Effective Professional Communication and Motivational Interviewing

Key Points

• Effective nursing communication is factual, practical, clear, concise, and appropriately persuasive.
• Professional communication includes understanding, respectful title/pronoun use, trustworthiness, assertiveness, and resolution.
• Motivational interviewing (MI) supports behavior change without coercion.
• OARS skills (open questions, affirmations, reflective listening, summaries) improve shared decision-making.

Pathophysiology

Communication effectiveness is a care-quality determinant rather than a biologic process. Poorly structured messages reduce trust and adherence, while clear and patient-aligned communication improves decision quality and outcomes.

MI reduces resistance by shifting from directive persuasion to collaborative exploration of patient values, readiness, and barriers.

Classification

• Effective communication elements: Factual, practical, clear/concise, persuasive.
• Professional elements: Understanding, respectful naming/titles, trustworthiness, assertiveness, resolution.
• Behavior-change method: Motivational interviewing using OARS.
• Goal framework: SMART-style communication for actionable care planning.

Nursing Assessment

NCLEX Focus

Prioritize communication that clarifies patient goals and readiness before selecting education or behavior-change strategy.

• Assess whether message content is accurate and practical for patient context.
• Assess patient understanding, concerns, and priority agenda.
• Assess readiness for change and ambivalence around recommendations.
• Assess team communication tone for trust and assertive safety advocacy.
• Assess whether conflict has reached actionable resolution.

Nursing Interventions

• Deliver information in short, structured, plain-language sequences.
• Use OARS to explore barriers and elicit patient-owned goals.
• Apply assertive communication when safety concerns require escalation.
• Use respectful naming and pronoun preferences to strengthen therapeutic alliance.
• Summarize agreements and document clear next steps.

Coercive Communication Risk

Pressuring behavior change without MI principles can increase resistance and reduce adherence.

Pharmacology

Medication counseling is more effective when MI techniques are used to uncover adherence barriers and align plans with patient priorities.

Clinical Judgment Application

Clinical Scenario

A patient with chronic pain declines physical therapy and repeatedly requests medication-only treatment.

Recognize Cues: Ambivalence, fear of worsening pain, and narrow treatment preference. Analyze Cues: Direct persuasion alone is unlikely to change behavior. Prioritize Hypotheses: MI-based engagement is needed before care-plan commitment. Generate Solutions: Use OARS to identify goals, concerns, and acceptable first steps. Take Action: Co-create a phased plan with measurable goals and follow-up. Evaluate Outcomes: Patient participation and plan adherence improve.

Related Concepts

• therapeutic-communication-and-relationships - Foundation for relational communication and trust.
• health-literacy-assessment-and-plain-language-education - Supports clarity and understanding.
• conflict-resolution-skills-in-nursing-management - Professional resolution in high-stakes communication.

Self-Check

1. Why is “practical” communication distinct from “factual” communication?
2. How does OARS reduce resistance compared with directive counseling?
3. When should assertive communication be prioritized in nursing practice?