, generate options and gather information, assess the predicted consequences of options, commit to the decision, plan how to implement the decision, implement the decision and assess consequences of implementation.

-affective processes: skilled communication must always be adaptively and reflexively responsive to the emotional needs of the other.

4. Response: plans and strategies decided upon are implemented at this stage, there is no guarantee that their translation into action will be flawless or successful, When people fail to achieve an interactional goal but persist, they tend to adjust low-level elements of the plan (e.g. volume or speed of speech) rather than more abstract higher order elements (e.g. general strategy)(Knowlton and Berger, 2007).

5. Feedback: enables us to assess the effects or our communications, convergence towards mutual understanding and shared meaning is proportional to the degree which feedback (verbal or nonverbal) is put to effective use.

6. Perception: not all information potentially available via feedback is perceived, and not all information received is perceived accurately. Perception is an active and highly selective process (Eysenck, 1998). Skilled communicators have the ability to make accurate perceptions of self and how one is being perceived by others.

Sources:
-http://www.redtierabbit.com/what-are-interpersonal-skills/
-Hargie O. 2010 Skilled interpersonal communication: Research, theory and practice. Hove Routledge.