This article outlines a framework for nurses to further develop their communication skills during
interaction with patients. It also shows how to implement this framework in nursing practice.
Keywords: Communication, Patient education
Stephen J. Hamilton, MSc, PG Dip, BSc, RMN, is lecturer in health communication;
David J. Martin, PG Cert, Adv Dip Management of Psychological Trauma, Dip Specialist
Practice, BSc, RMN, is a dual diagnosis worker and part-time lecturer; both at the University of
Hamilton, S.J., Martin, D.J. (2007) A framework for effective communication skills.
Extended version of Nursing Times; 103: 48, 30-31
This article outlines a framework for nurses to further improve and develop their communication
skills during interaction with patients. It also shows how to implement this framework in nursing
practice, and nurses’ role in communication skills is further outlined through the use of an
The use and benefits of effective communication skills in nursing have been extensively
researched and documented over the years. For example, Dougherty and Lister (2007), Kihlgren
et al (1993), Boore (1978) and Hayward (1975) all highlighted potential pain-reducing
implications and increasing recovery rates when patients are provided with additional
information/communication about their diagnosis, prognosis, care and treatment.
Harrison and Hart (2006), Northouse and Northouse (2004) and Robb et al (2004) discussed the
range of communication skills available to health professionals. Nurses can facilitate successful
and therapeutic patient contact through questioning, listening, summarising, reflecting,
paraphrasing, set induction and closure. Nurses use these skills on a daily basis to: gather
information; reassure; facilitate patient expression; harness attitudes, views and opinions;
encourage critical thinking; reduce anxiety; facilitate liaison with other disciplines; and promote
continuity in patient care (Berry, 2007; Murray et al, 2006; Bury, 2005; Bayne et al, 2002;
French, 1994; Hargie and McCartan, 1986).
In this article, we advocate a communication skills framework within which the use of these
various skills can be contextualised and applied by registered nurses and those in training alike,
in hospital and community settings. The purpose of the suggested framework is to reinforce and
complement not only the scope of nursing practice but also to encompass the wide range of
nursing duties, activities and responsibilities.
Box 1 provides a breakdown of the different features of the suggested framework and is then
followed with examples of how the framework could be used during contact time with patient
groups. The communication skills role of nurses is then further illustrated in Box 2, using the
acronym EDUCATE. The acronym itself serves as a guiding mechanism, mnemonic and future
point of reference.