Communication in healthcare— a soft skill?
Spoiler: there is nothing soft about communication
“Patients dying daily due to poor ‘soft skills’ among Australian surgeons, experts warn”
Working in within University schools for health and biomedical sciences as well as for business, I have found that the conceptualisation of communication as a “soft skill” is common across research and teaching. This has often bothered me. As a conversation analyst, my job is to analyse how people get things done through interaction. “Things” include all parts of social life — ordering coffee, chatting with friends, and, of course, all the interaction needed for work.
This work is done collaboratively. It isn’t “message sent and message received”. We co-create a shared understanding. We build relationships through interaction. While “soft skills” as term may not be intended to minimise such skills, they can often been side-lined or taken less seriously as compared to “hard skills” or “technical skills”. Interpersonal communication is central to doing our jobs and, given that this often requires specialised approaches for different jobs (e.g. negotiation, discussing difficult news, etc), it can be seen as a “technical skill” too.
In exploring this idea of shifting from “soft skills” to “core skills” or “critical skills”, I came across a paper by Erica Darcis who provides the following recommendations for improving communication education in management training:
Increasing interdisciplinary efforts to bring together organisational scholarship and linguistics in research and teaching.
Steering away from communication training as skill development, focusing on raising language awareness and the development of analytical skills.
Using linguistic and discourse awareness as a basis for self-reflexive, responsible management practice.
These recommendations are echoed in healthcare communication literature, with a systematic review demonstrating that personalised feedback is the most reliable way of improving medical student communication skills. Such feedback relies on all three of the above recommendations.
Effective communication should be integrated as a core clinical skill. How else do you find out why someone has come to see you or whether the treatment you’re recommending considers their preferences and concerns?
Building relationships and communicating effectively with patients are not soft skills — they are clinical skills. As Dr Ben Bravery commented in his reflections on humanity in medical school:
“I thought the things that mattered weren’t being rewarded”
Communication training is often front loaded in healthcare degrees, leaving plenty of time to unlearn it when the pressures of placements and then practice combined with its “soft” status mean that it’s given less importance. This is reflected in the lack of resourcing and investment in education and research on communication, even though there are systemic, scientific ways of observing, understanding, and improving communication skills.
Communication is a core skill in healthcare. Not a soft one.