22 - Roles & Communications in Collaborative Practice

What are some specific goals of communication?

• To change behavior

• To get action

• To ensure understanding

• To persuade

• To get + give information

• Interconnectedness: these goals overlap

What is the transmission model of communication?

• A linear model where a sender transmits a message through a channel to a receiver.

• No active feedback loop in this model

What are components of the transmission model?

• Sender: originator of the message who encodes the information

• Message: content being communicated

• Channel: medium through which the message is sent (e.g., email, verbal, text message)

• Receiver: recipient of the message who decodes it

What are limitations of the transmission model?

• One-way only: Assumes that communication is a one-time act where the sender has full control over the message and how it is understood

• No feedback loop: does not account for the receiver’s response or interpretation of the message

• Assumes the message is always understood

• It does not consider the influence of noise (disruptions that can distort the message) or context (social, cultural, or relational factors)

What is the interaction model?

Two-way model where communication includes feedback and happens between a sender and receiver, but still in turns (not simultaneously).

What are components of the interaction model?

• Sender: person who transmits the message initially

• Receiver: person receiving and interpreting the message

• Message:content being communicated

• Channel: method used to send the message (email, phone call, verbal,

• Feedback: response from the receiver to the sender

• Noise: anything that interferes with the clarity of the message (e.g., physical noise, psychological distractions)

• Context: situation or environment that influences the communication (can be relational, physical, or cultural)

What are limitations of the interaction model?

• Still not simultaneous

• Doesn’t show continuous exchange

• Overly simplified for complex healthcare environments

What is the transaction model?

• A simultaneous, dynamic model where all participants are both senders and receivers at the same time. Communication is influenced by context, environment, relationships, and shared meaning.

• Not just exchange of messages, but as a way to create and negotiate shared meaning and social realities within specific social, cultural, and relational context

• The most reliable and applicable

What are components of the transaction model?

• Social context: expectations and norms of a given society

• Relational context: personal dynamics between communicators (e.g., friends, coworkers, family members)

• Cultural context: influence of cultural background and practices on communication

• Communicators: no fixed "senders" or "receivers" because both participants continuously send and receive messages

• Messages: both verbal and nonverbal communication, and messages

• Context: occurs within multiple contexts simultaneously—social, relational, and cultural

• Noise: anything that can disrupt the message

• Feedback: constant feedback is present

What are limitations of the transaction model?

• Very complex

• Hard to clearly map who influences what

• Real-time interactions can be difficult to analyze step-by-step

List barriers in healthcare communication and their impacts.

Inconsistency in team membership: rotating staff → less familiarity
   Impact: missed info, unclear expectations, poor cohesion

• Lack of time: high-pressure settings
   Impact: rushed communication, errors

• Lack of information sharing: key info not communicated
   Impact: gaps in care, missed details

• Hierarchy: juniors afraid to speak up
   Impact: limited input, repeated mistakes

• Defensiveness: shutting down when feeling criticized
   Impact: blocked dialogue, reduced trust

• Different communication styles: direct vs indirect
   Impact: misunderstandings

• Fatigue: long hours, exhaustion
   Impact: poor attention, memory errors

• Overworked: heavy workload, burnout
   Impact: skipped steps, weaker communication

• Lack of role clarity: unclear responsibilities
   Impact: missed tasks, duplication

• Conventional thinking/misconceptions: outdated assumptions
   Impact: resistance to new ideas

• Emotions: stress/anger affect clarity
   Impact: conflict, misunderstandings

• Language differences: patient–provider language gap
   Impact: trouble describing symptoms, understanding instructions

• Poor listening skills: distracted or selective hearing
   Impact: missed concerns, incomplete histories

• Noise and distractions: chaotic environment
   Impact: incomplete information exchange

• Assumptions: thinking info was already shared
   Impact: gaps and errors

• Conflict: differing opinions or dynamics
   Impact: toxic environment, poor teamwork

• Distractions (internal/external): multitasking, busy settings
   Impact: missed details, reduced focus

What are some best practices for communicating in healthcare?

• Mutual respect

• Ask for input and opinions

• Care about team members as people

• Acknowledge others’ expertise

• Thank people for their work

• Constructive feedback — giving

• Give feedback privately and in a non-threatening setting

• Be timely

• Start with a positive

• Be specific and objective (not personal)

• Be respectful

• Explain consequences of the issue

• Provide next steps / solutions

• Goal: help and improve, not punish

• Constructive feedback — receiving

• Appreciate feedback

• Avoid excuses

• Take feedback seriously and reflect

• Do honest self-evaluation

• Treat feedback as a learning opportunity

• Follow up on progress

• Teamwork

• Emphasize collaboration and shared goals

• Highlight team accomplishments

• Stay focused on patient-centered care

• Redirect conflict back toward improving patient outcomes

How do you give constructive feedback?

• Give in a non-threatening setting: private, supportive environment.
  Ex: schedule a 1-on-1 instead of correcting someone in front of the team.

• Timely: give feedback as soon as possible while the issue is fresh.
  Ex: follow up after a procedure, not the next day.

• Start with a positive: begin with what they did well before offering improvement.
  Ex: “You’ve managed intake well; one area to improve is double-checking dosages.”

• Be specific (objective, not personal): focus on observable behaviors.
  Ex: “I noticed errors in the medication log,” not “You’re careless.”

• Respectful: calm, professional tone; avoid blame or personal attacks.

• Explain consequences: link the behavior to real-world impact.
  Ex: “Incorrect documentation can lead to med errors and affect patient safety.”

• Provide next steps: give clear guidance for improvement.
  Ex: “Let’s review the medication log process together.”

• Goal is to help, not punish: frame feedback as growth-focused.
  Ex: treat feedback as a learning and development opportunity.

How do you receive constructive feedback?

• Appreciate the feedback: acknowledge the effort and thank the person.
  Ex: “I appreciate you bringing this to my attention.”

• Don’t make excuses: avoid defensiveness; listen first.
  Ex: focus on how to improve rather than explaining why it happened.

• Take your feedback seriously: treat it as helpful, not personal criticism.
  Ex: reflect and act on the feedback.

• Do a self-evaluation: honestly assess your own behavior.
  Ex: “I tend to rush documentation; I can be more thorough.”

• Take it as a learning opportunity: use feedback to grow and improve skills.
  Ex: seek extra training if feedback reveals knowledge gaps.

• Follow up: show progress and ask for clarification if needed.
  Ex: “I’ve been working on your suggestions; any feedback on my progress?”

Why are other healthcare professionals important?

• improves patient outcomes

• fosters interdisciplinary collaboration

• reduces medical errors, enhances efficiency and workflow

• builds mutual respect and trust

• supports patient-centered care, improves communication

• aligns with value-based care models (emphasizes outcomes, quality, and patient satisfaction)

• prepares for leadership roles

• adaptation to evolving healthcare models

List some examples of different roles of nurses.

• Licensed Practical Nurse (LPN):
  Works under an RN; typically completes a 1-year technical program.

• Registered Nurse (RN):
  Holds an associate’s or bachelor’s degree; provides day-to-day patient care in many settings.

• Advanced Practice Nurse (APN):
  Master’s or higher; includes:

  • Nurse Midwife

  • Clinical Nurse Specialist (CNS)

  • Certified Registered Nurse Anesthetist (CRNA)

  • Nurse Practitioner (NP)

What is the role of the clinical psychologist?

Clinical Psychologists are responsible for conducting assessments and interventions for those with mental health disorders, including depressive and anxiety disorders.

What is the role of occupational therapy?

Helps people participate in daily activities by improving skills or modifying tasks/environment to support engagement.

What is the role of Public Health?

Protects and improves the health of communities through education, healthy lifestyle promotion, and research to prevent disease and injury.
Focuses on population health and designing programs influenced by genetics, environment, behavior, and policy.

What is the role of social work?

Social Work may be defined as the applied science of helping people achieve an effective level of psychosocial functioning

What is collective competency?

The shared ability of a team to collaborate effectively and function together, leveraging everyone’s skills, knowledge, and expertise of each member to achieve common goals.

It focuses on how the group works as a whole, not just on individual competence.

What are key elements of collective competence?

• A collective sense of events occurring in the workplace

• Developing and using a collective knowledge base

• Developing a sense of interdependency