In a 2014 study of 24 nurse educators exploring the factors involved in making clinical practice pass-fail decisions, the most common reason identified for failing clinical nursing students was poor communication. (DeBrew & Lewallen 2014)

The Patient Safety movement continues to exert pressure on healthcare systems with startling statistics that uncover significant risk for patients seeking care from the very system that is causing them harm. The ongoing scrutiny of adverse events continues to reveal that communication failures are the leading cause of adverse events that cause human harm (Beck 1993, James 2013).

This evidence of inadequate communication skills among care providers has led to an increased focus on communication in many health care professional programs. The content is typically focussed on communication with patients, not with each other. It is in the communication gap between health care providers that the deficits exist.

“Doctors and nurses are like intimate strangers who often seem to be engaged in a professional form of parallel play at the bedside.”

Suzanne Gordon 2012 p 45

The Interpersonal Gap

Research shows that as much as 80% of our communication doesn’t connect the way we want it to. This constitutes what John Wallen refers to as the interpersonal gap. (Chinmaya 1979) This misunderstanding occurs when one person sends a message with a specific intent in mind. This message is received and interpreted by another person and the impact that the message has on the recipient is too often not what the sender intended. This sets up a disconnect between the intent of the message that is sent and the impact that the message has on the receiver. I think we are all familiar with the consequences of this gap. The meaning of the message lies with the receiver and the impact is where respect is built or lost. Building an understanding of how the interpersonal gap works in communication can help develop skills in giving and receiving feedback.

Inadequate communication is not only a frequently identified cause for student failure in the clinical setting, but the inability to provide effective feedback has also been cited as a significant concern for others in positions of supervising student and graduate nurse practice. (Butterworth et al., 2008: Sorensen and Yankeck, 2008)