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Communication should be thought of as a clinical skill essential to clinical competence – one that can be learned and improved (Beck et al. 2002; Shaw et al. 2004; Shaw 2006; Kanji et al. 2012). Communication skills are significantly associated with outcomes of patient care, including patient health, patient and physician satisfaction, and malpractice risk (Shaw 2006). There are three principal types:

 Content Skills: The content of questions and information given.

 Process Skills: Verbal (words chosen) and nonverbal communication, including vocal indicators (speech tone and pace, rhythm, inflections, sounds used to convey understanding [uh‐huh, ahh, mm], volume, laughing, yawning, etc.), facial expressions, eye contact, posture, touch (beware of intense cultural differences), gestures (pointing), body movement (foot or finger tapping), smell, and appearance.

 Perceptual Skills: Cognitive (problem solving) and relationship (personal awareness and awareness of others) skills.

Shaw (2006) identified four core communication skills that highly effective practitioners should possess: nonverbal communication, open‐ended questioning, reflective listening, and displays of empathy.