Strategies for sharpening your verbal dexterity when you work together.

 

Heard doesn't mean understood

 

This is the third of four articles in the series on spoken communication in teamwork. When we work together, most of our communication happens out loud. The articles are especially about how you minimise communication that goes missing, comes out wrong, gets misread or misunderstood in busy situations. Many of the tools are drawn from aircraft cockpits and operating theatres, and they’re about how you get past the classic barriers in spoken communication:

Meant doesn’t get said

said doesn’t get heard

heard doesn’t get understood

understood doesn’t get done

This article is about spoken communication in your teamwork. Specifically, about how you make sure your colleague understands what you say the way you meant it. In these situations, the mistakes typically happen when you pass on a message, and when you talk to a colleague from another staff group. It could be between the engineer and the architect, or between the doctor and the nurse.

 

“Do you see what I mean?” you ask your colleague, who nods eagerly. But how can you be completely sure that what your colleague understands is also what you mean? When you have to give a colleague a message and a mistake creeps into your communication, the devil is often in the detail. “The devil in the detail” means that when mistakes happen, the cause is often hidden in one small detail. There’s a big difference, for example, between writing “Let’s eat, Martin” and writing “Let’s eat Martin.” In the first example you’re calling me to dinner. In the second, I’m the dinner. One comma – a world of difference! Here are two examples of heard not getting understood.

 

Errors in spoken messages: 30%

In 2010, researchers studied errors in spoken communication at five Danish hospitals. They went through 84 cases of serious so-called adverse events. According to the Danish patient safety authority, an adverse event is an error that isn’t caused by the patient’s illness – an error that has harmed, or could have harmed, the patient. In 30% of the cases, errors were found when a message was passed on (L. Rabøl, 2010). The researchers defined errors as verbal information between staff that was missing, wrong, misread or misunderstood.

 

A simple example: you and your colleague arrange a lunch meeting at a café not far from your office. You send a text with the message: “Let’s meet out front in the car park at 1pm.” At 1:00pm you’re standing in the car park in front of the café, while your colleague is waiting in the car park in front of your office.

 

The devil in the detail is that your message didn’t say which car park you meant, so your phone call probably opens with the line: “I’m here – where are you?”

 

The researchers defined errors as verbal information between staff that was missing, wrong, misread or misunderstood.

 

Errors in spoken communication between staff groups: 43%

In the study at the five hospitals, the researchers also looked at the cases for errors in communication between different staff groups. Here the error rate was 43% (L. Rabøl, 2010). These errors were defined as verbal information that was missing, wrong, misread or misunderstood between staff from different staff groups (doctors, nurses, and so on).

 

One example of a communication error between two staff groups was when NASA launched the Mars Climate Orbiter probe in 1999. The probe was meant to go into orbit around Mars, but came too close to Mars’ atmosphere and burned up. The devil in the detail was that one team calculated the distance in metres and another team calculated it in feet (0.3 metres). The project cost $125 million (B. Sauser, 2009).

 

These errors were defined as verbal information that was missing, wrong, misread or misunderstood between staff from different staff groups.

 

5 strategies to make heard also get understood

Luckily, there’s a great deal you can do yourself to make sure your message is heard the way you meant it. Here are five strategies that are especially useful in busy situations:

 

  1. Get your colleague to repeat back what you’ve said
  2. Don’t assume
  3. Give your message structure
  4. Notice how your colleague listens
  5. Be aware of how you present your information

 

1. Get your colleague to repeat back what you’ve said

An effective way to avoid that is to get your colleague to repeat the message you’ve just given. The method is known from aviation and is used when pilots receive a message from the control tower. In 2004, the method was tested at a hospital. They did this by listening in on 822 phone calls from the hospital’s laboratory. 29 errors were caught because the member of staff repeated the lab technician’s message. The errors were mainly about the wrong patient name and the wrong test result (J. Barenfanger, 2004). 29 errors may not sound like much, but think about what it means if you, as a patient, get someone else’s test results, or if your test results aren’t correct.

 

In your situation at work, it may not be a matter of life and death if your message is misunderstood. But mistakes create misunderstandings, and misunderstandings can quickly lead to friction and conflict (DS. Wakefield, 2009).

2. Don’t assume

To assume means we expect one thing or another. Assuming the future will be better can be a useful defence mechanism in stressful situations. The problem arises if you assume your colleague understands your message the way you meant it. Research suggests we get it wrong in more than half of cases when we make assumptions about other people. On top of that, when we assume, the other person rarely thinks: “That was a logical assumption.” Often we don’t see other people’s wrong assumptions about us as something positive, but as something negative. So you’ll find that when you make an assumption about your colleague – especially a colleague from another professional group – there’s a big risk the assumption is wrong, and therefore that it will be read negatively.

 

Assuming your colleague knows what you’re thinking is like assuming your spouse understands why it annoys you when the lid on the pickled gherkins isn’t screwed on tight. You want the lid tight because you don’t want vinegar in the bottom of the fridge. In your spouse’s eyes, the lid is just one more example of you needlessly letting small things get to you. For your spouse, your view of the gherkin jar lid may sum up, more or less, exactly why you’re always so stressed.

 

In the same way, you have to explain to your colleague exactly what you’re thinking. You need to explain, clarify and give details. You can’t assume that what’s important to you is also important to others. Otherwise you end up with spilt vinegar in the bottom of the fridge.

 

Even though we’re often in a hurry to move on, it’s a really good investment to spend time making sure you share the same picture of what’s going to happen: “You said you’d take care of this part of the project. Can we spend a couple of minutes clarifying what ‘taking care of this part of the project’ means to you?”

3. Give your message structure

Under enough pressure, even the simplest task can be really hard. In a stressful situation, it’s crucial that you can get a message across briefly and precisely. The military knows all about that. That’s why the American navy developed a strategy to standardise communication in critical situations. The strategy was developed for the crews on the nuclear submarines and is today used in the aviation industry and the health sector too. It’s called ISBAR (KM. Haig, 2006):

 

  • I – Identify yourself: “Hi, my name is …”
  • S – Describe the situation: “I’m calling because…” – give the situation a headline of no more than six words
  • B – Describe the background briefly – give a short summary of what’s happened
  • A – Give your analysis of the situation: “My assessment of the problem is…”
  • R – Give or get a recommendation on the problem: “I suggest…” or “What do you think?”
4. Notice how your colleague listens

When you use the ISBAR method, you should notice how your colleague listens. Because there’s a difference between listening to understand and listening to reply (G. Noesner, 1997). At work, we often listen to reply. We spend energy interpreting what’s being said and finding meaning in our own past experience. In other words, we’re not listening to the colleague but to our inner voice – and have, in effect, invited a third person into the conversation. You can clearly tell when your colleague is listening to reply. You can see in their face that they’re preparing an answer while you’re still talking. When your colleague has spent time preparing their reply while you’ve been speaking, there’s usually no pause between your words and theirs. You probably know it from giving a child a message. There’s usually a short pause after you’ve spoken. That’s because the child first reflects, and only starts to put their answer into words once you’ve stopped talking.

 

If you’re talking with a colleague and you’re both listening to reply, it means you’re both running an inner dialogue while the other one speaks. That raises your risk of mistakes and can make it feel a little surreal – four people taking part in the conversation when there are only two of you in the room.

 

To make sure your colleague has understood what you’ve just said, use the tool I described above, where you ask your colleague to repeat your message.

5. Be aware of how you present your information

When you give a message, you need to pay attention to how you present it. Because the way you present a message has a big influence on the decision your colleague makes. It’s called the framing effect (J. Gong, 2013). When I want to show in a workshop how framing works, I split the participants into two rooms. The participants in one room I ask to estimate how long they’ll take on a given task. The other group I ask to estimate how quickly they’ll be able to do a given task. It’s the same question, but because I use the words “a long time” with one group and “quickly” with the other, the difference is typically 20%. The same question, but two wildly different answers.

 

The point is that specific words are understood differently depending on stress level, workload, culture, seniority, profession and so on. Especially when we’re busy or going through a crisis, it’s easy to get emotional. Talk that’s too aggressive or too passive isn’t good. It shifts your interaction from focusing on the task to focusing on the balance of power.

 

I worked, for instance, with a team where the manager told the staff he’d like them to “question things” a bit more. What he meant was that he wanted the team to think unconventionally, so their work processes became more innovative. The problem is that, in Danish, the word he used carries a negative charge – the way casting suspicion does. Not surprisingly, trust in the team was, for that very reason, very low, both in the manager and between the staff.

The quality of our work is, to a large degree, about the quality of our spoken communication.

 

Why the mistakes happen

When mistakes happen in an organisation, it’s mainly down to us humans. These mistakes typically happen because of errors in our spoken communication. Errors in our communication often happen when there’s a big gap in power and status between the people talking. Especially when one of them worries about coming across as incompetent, doesn’t want to offend the other, or feels the other one is talking in a closed-off way. Errors in our communication are also caused by role conflicts or unclear roles. And finally, errors in our communication happen because we’re different as people and read words very differently (M. Leonard, 2004).

 

So communication errors happen both at an individual level – because we’re tired or too busy – and at a more systemic level, because of norms and culture.

 

The quality of our work is, to a large degree, about the quality of our spoken communication. So it makes good sense to invest in bringing this error rate down – at an individual level, for the team and for the organisation as a whole.

 

If you want to get started

My experience is that there’s an endless number of tools for solving an undefined problem. Because spoken communication spans so much, the topic can quickly become overwhelming if you’re not completely specific about what you want to improve. My experience is that many teams are far too ambitious about what they want to achieve in a day together, but also not ambitious enough about what they can really achieve in a year. Improving your communication doesn’t need to take eight weeks at a course centre at all. Just as you’ve now been given five concrete strategies for making heard get understood in busy situations, here’s my recommendation to you:

 

  1. Start small
  2. Be completely specific about what you want to improve
  3. Repeat.

 

 

Sources and further inspiration

 

Republished Error Management

L. Rabøl, 2010, Postgraduate Medical Journal

 

Improving Patient Safety by Repeating (Read-Back) Telephone Reports of Critical Information

J. Barenfanger, 2004, American Journal of Clinical Pathology

 

An Exploratory Study Measuring Verbal Order Content and Context

DS. Wakefield, 2009, National Center for Biotechnology Information

 

Why Projects Fail?

B. Sauser, 2009, International Journal of Project Management

 

Communication Failures: An Insidious Contributor to Medical Mishaps

KM. Sutcliffe, 2004, National Center for Biotechnology Information

 

SBAR: A Shared Mental Model for. Improving Communication. Between Clinicians

KM. Haig, 2006, National Center for Biotechnology Information

 

Crisis Intervention: Using Active Listening Skills in Negotiations

G. Noesner, 1997, Law Enforcement Bulletin

 

The Framing Effect in Medical Decision-Making: A Review of the Literature

J. Gong, 2013, National Center for Biotechnology Information

 

The Human Factor: The Critical Importance of Effective Teamwork and Communication in Providing Safe Care

M. Leonard, 2004, BMJ Quality & Safety