doi: 10.56294/mw20225

REVIEW

Development of communication skills in the health sector

Desarrollo de habilidades de comunicación en el sector de la salud

Vanessa Pérez-Del-Vallín¹ *

¹Hospital Catalina Cargol. Girona, España.

Cite as: Pérez-Del-Vallín V. Development of communication skills in the health sector. Seminars in Medical Writing and Education 2022;1:5. https://doi.org/10.56294/mw20225.

Submitted: 16-06-2022          Revised: 31-08-2022          Accepted: 19-10-2022          Published: 20-10-2022

Editor: Dr. José Alejandro Rodríguez-Pérez

ABSTRACT

In the present study, the importance of communication skills in the health sector was analyzed, with a focus on communication between health professionals and patients. The need to develop skills for clear and effective communication is highlighted, a determining factor in quality medical care, especially in the context of telemedicine, which has become more relevant in today’s digital society. The digital divide is presented as a challenge in establishing effective and assertive communication, since it can limit access to quality medical care and active participation in one’s own medical care for certain groups of the population. It is concluded that a more deliberate incorporation of training in communication skills in medical education is essential, as well as the need for training curricula that offer tools for its refinement. In this context, the development of communication skills that allow providing a better health service with results in the quality of life of the general population becomes crucial.

Keywords: Health Communication; Communicative Skills; Communicative Skills.

RESUMEN

En el presente estudio se analizó la importancia de las habilidades comunicativas en el sector de la salud, con un enfoque en la comunicación entre profesionales de la salud y los pacientes. Se destaca la necesidad de desarrollar habilidades para una comunicación clara y efectiva, determinante en la atención médica de calidad, especialmente en el contexto de la telemedicina, la cual ha cobrado mayor relevancia en la sociedad digital actual. La brecha digital se presenta como un desafío en el establecimiento de una comunicación efectiva y asertiva, ya que puede limitar el acceso a la atención médica de calidad y la participación activa en la propia atención médica para ciertos grupos de la población. Se concluye que es esencial una incorporación más deliberada de la formación en habilidades comunicativas en la educación médica, así como la necesidad de currículos de formación que ofrezcan herramientas para su refinamiento. En este contexto, el desarrollo de competencias comunicativas que permitan brindar un mejor servicio de salud y con resultados en la calidad de vida de la población en general se vuelve crucial.

Palabras clave: Comunicación En Salud; Habilidades Comunicativas; Competencias Comunicativas.

INTRODUCTION

Communication is the process by which a person contacts another person through a message and expects a response, be it an opinion, attitude, or behavior. It seeks to establish contact between subjects using ideas, facts, thoughts, and knowledge in order to obtain a reaction to the communiqué that has been sent and thus close the circle of communication.^(1,2)

The communicative process is a form of interpersonal relationship in the process of activity of human beings. It constitutes an inseparable part of the social being and a means of formation and functioning of the individual and social conscience.⁽³⁾ Interrelation and communication between individuals is a need present in all human beings in the performance of their activities and acquires increasing value for life in society and the integral development of the individual in all areas where he/she develops.

In health-related processes, communication is based on the relationships and behaviors between health professionals and patients, family members, and other community actors. It is an indispensable tool for the doctor-patient relationship.^(3,4,5) If there is adequate communication, more detailed attention, effectiveness in treatment, and better clinical results are achieved, which have a satisfactory impact on the patient's quality of life.^(3,6)

According to the World Health Organization (WHO), "health communication encompasses the study and use of communication strategies to inform and influence individual and community decisions that improve health".⁽⁷⁾ It is part of a set of initiatives highlighting communication as a relevant field of study in this sector.⁽⁶⁾

Communication in the health sector, the bridge between professionals and beneficiaries of health services, requires solidity and security. This means that communication must be adequate to realize the indisputable benefits of efficient communication in health care.

Effective communication is a fundamental skill in any setting. In the context of health sciences, it becomes even more relevant because of the implications for the population's health status. Health professionals must communicate clearly and effectively with patients to understand their needs and concerns and to safely and ethically influence aspects of patient care.⁽⁸⁾

In addition, effective communication among colleagues is essential to enhance collaboration and teamwork. Addressing health problems through interdisciplinary teams, where various points of view converge, ensures safety and quality in medical services.⁽⁸⁾

The ability of health personnel to have complete and accurate information to fulfill their functions depends on communication in its different modalities. Situations of possible conflicts, such as the communication of bad news, decision-making, or understanding the prognosis, should be based on effective communicative processes and with adequate levels of information, thus enabling better professional performance.⁽⁹⁾

Due to this role of communication in medical professions, effective communication is currently considered one of the essential competencies of medical education.⁽¹⁰⁾ This process allows for overcoming gaps in expectations, demands, culture, and historical values between the professional and the society in which they are inserted. When considering communication as part of the profession's skills, it is essential that the medical training curricula consider tools that allow its improvement.

Improvement.⁽⁹⁾

The exponential development of Information and Communication Technologies (ICT) also encompasses strengths, opportunities, weaknesses, and threats to health communication. It is practical to count on these tools to support with resources that transform the exercise of medical practices from new communication paradigms.⁽¹¹⁾ The communication skills of the medical professional can be improved through communication tools for a better interpersonal relationship.

However, the deficiencies that may exist in training professionals with communicative and informational competencies jeopardize the quality of health services. In the same way, the development of ICTs is accompanied by a digital divide that establishes a disparity in access and the ability to use technology among different population groups to communicate. These aspects pose challenges for effective communication in healthcare.   

Given these dilemmas, the present study is developed due to the communication needs in the health sector, focusing on the approach to communication skills of professionals in this area. To explain the emerging trends, challenges, and opportunities of communication in health, with a particular focus on the development of communication skills, the impact of ICT, and the digital divide.

METHODS

A literature review was conducted on communication skills in health professionals. Research articles located in the Scopus, SciELO, PubMed, and Google Scholar databases were evaluated for the review. The following terms were used for the search: "comunicación/comuncation"; "comunicación en salud/health comuncation"; "habilidades comunicativas/communicative skills"; "habilidades comunicativas en salud/health communicative skills"; "comunicación en profesionales de salud/communication in health professionals". Other sources of information located manually were included.

The systematization of the literature included sources of information that, in the authors' opinion, were relevant to the topic of the study. Finally, 32 sources of information were included, including scientific articles, newspaper articles, books, and informative websites.

DEVELOPMENT

Communication skills in healthcare professionals

Communication skills, or competencies, facilitate effective communication and can be developed throughout life. These skills are essential for efficient communication and for enhancing social connections.⁽¹²⁾

Various sources highlight the four basic language skills: speaking, listening, reading, and writing.⁽¹³⁾ These skills are fundamental to communication, and mastery can significantly improve communication capabilities.

Other sources agree that critical communication skills also include empathy, active listening, emotional validation, nonverbal language, and the ability to maintain eye contact. ⁽⁶⁾ These skills are critical in the healthcare field, where clear and effective communication can significantly impact patient outcomes.

Arteaga-Olleta⁽¹⁴⁾ also advocates the assessment of different alternatives, the demonstration of attention, the formulation of questions, paraphrasing, the demonstration of emotions to convey an understanding of the patient's situation, assertive communication, frustration management, good care and closeness to patients, knowing how to manage emotions, and tolerance and patience. Adequate training and practice of these skills does not guarantee success in the healthcare relationship, but it does reduce the likelihood of undesirable situations and less favorable clinical outcomes.

These skills can be practiced at different levels, from an individual and group level to a whole system. Moreover, health communication theory is separate from the field of applied research. This can be divided into five main branches: effectiveness studies, audience studies, communicator analysis, message content analysis, and cultural studies.⁽¹⁵⁾

Each of these branches provides a unique and valuable perspective on how health communication can be improved: ⁽¹⁵⁾

· Effectiveness studies evaluate the impact of health communication interventions on patient outcomes.

· Audience studies seek to understand patients' needs and preferences in terms of communication.

· Communicator analyses examine the communication skills and strategies of health professionals.

· Message content analyses focus on the content and structure of health messages.

· Cultural studies explore how culture and society influence health communication.

Together, these five branches form a comprehensive field of research that seeks to improve communication in the health sector to improve patient care and health outcomes, and for which professionals must be adequately prepared. The emphasis on combining theory and practice in research to understand communication processes and change human behavior is pertinent when many threats to global public health originate in people's behavior.^(16,17)

From his training, the health professional should achieve the necessary skills to perform adequate individual communication to undertake the physical examination and the interrogation in a way that allows him to identify the needs or condition of each individual without incurring iatrogenesis and take care of the basic principles of medical ethics.⁽¹⁸⁾ It is, therefore, essential to have assertive communication tools.

In order to perform assertive communication that enables a good diagnosis and interaction with patients and other health professionals, communication skills are required as part of social and personal development. For this reason, the need to teach and value communication skills from training and during specialization and continuing education has achieved a high level of recognition.^(6,19)

Training in communication skills is a fundamental aspect of medical education. Including communication training programs in the curriculum of health specialties can significantly improve the communication skills of future health professionals. The most impactful programs often include simulations of clinical situations, structured feedback, and techniques for handling difficult conversations.^(20,21)

Appropriate language (verbal and nonverbal) can be practiced, learned, and perfected so that in health training, it is part of the fundamental skills of the profession. Building a respectful relationship complements diagnosis and treatment by contributing to its fluency.^(20,21)

Communication in the clinical setting would be significantly enhanced if it is included in their training. Professionals can be more competent and effective in communicating with patients if they receive early training in their undergraduate curriculum.⁽²²⁾

With the development of communicative competencies from the first years of study, it is guaranteed that, within their academic training as health professionals, they learn to transmit a message eloquently and to develop a comprehensive work of reception that allows them to give feedback there would be more possibilities that in their professional performance, they perform an effective communication, bringing benefits for their relationship both with the patient and with other health professionals.⁽²³⁾

In this sense, training professors at medical science universities to teach attitudes, techniques, and communication skills sufficiently is essential. This will bring them closer to the ideal of assertive communication in interprofessional and doctor-patient relationships.⁽⁷⁾

Despite the relevance of health communication for professional performance, the gap in university training in this aspect persists.⁽²⁴⁾ Reyna states that strategies have been proposed to address this challenge, such as the reorientation of the training of health professionals through community-based education and the institutionalization of communication in national and academic public health plans. However, implementation of these strategies remains a challenge.⁽²⁵⁾

Although progress has been made in incorporating health communication into the curricula of health careers, much remains to be done to ensure that all future health professionals are adequately trained in this crucial aspect of patient care.^(24,26)

Relationship between quality of care and communication

Communication skills are essential to establishing a solid therapeutic relationship between healthcare professionals and patients. Effective communication can improve patient adherence to treatment, reduce stress and anxiety, and promote positive clinical outcomes. Empathetic and compassionate communication can influence shared decision-making and the patient's perception of the quality of care received.⁽⁷⁾

The growing demand from citizens for more personalized care, along with the proliferation of studies evidencing the benefits of effective communication on clinical outcomes and patient and professional satisfaction, are realities that cannot be ignored. These factors underscore the need to integrate communicative and relational competence in the training of future healthcare personnel.⁽⁷⁾

Communication skills, conflict management, emotional intelligence, relationships with patients and colleagues, and teamwork are equally crucial to medical professional competence's technical and clinical dimensions.⁽⁷⁾

This connection is related to constructing emotional events that can generate empathy. In the healthcare relationship, the construction of this empathic interaction makes it possible to face the conflictive situations that may arise in health or disease.⁽⁹⁾

For health systems, communication also represents a favorable element for achieving better results and high satisfaction levels for those who receive this care. Health professionals are committed to guaranteeing the technical quality of the procedures performed and their efficiency and effectiveness.

A health professional is responsible for cultivating relationships based on trust and mutual respect. He or she engages in two-way communication, interacting with the community at prominent and other healthcare team members. In health practice, which is characterized by applying a professional method ranging from diagnosis to evaluation, this professional must strive to understand his patients' behavior and help them identify and resolve their difficulties, mainly through communication.⁽²⁾

In the context of numerous innovations that establish new ethical approaches to health, communication is fundamental, both in the sense of the necessary transfer of information that allows interaction between people and in the objective of decision-making, where the word acquires meaning through dialogue. In this way, the person is represented in his individuality and in the process of humanization, by which man differs from other animals due to his biopsychosocial characteristics.⁽²⁷⁾

A professional with communication limitations cannot exert a transforming influence on the patient or society. Therefore, having a broad knowledge of the theoretical, psychological, and social foundations of the formation of communication skills, according to their profession, and complete mastery of communication techniques is essential for them to produce, evoke, or promote health behaviors that result in healthy lifestyles and behaviors.

The fundamental skills that should be developed in a physician, such as diagnosing, treating, and preventing, are closely related to the quality of the communication he/she establishes. Raba et al.⁽²⁸⁾ consider that communication skills in the doctor-patient relationship influence better results in physical, mental, functional, and subjective health, in the level of satisfaction of patients and family members, in compliance with treatments, in clinical efficiency, and in the reduction of the number of complementary procedures.

The doctor-patient relationship is a particularity within interpersonal relationships. This relationship is predetermined by the patient's need to be cared for and professionally informed about the diagnosis, treatment, and prognosis of his disease. In this sense, respect must prevail, allowing the patient to participate in the decision-making process regarding the patient's health.⁽¹⁸⁾

However, health professionals are exposed to different stressful environments that hinder communication between them, causing a tense work environment and sometimes problems in the management of information for the development of procedures and communication between them and patients. Communication requires great skill on the part of the professionals, mainly in difficult decision-making moments involving the technique, academic knowledge, ethics, and sensibility of each one.⁽²⁾

Therefore, it is essential to generate communication skills that ensure effective communication practices and the efficient development of their profession.⁽⁶⁾ Thanks to this understanding, it is possible that professionals take respect for the fundamental and interrelated concepts of bioethics as part of their daily professional work: beneficence, nonmaleficence, justice, and autonomy.⁽²⁾

It should be remembered that the right or just decisions, beyond technical knowledge, are based on personal values and priorities, both for the professionals and the recipients of care. For this level of understanding to be assumed, it is essential to deepen communication. ⁽²⁾

The lack of adequate communication in health professional practice directly impacts the patient. However, the professionals have clarity in the concepts, and knowing how to express themselves could be more apparent to the patients.

One study estimates that 77 % of physicians believe that patients are aware of their diagnoses, yet only 57 % are aware of them. Two-thirds of patients reported having received a new medication in the hospital, of which 90 % reported not having received information about adverse drug events.⁽²⁹⁾ In other words, they sometimes assume that the patient knows and, therefore, do not give them the necessary indications for treatment.

The lack of effective communication also impacts the relationship between health professionals since, although the new concept of professionalism in health care includes numerous commitments, one is the adequate management of communication with patients and colleagues. However, there are barriers to professional communication, producing medical errors with repercussions on the safety of a patient, failures in the protocols, and, in general, risks to the lives of patients.⁽¹⁵⁾

Given the above, assertive and effective communication is necessary to guarantee the integration of the health team, therapeutic compliance, and the availability of tools to manage complex situations.⁽²²⁾ Conflict can be avoided, which can lead to greater dissatisfaction with the services, in addition to causing unpleasant situations in which it is easier for misunderstanding and aggressiveness to emerge.⁽¹⁴⁾

Current and future directions in the development of communication skills.

The media are an essential part of reality. The enormous possibilities resulting from the monumental technological progress that has taken place in the health sciences have made possible an omnipresence that no one can escape. This technological evolution has endowed them with an almost unlimited scope and instantaneousness.

In addition, with the rise of telemedicine, healthcare professionals must incorporate effective communication through digital platforms into their professional competencies. This includes the use of videoconferencing for remote consultations, the use of messaging applications for patient follow-up, and the use of electronic health records to share medical information.⁽¹⁹⁾

In the future, communication skills in the healthcare sector are expected to become even more vital. With the advent of artificial intelligence and robotics, healthcare professionals will need to learn how to interact with these technologies and use them to improve patient communication. For example, they may need to learn how to interpret and explain results generated by artificial intelligence algorithms or how to work with assistant robots in patient care.⁽¹⁹⁾

In addition, as medical care becomes more personalized, healthcare professionals will need advanced communication skills to discuss personalized treatment options and make shared decisions with patients. This involves discussing the risks and benefits of different treatment options and working with the patient to make a decision that aligns with their values and preferences.⁽¹⁹⁾

The complexity of communication and the transformation of paradigms and communicative practices have changed drastically due to the advances in ICTs and the impulse to use these advances that led to the COVID-19 pandemic. New approaches and systematization of experiences during and after the pandemic are required.⁽³⁰⁾

In many cases, new health communication models contribute to a greater generalization of services. It is possible to carry out various activities at a distance, eliminating physical and geographical barriers, thus facilitating access to health care. This is mainly thanks to telemedicine, which has become a fundamental support tool in medical practice. Its constant evolution shows a promising future for healthcare systems in a digital society.^(31,32)

However, for telemedicine to be genuinely effective, transparent, and practical, communication must be established between healthcare professionals and patients. Communication in telemedicine involves the exchange of medical information and the building of a therapeutic relationship at a distance.

In addition, the digital divide challenges establishing effective and assertive communication between the actors in the health processes. People with less information literacy, less access to ICTs, lower income, or people with disabilities may have difficulties developing communicative processes through digital technologies. This may limit their ability to receive quality health care and actively participate in their health care.^(1,25)

Developing the necessary communication skills and reducing inequities in access to information and health through ICTs is a significant challenge today that requires a multifaceted approach. In this context, it is essential to have professionals capable of developing efficient, communicative processes in any medium based on the communication competencies that allow for providing a quality health service that results in the quality of life of the population in general.

CONCLUSIONS

A more deliberate incorporation of communication skills training in medical education is essential, as well as the need for training curricula that offer tools for its improvement. It is concluded that communication is a fundamental skill in professional performance in healthcare due to its implications for the population's health status. Facing the challenges of the digital society, which presents new paradigms in the modes of communication, is a crucial aspect in this context.

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FINANCING

No external financing.

CONFLICT OF INTEREST

None.

AUTHORSHIP CONTRIBUTION

Conceptualization: Vanessa Pérez-Del-Vallín.

Research: Vanessa Pérez-Del-Vallín.

Methodology: Vanessa Pérez-Del-Vallín.

Writing - original draft: Vanessa Pérez-Del-Vallín.

Writing - revision and editing: Vanessa Pérez-Del-Vallín.