"I'm sorry, that wasn't my intent!" Intent versus impact in healthcare communication

The blended learning program will introduce participants to the potential difference in interpretation throughout healthcare communication. Participants will complete this ten-minute online session exploring verbal and non-verbal communication, then attend a ten-minute face-to-face session the following week to discuss individual responses, share examples and learn from colleagues.

Communication in Healthcare

Learning Objectives

The learner will...

  • Define communication

  • Identify the different modes of communication and their role within the healthcare setting

  • Recognise the components of communication

  • Demonstrate the effect of tone of voice on communication

  • Differentiate possible interpretations of non-verbal communication

That wasn't what I meant!

Intent and Impact

Sometimes our intended message is very different to what is received. In the healthcare context, this can have a very significant impact.Video: (Zayam88 2009)

Spend a moment thinking about a situation where the content in your message was received or interpreted differently than you expected. As you read the following information and activities, refer back to this situation to relate the content to your real life situation.


Defining communication

Communication is the process of conveying meaning from one party to another through a variety of modes, with an assumption of reciprocity of understanding of the content (Zani et al. 2014). It is the assumption of reciprocity of understanding that can cause trouble – is the message intended the same as the message received?

How the message is received and interpreted is affected by the receiver's eyesight, hearing, mood, values and beliefs, social context, expectations and previous experiences (Altman et al. 2010).

Communication in healthcare

Within the healthcare context, communication is used to convey information to patients, colleagues and visitors, as well as support and comfort patients (Zani et al. 2014). Communication between the healthcare professional and the patient requires active participation from both parties, with potential interferences in the transaction resulting in miscommunication and a difference between the intended message and the message received (Zani et al. 2014).

Communication as a learned skill

The ability to communicate effectively relies on an understanding of the modes of communication and an acknowledgement that the interpretations of the message conveyed may vary between the source and the receiver (Zani et al. 2014). An individual can concentrate on, practice and develop skills for each mode of communication, but the overall effect of communication is greater than the sum of the parts (Chant et al. 2002).
Image: Wrench (2017)

Verbal Communication

Verbal Communication

Verbal communication can be speech, sounds, songs or noises, of varied volume, pitch and rate (Zani et al. 2014; Altman et al. 2010). Within the healthcare setting, information provided to patients may not be understood due to unfamiliarity with terminology (Zani et al. 2014). Similarly, staff withholding information can also create confusion and frustration due to a lack of understanding (Zani et al. 2014). Issues can arise when particular words are interpreted by the receiver with a meaning different than intended by the sender.

Image: (Clipartfest 2017)




Local colloquialisms

Tone of voice





Rate and volume

Too fast or loud:

- Overwhelming; Confronting; Uncomfortable; Uncomfortable

Too slow or soft:

- Frustrating; Distracting; Boring

Lost in Translation

Issues can arise when particular words are interpreted by the receiver with a meaning different than intended by the sender.

Which word in the previous scenario have the source and receivers interpreted differently?

  • husband
  • crook
  • last week

Non-verbal Communication


Non-verbal communication is the manifestation of behaviour not expressed in words, which adds value and enriches communication by means of body gestures, facial expressions and posture (Dayton & Henriksen 2007; Altman et al. 2010; Zani et al. 2014). Non-verbal communication strongly influences the relationship between the source and the receiver (Zani et al. 2014). Incongruence between verbal and non-verbal communication can create confusion and frustration. From the patient’s perspective, there are numerous physiological reasons for changes in non-verbal communication, affecting body movement and facial expressions (Zani et al. 2014). Similarly, there may be reasons from the staff member perspective that our non-verbal communication is interpreted differently than intended. Continue to the scenario on the next page to explore this further.

Images: (Giphy.com 2017; AvatarWikia.com 2017)

Judge Judy eye roll

If a picture says a thousand words, how do you quantify an expression? Can you imagine the next words coming from Judge Judy?

Robert "Frowny" Jnr

A brief gesture can convey so much.

Facial expression scenario

Suggested reasons

Consider why the healthcare worker may have this facial expression, and what this could be interpreted as by the patient (receiver). Fill in your suggestions on the next page and these will be discussed in the face-to-face session next week.

Images: (Dreamstime 2017; The New York Post 2017; Pintrest 2017)

Why does the healthcare worker have this expression? How may this facial expression be interpreted by the patient?

Please write at least three possible reasons for the healthcare worker having this facial expression, and at least two possible interpretations of this facial expression.


Face-to-face session

Thank you for completing this ten-minute online session, in preparation for our face-to-face session next week.
Please consider the examples provided in this session, and bring your own to share with the group next week. We will be conducting some activities to demonstrate the importance of both verbal and non-verbal communication, and how our intent may be interpreted very differently by the receiver.



Altman, G, Kerestzes, P & Mcisel, M 2010, Fundamental & advanced nursing skills, 3rd edn, Delmar Cengage Learning, Clifton Park USA.

Chant, S, Jenkinson, T, Rangle, J, Russell, G 2002, ‘Communication skills: Some problems in nursing education and practice’, Journal of Clinical Nursing, vol. 11, pp. 12-21.

Dayton, E & Henriksen, K 2007, ‘Communication failure: Basic components, contributing factors, and the call for structure’, Joint Commission Journal on Quality and Patient Safety, vol. 33, no. 1, pp. 34-47.

Zani, A, Marcon, S, Tonete, V & Parada, C 2014, ‘Communicative process in the emergency department between nursing staff and patients: Social representations’, Online Brazilian Journal of Nursing, vol. 12, no. 2, pp. 135-145.


AvatarWikia.com 2017, Discussion board, Viewed 20/04/2017, <http://avatar.wikia.com/wiki/Thread:1312618>

Clipartfest 2017, Speech bubble with person, Viewed 20/04/2017, https://img.clipartfest.com/80c3b83cd258515364a0301de6dda00b_person-with-speech-bubble-people-with-thought-bubble-clipart_2365-1774.jpeg

Dreamstime 2017, Stock Images, Viewed 20/04/2017, <https://thumbs.dreamstime.com/x/female-healthcare-patient-hospital-gown-sad-28747469.jpg>

Giphy.com 2017, Annoyed eye roll, Viewed 20/04/2017, <https://giphy.com/gifs/annoyed-eye-roll-judge-judy-Rhhr8D5mKSX7O>

Pintrest 2017, Therapeutic Communication, Viewed 20/04/2017, <https://au.pinterest.com/lindareed47/therapeutic-communication/>

The Blaze 2017, Image, Obamacare is paying hospitals to make patients happy is actually a horrible thing, Viewed 20/04/2017, <http://www.theblaze.com/news/2015/04/20/obamacare-is-paying-hospitals-to-make-patients-happy-its-actually-a-horrible-thing/>

The New York Post 2017, Image Search, Viewed 20/04/2017, <https://thenypost.files.wordpress.com/2017/02/170227-lady-turn-ons-01.jpg?quality=90&strip=all&strip=all>

Wrench, J 2017, Communication, Transactional model of communication, Viewed 20/04/2017, <https://en.wikipedia.org/wiki/Communication#/media/File:Transactional_comm_model.jpg>

Zayam88 2009, Importance of Right Communication, online video, viewed 17th April 2017, <https://youtu.be/87HsUukEj4Y>.