Interpersonal Skills ‘The Health Care Manager Volume 25, Number 2, pp. 177-187 004, Lippincott Willams & Wilkins, Inc What They Are, How to Improve Them, and How to Apply Them Charles R. McConnell, MBA, CM Interpersonal skills are those largely on a oneonone basis. sential skills involved in dealing with and relating to other people The interpersonal communication behavior of many people sts they assume to have the ability to communicate effe ively, which they do not possess and which they take for granted, One must work conscientiously to develop interpersonal competence by doing the right things ingrained. As with any human skills, wh le countering their shaping behavior. all times and doing them repeatedly until the} terpersonal skills can be improved through conscious effort, Successful interpersonal communication involves sh To have a ch. become ping the beh nce of bei vior of other successful often interpersonal contact must have «an objective and every effort must be made to avoid creating wirlose transactions whenever possible. Key words: communication, interactive skills, interpersonal communication, interpersonal competence, interpersonal skills NTERPERSONAL SKILLS ARE those partic- ular communication skills that when we are behaving in am: are used nner intended to achieve certain results or objectives in face-to-face encounters. Common interper- sonal situations on the job include numerous contacts with direct-reporting employees, such as directing, coaching, counseling, praising disciplining or reprimanding, training, prob- lemsolving, and many others. For the de partment manager, common interpersonal situations also include one-on-one contacts with peers, higher management, and other employees and persons external to the orga: nization. A truly exhaustive list of potential © situations would likely be ex tremely lengthy Everyone possesses interpersonal skills’ as such; however, while a few individuals may exhibit exceptional interpersonal skills, -on-one From the VMC Group, Inc Mr. McConnell is also a Human Resource Consultant, Ontario, New York, and Eattor of BCM. Niagara Falls a great many others may demonstrate weak or negative or virtually inter- personal skills. Such considerable difficulty nonexistent as we know exists with interpersonal com- munication seems to exist because most in- dividuals do not believe there is anything wrong with the way they communicate face to face. In general, we take a certain facility with interpersonal communication for granted. As a result, most persons inherently believe they are better communicators than they actually are In any given face-to-face encounter, one is organizing one’s own behavior for the accomplishment of some specific objective. SHAPING AND ENHANCING BEHAVIOR Our behavior consists of what we say along with the things we do that are overt and observable and thus become part of the message being communicated. Our be- havior in communication enco: words we use, the manner in which we apply the words we use, and the nonverbal178 THE HEALTH CARE MANAGER/APRIL-JUNE 2004 indicators that we apply both consciously and unconsciously. The latter, the nonverbal indicators, can encompass reflex mu: movements, those motor habits, gestures, and movements we make without conscious thought, along with other physical move- ment accompanying a verbal communi tion, which, when taken together, become the indicators that comprise what we fre- quently refer to as body language. Body language is behavior that is largely conveyed unconscior but this may also be accompanied by deliberate actions, both verbal and nonverbal, such that the inten- ded result is the intentional arranging of behavior so as to incre: the chances of achieving specific communication objectives. Simple example of such behavior shaping might include yawning or overtly examining one’s wristwatch during a lengthy explana- tion or presentation (nonverbal) or asking a specific leading question or deliberately open-ended question during an interview (verbal), Our individual behavior matters consider- ably in face-to-face communication, because it has effects on others and, sometimes to a considerable extent, influences what others think and do, And that individual behavior is proscribed largely by that complex sum of traits, characteristics, capabilities, beliefs, and tendencies that we refer to as personality, One might have a personality that lends itself to effective interpersonal communication with others; one might exhibit personality traits and characteristics that impede effec- tive interpersonal communication. It is likely that the most important factors in interpersonal communication are personal credibility and interpersonal competence. Of lesser importance, although still at times significant, are technical expertise, tempers ment, and attitudes toward others. Motives feclings, and attitudes, although often influ- encing behavior, are ordinarily less visible than immediate behavior. Thus, interper- sonal competence, supported by personal credibility, will frequently be the strongest determinant of success at interpersonal communication. rg ACQUIRING INTERPERSONAL COMPETENCE There are two equally important sides to the matter of interpersonal competence. On. one hand, it is necessary to become skilled in the behavior necessary for effective face- to-face interactions, On the other hand, it is essential to learn how to interpret the behavior of others so that our own behay- ior can be adjusted accordingly. To acquire or enhance interpersonal competence, we must continually observe others and inter- pret their actions and arrange our behay- ior to suit the objectives of any particular interaction. What is initially required for the acquisi- tion of interpersonal competence is repet tion—that is, of the proper sort; deliberate repetition through contact after contact after contact, in which one relates to others with thoughtfulness and respect. Said repetition s necessary for two reasons: first, it is no secret to anyone that any skill is improved through practice; and second, repetition also serves to temper and eventually overcome the fears and apprehensions that so many people experience concerning face-to-face contacts with others. Take the first reason as a given, or at least a statement backed by the common-sense knowledge that most activities improve with practice, and look more closely at the second reason. Consider, for instance, some of the con- tacts a department manager experiences in the normal course of duty. When one new to supervision, there is probably some reluctance felt and some minor measure of discomfort experienced when it is neces- sary to announce an unpopular decision or perhaps even just to provide an employee with direction contrary to what might have been expected. Surely, there was apprehen- sion to be experienced the first time or two that the new supervisor realized that n employee had to be reprimanded or disciplined. However, anyone who has man- aged others for an appreciable time knows that these particular tasks become easier with repetition. One might always approachdisciplinary action with a certain amount of trepidation—actually, some apprehension con- cerning disciplinary action is a healthy, if not essential, adjunct to the process—but it can- not be denied that one becomes better at these tasks through conscientious practice As managers have been discovering since ne immemorial, it is easier to pass along good news than it is to disseminate bad news, and it is surely easier to dispense praise than it is to reprimand or dispense criticism. The way one gets better at handling the interper: sonal contacts that inspire hesitation and apprehension is to just do it. And do it, and do it, until a workable level of competence is attained and one is able to address necessary negatives kindly but respectfully, thoroughly, and constructively. The supervisor or man- ager who, through fear and apprehension, shies away from disciplining or disciplines too late or in watered-down fashion is se- verely limiting his or her growth in manage ment. Facing the apprehension again and again, however, will enhance personal growth and contribute to interpersonal competence. Repetition is as essential as saying and doing the correct things. Consider, for a moment, the matter of con- ducting a performance appraisal interview Perhaps one has had occasion to wonder why performance appraisals seem to be far from the average manager's favorite task. A manager's dislike of—and apprehension concerning—performance appraisals is prob- ably owing to two areas of cause. First, there is the knowledge that this process is impor- tant to the employee, perhaps affecting pay increases, promotional opportunities, maybe even continued employment itself, all of which, in addition to the possibility of hav- ing to criticize, conspire to raise a manager's level of apprehension. Second, the manager may have limited opportunity to acquire com- petence through repetition. Each employee 4 unique individual, and each must be dealt with in a manner that is, in some different from how the manager deals with all others. However, within most ap- pri but once per y ways 1 systems, the formal appraisal occurs hardly a frequency that Interpersonal Skills 179 permits building interperson: with cach individual employee. So the perfor- mance appraisal is likely to remain a of dislike for some managers, especially for those who have little or no other perfor. mance-related contact with the employee throughout the year (surely, a serious error of omission for some managers, but unfor- tunately a practice encountered all too often the work force). One also becomes skilled in face-to-fi teractions by observing others and inter- preting their actions and arranging one’s own behavior to suit the objective of any par. ticular interaction. In interpreting the behav- ior of others, however, it is necessary to be mindful that we are usually specu because we see only the outer indica of behavior and we have to infer feelings and motives from this behavior. Our inter- pretation of others’ behavior is conditioned by our past experiences with others, and it is necessary to accept the likelihood of often being wrong i ing another's behavior. ‘This suggests why it is extremely important for a manager to truly know each employee in the group as an individual; the better the manager is acquainted with a person’s moods and tendencies and personality char- acteristics, the better the manager will be at imterpreting the person's behavior. Interpersonal competence, then, comes with time and practice. It comes to those who can accept the truth of the statement noted earlier: most persons inherently be- lieve they are better communicators than they actually are. Those who can believe that they are not nearly as good at commu: nication as they could be are those best situated to seck the improvement necessary to gain interpersonal competenc ompetence source asses IMPROVING INTERPERSONAL SKILLS A great deal can be offered concerning var- ious means of improving one’s interpersonal skills. However, there is a single factor tha is probably central to ensuring the success of any face-to-face interaction, and that is the presence of a clearly understood objective.180 THE HEALTH CARE MANAGER/APRIL-JUNE 2004 Why objectives? Setting an objective for any particular in- teraction may not change the interaction at all. Surely, we can—and frequently do—have interactions without objectives, However, having a specific objective requires that something arise from the interaction to serve that objective. Objectives require that something be done to achieve them. More often than not, interactions without objec- tives are unproductive. Interactions without objectives leave one with feelings like: ‘Three hours in a meeting and I can't see what we accomplished” or “Pleasant conver- sation, but was anything really decided? Going into an interpersonal exchange knowing in advance what one wishes to get from it will set the exchange on a poten- tially productive track. The objective may be modified or completely changed along the way as information is exchanged, but even a changing objective is more likely than no objective at all to keep an interchange on track. Managers consume a great deal of time mecting with others both one-on-one and in groups. The manager who enters every communication situation with a spe- fic objective in mind will, in the long run, be more productive while spending less time communicating, What is an objective, anyway? An objective is a specific prediction of cir- cumstances that you wish to attain at some specific time in the future. Simply described, an objective is a target. As far as a particular sonal contact is concerned, the ob- jective is the state of things that you intend to exist at the conclusion of the interchange or perhaps a statement describing the out- come you desire for a situation. In on-the-job situations, objectives frequently refer to reaching agreement on something, determin- ing a plan of action, making or affirming a decision, or resolving a particular issue. For example, one might wish to convince an em- ployee of a necessary policy change (reaching agreement on something), spell out how to go about protesting an apparently faulty pol cy (determining a plan of action), establish- ing mutual agreement on how to proceed (making or affirming a decision), or solving a scheduling problem (resolving a particular issue). Even the simplest of objectives must pos- sess two essential elements; a description of the outcome one wishes to achieve (always both desirable and realistic) and some means by which success is to be measured. Going into any interaction, it is necessary to know what you wish to accomplish and how you will know it has been accomplished. An objective may be altered as it is pursued; this is often the case because the interaction can produce information that can suggest a change in direction or emphasis. However, to proceed with no specific objective in mind is to run the considerable risk of ac- complishing nothing: if you do not know where you are going, you will never know when you arrive there, Even pursuing an ob- jective that you feel is shaky and will un- doubtedly change to some extent before you get there is better than having no ob- jective at all—at least you know you are pointed in the right general direction Setting an objective in any interaction clar- ifies what you have to do; you can compare the outcome with the prediction and gauge the extent of success or failure. And fully as important as knowing where you are going, having a specific objective helps you in communicating to other what you want to accomplish. Some guidelines to keep in mind when tting objectives for face-to-face interaction are the following: + Formulate your objectives, taking into account what you know about the individuals with whom you are dealing, Every individual is unique in some re- spects, and the better you know those you are interacting with—whether em- ployees, peers, superiors, or others—the better you can focus your objectives + Know specifically what you need to a complish with any specific interaction In other words, avoid overall objectivesthat are too large for accomplishment within the context ofa single interaction. + Although you cannot know in advance whether you will succeed in reaching a particular objective, you should have de- cided in advance what sort of results would constitute success or failure. + Have a clear idea of the likely directions ‘open to you depending on the results of a given interaction, That is, what might you do next if your immediate objective is achieved as envisioned? If the objec- tive is missed altogether? If the results of the interaction indicate the need for an entirely different approach? Why and how to set objectives for interaction Through the conscientious and repeated analysis of interactive behavior, we gradually become proficient at monitoring our own behavior and that of others. This should lead to an improved ability to adapt any par: ticular style of behavior as may be most appropriate to the achievement of our ob- jectives. We come to know ourselves, and we come to know others and how they are likely to react in interaction with us, and thus we pattern our own behavior accordingly Quite simply, having an objective in any particular interaction gives you a specific tar- get for which to aim. This target may have to be modified as you acquire new information through the interaction, but it still provides valid direction. The assessment of behavior provides you with essential guidance in choosing how to approach that objective. We hear much about the desirability of pursuing win-win outcomes as opposed to dealing in winose situations. Most working managers would likely profess a preference for win-win outcomes for most interactions; however, many unconsciously structure their interactions as win-lose scenarios. Without necessarily realizing they are doing so, many individuals approach interpersonal commu- nication as though most interchanges end with someone “winning” and someone “losing.” Interpersonal Skills 181 ‘0 some people, communication appears to be a game or a serious competition in which one must always endeavor to “win. ‘These, of course, are the individuals who will prolong a discussion until they get their way or who will become emotional and re- sort to argument, perhaps using the deadly weapons of sarcasm, ridicule, name-calling, and blaming, the illegitimate tools of commu- nication that serve to inflame and alienate. Many people exhibiting the winose men- tality enter their interactions with narrowly defined objectives in mind, literally premade decisions that leave no room for negotia- tion, and they tend to take every “loss” asa personal affront We set objectives to conceptualize in ad- vance the results we would like to achieve. However, if the objectives are narrow and rigidly defined and take into account only what the initiator of the interaction wants to accomplish, unmindful of the feelings and needs of the other party, the interaction will play out in a windose scenario. Should the other party be one of those who must ‘win’ to maintain a sense of self-worth, the stage is set for conflict, Surely, a genuine win-win situation is not Iways possible given the variety of commu- nications situations a department manager is likely to become involved in. There are those occasions when one party cannot realistically expect to “win.” Consider, for example, the following situation in which disciplinary action or at least serious criticism is warranted, ‘The nurse man ger of a medical/surgical nursinig unit centered the workroom of the unit justin time to see Sally, 4 nursing assistant whom the manager considered a usually careful worker, commit an act that could only be described as horseplay. Sally’s behavior caused another employee to be startled into dropping and breaking two pieces of glassware. In addition to Sally and the person who dropped the glassware, there were two other stafT ‘members present Sines the manager personally saw Sally commit the act, there is no room available for Sally to “win” in the inevitable interaction with the manager. The manager can, how- ever, limit Sally's losses to what is absolutely182 THE HEALTH CARE MANAGER/APRIL-JUNE 2004 necessary and can do so in a reasonable manner. Should the manager verbally take off on Sally right on the spot and promise punishment for her action, Sally would find herself criticized in the presence of others (an error for any manager to commit) and would thus “lose” additionally by being be- rated in the presence of her colleagues. This would suggest that the manager's hastily formulated objective for the interaction was “Punish Sally and make an example of her for others.” This objective violates 2 of the fundamental principles of fair and effec- tive disciplinary action: discipline only in private, never in the presence of others; and never make an example of anyone. If, along the lines of criticism or disci- plinary action properly addressed, the man- ager were to get Sally alone, describe what was seen, and ask Sally for her version of the incident, stress precisely why Sally's be havior was inappropriate, provide advice for future behavior, and explain how this inci- dent stands in contrast to Sally's usually good performance, the manager's implied objective becomes: “Correct Sally's behavior so that similar incidents are avoided in the future.” In pursuing this objective, the manager has stayed focused on Sally's be: havior in this specific instance, addressed the problem constructively, and did so in a way that ensures Sally ‘loses’ than absolutely necessary. Being disciplined in the presence of others and being held up as an example would constitute per sonal “losses” for Sally well beyond that which is necessary to inspire correction of behavior Objectives, such that they + Focus specifically on what must be accomplished, avoiding the likelihood of peripheral “losses” that can result when objectives are harshly winlose i character; + Employ win-win scenarios when possible, + Limit any party's perceived “losses” to no more then, should be established the essential minimum; + Respect and protect the dignity of am and every party to an interaction. USING INTERPERSONAL SKILLS Some opening assumptions Given that any particular interaction prop- erly approached begins with certain end: of.interaction objectives in mind, without stretching too far, we can safely proceed with the following assumptions about inter personal communication + There is a connection between the be havior of one party and that of the other; ays or does will influence what the other says or does. + It is possible to arrange one’s outward behavior to influence or shape the be havior of the other party; this may be done unconsciously or it may be done deliberately what one + Only the other party’s overt or visible behavior is directly accessible; it is not possible to know precisely what 3 is thinking or feeling + There is no win-lose scenario, no strug. gle for dominance in an interchange, if both parties to an interaction have equiv alent obje + Interpersonal skills are far more effective when applied in one-on-one interactions than when applied in a one-on-several or one-on-many situation, where the oppor- tunities for effective behavior shaping are far less available nother ves. Shaping behavior Necessarily a two-way process The manager who is communicating to convince another person to do something, believe something, or change something is attempting to shape that individual's behav r. Behavior shaping, however, is frequently two-way process, so the person who is ‘tempting to shape another's behavior may in turn have his or her behavior shaped by the other party. There is in fact nothing wrong with this turnabout behavior shap- ing; this is in part how one learns, how one acquires new information and forms new attitudes, and thus legitimately modifies ob- jectives during an interaction.Frequently, the language of an interact bears a direct relationship to the behaviors experienced. For example, harsh, accusatory language, name-calling, and blame-casting signal belligerent, arbitrary, harsh behavior that suggests the interaction is on its way to a win-ose conclusion. This is highly likely to inspire strongly defensive behavior on the other person’s part, setting up a situa tion in which the likelihood of any meaning- ful communication occurring is dramatically diminished. Since our behavioral activity is likely to trigger corresponding reactions in response, the initiator of an interaction —we will continue to assume this is the depart ment manager—must be sufficiently discip- lined to avoid projecting an overbearing or threatening posture that is likely to turn the interaction into an argument or an change of charges and countercharges. Strong bebavior shapers Some particular behaviors are more pow- erful than others in their effectiveness as shapers of the behavior of other people. It will perhaps come as no surprise that these stronger behavior shapers are generally those that provide maximum opportunity for in- clusion or participation by the other party The department manager will surely re- cognize among the following a number of frequently offered suggestions for eliciting employee cooperation and participation + Seeking suggestions: asking for sugges- tions, perhaps even inviting the other party to propose a direction or solution, in effect offering to open the interaction so that it is less likely to be viewed as a one-way contact Offering suggestions: actively offering suggestions and inviting the other party to respond or make counter-offerings. + Extending proposals: offering a tenta tive proposal, complete with both pro- cess and intended result, and again encouraging the other party to accept, reject, or modify what is presented. + Soliciting clarification: asking for the other party’s understanding of the Interpersonal Skills 183 of mutual concern to them to ensure that both parties are “on the same page. If dealing with direct-reporting employees, in using any of the foregoing behaviors, make every reasonable effort to tap into the employees’ knowledge of the work of the department. The manager's knowledge of the department's work may be superior to that of the individual employees in the macro ‘nse of knowing how all elements fit to- gether in fulfilling the de objectives, but the manager cannot reason: ably expect to know the interior worki details of every job in the department. It is always worth remembering that no one has better knowledge of the detailed require: ments of a job better than the person who does that job every day Countering another's shaping bebavior In the majority of face-to-face interactions, cach party will have an objective that he or she would like to attain, and whether consciously or unconsciously, each party will be attempting to shape the other's behav- ior such that a personal objective can be achieved, As an example, consider a partic ular face-to-face encounter between a man- ager and an employee on the subject of a proposal to change the individual's daily shift to start and end an hour earlier than pre- viously. The manager’s objective is to con- vince the employee that the new starting time is appropriate; the employee's objective, we shall say, is to retain her present hours and make no change. Given the employee's objective, she will likely counter whatever the manager has to with arguments in favor of making no change. Perhaps, she pleads transportation problems associated with the proposed change: perhaps, she cites disruption of child-care ar- rangements in a manner that suggests the new hours would create hardship for her. Perhaps, her behavior even suggests that she believes she is being picked on or punished by being forced to change her hours. If the manager buys in to the employe arguments and reconsiders the change, the184 THE HEALTH CARE MANAGER/APRIL-JUNE 2004 manager has given in to the other's shaping behavior. This suggests the presence of one of three possibilities: the proposed change was not really needed and thus could not be “sold”; the employee is the stronger person- ality and simply overpowered the manager; or the manager was not adequately prepared for the interaction. ‘There are essentially three ways in which to go about getting employees to adopt a given change: the manager can tell them what to do, sell them on what must be done, or involve them in determining what must be done. In managerto-employee interactions, the first way, telling them, is likely to gen- erate resistance; it might get done, but there will likely be resentment and less than wholehearted cooperation, With anyone and especially with direct reporting employ- ces, the telling route will most likely trigger significant shaping behavior. When the man: ager in our example says, in effect, “Here's your new schedule, like it or not,” this manager can expect significant resistance and thus significant shaping behavior from the employee. Should the manager uy to convince the employee—"We need to change your starting and quitting times by one hour because. ..,”" resistance may be less than under the telling route and the employee's shaping behavior will be less. If the manager ‘an go into the interaction without offering a preconceived solution—say, for example, We're having a problem with adequate coverage because of some significant changes in client arrival patterns, let's put our heads together and see if we can fix it" —resistance is avoided, and shaping behavior by the employee is avoided because the manager and employee acquire a common objective: solve the problem. And—who knows?— once drawn into a common objective, the employce may help formulate a more appro- priate solution than indicated by the manag- er's premade decision. Therefore, successfully countering shap- ing behavior requires + Advancing one’s ideas as suggestions or possibilities, not as proposals and cer- tainly not as orders or edicts. Avoiding argument + Differentiating between legitimate feed- back and emotional reaction (legitimate feedback contributes to problem-soly- i ction associates with shaping behavior). + Utilizing constructive “idea-building” (as instorming) to generate explore possible paths toward solution. Permitting maximum possible participa tion and involvement of the other party. Changing another's bebavior This reference to changing another's be- havior concerns behavior change in a planned interaction, action-oriented and undertaker to achiev specific objective. This is a considerably narrower view of behavior change than that which we would associate with routine disciplinary action. In most in- stances, the primary purpose of disciplinary action is the correction of behavior; for example, if the manager disciplines an em- ployee for chronic tardiness, the prima purpose of the action is to encourage the employee to no longer be tardy. However, behavior change within the context of an interpersonal contact requires an exclusive focus on the behavior of the other party during that specific interaction. Changing another's behavior begins with carefully observing the person's behavior and feeding back observations that can make the other party aware of the behavioral char- acteristics coming across in the interaction. If, for example, the other party is told that he or she is “beginning to speak faster and louder and is starting to show signs of agitation,” that may be all that is needed to bring the communication back into bal ance. This is eminently workable in the manager-employee relationship, which the manager controls (or should control) the interaction and can provide feedback that may sound corrective in nature. Diplo- matically approached, this process may also be fully appropriate in interactions be: tween peers, as in, a manager-to-man- ager interaction.Another's behavior is changed by provid- ing the person with constructive feedback, keeping the interaction on track toward its intended objective and providing what- ever support and encouragement may be necessary to ensure the other party’s active participation. FACTORS REDUCING INTERPERSONAL EFFECTIVENESS ‘The most commonly encountered reasons for reduced effectiveness of one-on-one in. teractions are conflicting objectives, shortage of time, emotional arousal, and inadequate tening, Conflicting objectives There is an age-old exercise in improvisa- tion that involves a one-on-one interaction in which the two parties each receive their instructions in private and are then required to play out a scene based on what they been told. Each is to react extemporaneously to what the other says. Example: The scene is to involve a manager and an employee. ‘The instructions to the “manager” are that this generally valued employee is to be re leased as part of a company-wide cutback, and must be told so as diplomatically as possible. However, the “employee” is told that he or she is most likely being called in to be given a promotion and modest pay increase. One can imagine the confusion that can develop in this sort of interaction and can pethaps also envision the extremes to which two enthusiastic participants could take this scene. This example illustrates sharply different ‘objectives in a one-on-one interaction, The manager” wishes to humanely effect a ter- mination; the “employee” wishes to receive official word of the expected promotion and increase. Although rarely will the objec- tives in any ordinary workaday interaction be as diverse as those in the example, it is common for the objectives of the two par- ties to differ. Say, the manager's objective is to solve a particular problem by any reason- Interpersonal Skills 185 able means, while the employee's objective is to help solve the problem without acqui ing an added assignment. Or perhaps, the manager's objective is to resolve an appar ent quality problem, while the employee's immediate objective is to avoid being blamed for the problem, One party to the interaction must be in a position to exercise control and influence and remain aware of the need to get both participants “on the same page.” This is ordinarily the person who initiates the in- teraction for some particular reason. In a manageremployce relationship, it will usual ly be the manager who must accept respon- sibility for the interaction and for making every reasonable attempt to ensure a com: mon objective. Shortage of time Shortage of time—or, perhaps more ap- propriately expressed, time not committed to the extent necessary for effective commu- nication—is a significant cause of ineffective one-on-one communication. Involved with this matter of time is the necessity for feed- back in any interaction, feedback that is necessary if only to ensure that the message communicated by one party is properly un- derstood by the other party. Feedback is required to ensure that any interaction con- stitutes two-way communication; without feedback, we are left with one-w commu nication, which, if we can accept a simple definition of communication as the transfer of meaning, is not communication at all Conflicting objectives generally foster frus- tration and wasted time as participants circle about in search of common ground, Inade- quate time devoted to face-to-face communi. cation, especially insufficient time devoted to offering, receiving, and responding to feed back, fosters misunderstanding. It happens more often than one might imagine: person A says something to person B, person B nods and moves on; A believes that B has received the message as intended, and B believes that he or she has understood the message intended, yet they part with each having186 THE HEALTH CARE MANAGER/APRIL-JUNE 2004 completely different meanings in mind. Such results occur time and again, especially in the work situation, simply because someone does not take the time to obtain verific via feedback In most presentday work settings, and especially in health care given its present trend toward leaner staffing, managers and employees alike are usually extremely busy Busy people feel pressured to make the most of their time, and as they move from problem to problem and issue to issue, they tend not to linger over supposedly “simple” matters; they ask, instruct, order, and move on to the next concern. Many times, the absence of feedback causes no problems and messages are received properly, Many other times, however, without feedback, misunderstanding results and problem arise, and the time that was supposedly saved by being “efficient” in communication must be spent, often several times over, in correcting the results of misunderstanding. There is perhaps a certain wisdom in the old, anon ymous question: “How come there is never enough time to do it right the first time, but we can always find the time to do it over? ‘Time and the pressures of time will for- ever be the enemies of effective interper- communication. Emotional arousal he presence of emotion, primarily the negative emotions—anger and all of its var iants—reduces the effectiveness of interper sonal communication, often so much so that long-lasting damage results. The latter can occur when someone, usually in the heat of anger, says something that upsets another by causing pain or distress, Doing so is likely to ensure that nothing helpful results from the current interaction, and this behavior can also create a degree of alienation that ham- pers interactions between these people for some time to come. Although it can perhaps be said that, on rare occasions, a bit of righteous anger, carefully controlled, can be effective in certain kinds of situations; by and large, anger is destructive in interper: sonal communica mn. We can safely say that in the overwhelming majority of inter- as the level of anger increases, the chances of meaningful communication oc- curring decrease. There often seems to be no ready means of overcoming another's anger in an inter- action. Much will of course depend on the style and temperament of the individuals involved, Frequently, anger inspires anger, nd an escalating argument ensues. However, it should be recognized that the party who is ostensibly in control of the interaction should assume the responsibility for remain- ing calm in the face of anger, refusing to be baited and refusing to engage in argument, and doing everything reasonably possible to defuse the other's anger. In addition to not offering argument, this also means avoiding criticizing, blaming, or contradicting what is said. More often than not, the best course of action in the face of anger is to terminate the interaction until such time as tempers cool and rational behavior can prevail. Inadequate listening In interpersonal communication, one be fully effective in imparting information or reaching an agreement only if the other party is listening effectively. Here lies the greatest shortcoming to be encountered in communi- cating in the one-on-one relationship: one party can be doing everything right, can be saying the proper things in the right way and behaving respectfully, perhaps even def- crentially, and all can be for little or nothing, if the other person is not listening, Listening can be described as communica- tion along one of the four basic communica tion channels, the others being reading, writing, and speaking. Two are for incoming formation—listening and reading; two are for outgoing information—writing and speak- ing. Listening, however, differs from the other three means in one important respect. ‘The others are inherently active processes; one cannot read, write, or speak without ma- king a decision to do so and consciously tak- ing the necessary steps. Listening, however, anis not inherently active. That is, because one can “hear” without taking any steps to make it possible and because there is oft subsequent effort to make listening activ what is being said is taken in superficially with no effort expended to truly understand the message ‘The best defense against inadequate listen- ing is, once again, the required use of feed- back. If you wish to be certain your message has gotten across, the kind of question not toaskis, “Do you understand? especially n no Many people, employees in interaction with managers, will answer “yes” whether they fully understand or not. (It is a sad fact of business life to know that there are oc- casional managers who take offense if it seems as though employees have not unde: stood the great pronouncements upon initia hearing.) ‘The kind of request to make of the other party: “Tell me in your own words what I just asked you to do, so I can make sure we both see it the same way.” The forthcoming sponse will be the sort of deliberately solicited, focused feedback that will reveal the extent to which the person has been listening. well as allowing the requestor to supplement or clarify the message if nec Interpersonal Skills 187 essary defense against inadequate list Enforced feedback is the primary ning. CONCLUSION: PRACTICE, PRACTICE to become proficient about anything is to make the right moves and make them again and again. Proficiency in one-on-one interactions—interpersonal competence, if you will—is one of the hall just marks of the successful manager of people Some managers spend as much as three fourths or more of every workday in face-to- face contacts with others, be they employees, peers, superiors, clients, visitors, suppliers or whoever. Those managers who may have occasion to feel that all of the people: contact that seems to consume the days to the extent of keeping them from the “real work” have yet to recognize that many of the most important elements of a manager's real work’ involve face-to-face, one-on-one interactions. Interpersonal skills are not to be assumed; they are not to be taken for gra other skills employed in busi and health care in partic their use requires consci and pi inted, Like any ess in general ar, proficiency in -atious application tice.Copyright of Health Care Manager is the property of Lippincott Williams & Wilkins -- Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.