CHAPTER 1: Communication Revisited

Introduction

Chapter Overview

This chapter begins with the exploration of two common assumptions that may contribute to the belief that communication skill training is unnecessary in doctoral-level physical therapy (PT) education. These two assumptions are countered with evidence suggesting that today's physical therapist must confront unique communication challenges that require ongoing skill development. Of particular significance is the increasing number of technologically based communication options at our disposal. Each of these options affords specific benefits and liabilities that must be considered in order to optimize communication in all contexts. In order to facilitate this consideration, a theoretical Communication Pyramid is introduced as a reflective model to guide the selection of optimal modes of interaction.

A major theme of this text is that happy, authentic, and successful individuals view personal and professional interaction as a seamless continuum involving three levels of communication. These are defined as internal, external, and instrumental communication. This chapter provides a theoretical framework linking these three communication levels to engaged professionalism. Engaged professionals possess the virtues of commitment, empowerment, and a sense of mission. Most important, engaged professionals use the three levels of communication to promote effective change in self, profession, and society.

Finally, the chapter presents key experiential learning activities that will be used throughout the text to facilitate the development of skill at each of the three levels of communication.

Key Terms

• Affective domain

• American Physical Therapy Association

• Federation of State Boards of Physical Therapy

• National Physical Therapy Examination

The Evidence Is In! Communication Matters!

The Value of Communication: Patients Will Not Care How Much You Know Until They Know How Much You Care

The value of effective communication skills in the practice of health-care delivery, including PT, is inarguable. Communication has been called “the most important element of practice that health professionals must master.”¹ Effective communication is associated with greater patient adherence, improved patient outcomes, and patient satisfaction. Thus, as health-care delivery has become more competitive, every related discipline has recently directed increasing attention to the development of this skill. Professions serving as points of entry into the health-care system—such as medicine, nursing, and physical therapy—have a critical responsibility in this regard.

Accordingly, communication skills training has become a top priority in U.S. medical schools in the past 10 years. Prior to this, studies of physician–patient interactions revealed patterns of communication that were less than successful. One study showed that physicians interrupted their patients within the first 18 seconds of an initial interview, with only 23% of patients completing their sentences.² In 1999, the American Association of Colleges of Medicine Medical School Objectives Project issued ...