Communication Models in Healthcare

Why This Matters

Communication isn't just a "soft skill" in healthcare—it's the foundation of accurate diagnosis, treatment adherence, and patient safety. You're being tested on your ability to understand why different models exist, how they structure provider-patient interactions, and when each approach is most effective. These models represent decades of research into what actually works when lives are on the line.

Don't just memorize acronyms and model names. Know what problem each model solves: Is it designed to reduce miscommunication errors? Improve patient satisfaction? Address cultural barriers? Train new clinicians? Understanding the underlying purpose of each model will help you compare them on exams and apply them in clinical scenarios. The best answers connect specific model features to improved patient outcomes, shared decision-making, and therapeutic relationships.

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Foundational Communication Theories

These models explain the basic mechanics of how messages travel between people. They're the theoretical backbone that more applied healthcare models build upon.

Shannon-Weaver Model

• Linear transmission framework—communication flows in one direction from sender to receiver, with feedback as a secondary loop
• Noise disrupts message clarity; in healthcare, this includes medical jargon, environmental distractions, and patient anxiety
• Encoding and decoding determine whether the intended message matches the received message—critical for preventing medical errors

Transactional Model

• Simultaneous sending and receiving—both parties create meaning together in real-time, not sequentially
• Context dependence means that relationships, physical environment, and cultural background all shape interpretation
• Co-created meaning recognizes that patients and providers each bring experiences that influence how messages land

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Patient-Centered Frameworks

These models shift focus from the provider's agenda to the patient's experience. They emphasize understanding patient perspectives, values, and preferences as central to quality care.

Patient-Centered Communication Model

• Patient perspective first—prioritizes understanding what matters to the patient before delivering clinical information
• Active listening and empathy build the therapeutic alliance necessary for honest disclosure and trust
• Shared decision-making empowers patients as partners rather than passive recipients of care

Four Habits Model

• Invest in the beginning—first impressions set the tone; greeting warmly and establishing agenda matters
• Elicit perspective and demonstrate empathy—the middle habits focus on understanding the patient's illness experience, not just symptoms
• Invest in the end—closing well with clear next steps improves adherence and satisfaction

Kalamazoo Consensus Statement Model

• Consensus-based competencies—developed by experts to define essential communication skills all clinicians should master
• Building rapport and exploring context are foundational; you can't do patient-centered care without understanding the patient's world
• Training guideline function—primarily used in medical education to standardize what "good communication" looks like

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Structured Interview Frameworks

These models provide step-by-step guides for conducting clinical encounters. They're practical tools that break complex interactions into teachable, repeatable phases.

Calgary-Cambridge Model

• Phased interview structure—includes initiating, gathering information, physical exam, explaining, and closing as distinct stages
• Dual focus on process and content—communication skills and clinical reasoning are equally important
• Non-verbal communication explicitly addressed; body language, eye contact, and positioning affect patient comfort

SEGUE Framework

• Acronym structure: Set the stage, Elicit information, Give information, Understand perspective, End encounter
• Comprehensive checklist approach—each letter represents observable, teachable behaviors
• Flow awareness encourages providers to monitor conversational pacing and patient engagement throughout

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Cultural Competence and Relationship Models

These frameworks address the relational and cultural dimensions of healthcare communication. They recognize that trust, respect, and cultural awareness are prerequisites for effective care.

RESPECT Model

• Acronym components: Rapport, Empathy, Support, Partnership, Explanation, Cultural competence, Trust
• Cultural competence explicitly included—providers must recognize and adapt to diverse health beliefs and practices
• Relationship-building emphasis—trust and partnership aren't extras; they're essential for adherence and outcomes

LEARN Model

• Acronym components: Listen, Explain, Acknowledge, Recommend, Negotiate
• Negotiation as final step—care plans should be collaboratively developed, not dictated
• Cross-cultural application—originally designed for encounters where provider and patient have different cultural frameworks

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Research and Analysis Tools

This model differs from the others—it's designed to study and evaluate communication rather than guide it directly.

Roter Interaction Analysis System (RIAS)

• Coding system for research—categorizes every utterance in medical dialogues into task-focused or socio-emotional categories
• Pattern identification reveals how much time providers spend on information-giving vs. relationship-building
• Quality improvement tool—helps identify effective and ineffective strategies through systematic analysis of recorded encounters

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Quick Reference Table

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Self-Check Questions

1. Which two models both use acronyms to guide clinical encounters but differ in their emphasis on cultural negotiation versus comprehensive coverage? How would you explain this difference on an FRQ?

2. A patient feels rushed and unheard during a visit. Which models specifically address "investing" time at the beginning and end of encounters, and what habits do they recommend?

3. Compare the Shannon-Weaver and Transactional models: What fundamental assumption about communication does each make, and which better explains miscommunication caused by differing cultural backgrounds?

4. You're designing a communication skills curriculum for medical students. Which two models would you use as foundational frameworks, and why are they better suited for training than the others?

5. An FRQ asks you to evaluate the quality of a recorded patient-provider interaction. Which model is specifically designed for this purpose, and what categories does it use to code communication behaviors?