[Skilled communication as "intervention" : Models for systematic communication in the healthcare system]

Specific communication training is currently not integrated into anesthesiology curricula. At the same time communication is an important key factor when working with colleagues, in the physician-patient relationship, during management of emergencies and in avoiding or reducing the legal consequences of adverse medical events. Therefore, focused attention should be brought to this area. In other high risk industries, specific communication training has been standard for a long time and in medicine there is an approach to teach and train these soft skills by simulation. Systematic communication training, however, is rarely an established component of specialist training. It is impossible not to communicate whereby nonverbal indications, such as gestures, mimic expression, posture and tone play an important part. Miscommunication, however, is common and leads to unproductive behavior. The cause of this is not always obvious. This article provides an overview of the communication models of Shannon, Watzlawick et al. and Schulz von Thun et al. and describes their limitations. The "Process Communication Model®" (PCM) is also introduced. An overview is provided with examples of how this tool can be used to look at the communication process from a systematic point of view. People have different psychological needs. Not taking care of these needs will result in individual stress behavior, which can be graded into first, second and third degrees of severity (driver behavior, mask behavior and desperation). These behavior patterns become exposed in predictable sequences. Furthermore, on the basis of this model, successful communication can be established while unproductive behavior that occurs during stress can be dealt with appropriately. Because of the importance of communication in all areas of medical care, opportunities exist to focus research on the influence of targeted communication on patient outcome, complications and management of emergencies.