Good communication is at the heart of effective teaching practice, whether you are giving a lecture, facilitating a small group or teaching at the bedside or in the workplace. 

Understanding some aspects of communication theories can help teachers communicate more effectively with diverse student groups. There are numerous communication theories that inform communication practice. Schulz von Thun suggests that communication can be considered in terms of four sides of a square, each side reflecting a different aspect of the communication process. Each time, teachers communicate with students they convey several messages concurrently. The main message is the intended one but other messages may accompany this primary message. These other messages may be "coloured by" cultural and personality factors.

According to von Thun's model (see figure below):

1. The factual information component relates to the information that the teacher wants to impart to the student. This information is what the teacher (or sender) feels the student (or receiver) will comprehend. In a diversity situation, the teacher needs to consider difference with respect to cultural background, linguistic and knowledge understandings, levels of competency, reasoning abilities, and capability of retention.

2. The self-revelation aspect is concerned with what the teacher says about their 'inner being' to the student. This type of information may be affect-related or context driven and tells the student about who they are at that point in time. It might be anger, frustration, humour, or delight. In relation to a diversity situation, humour, for example, can be misinterpreted by the student if that student comes from a different culture, or whose language codes are very different to those of the teacher.

3. The relationship aspect refers to how the teacher relates to the student. This is a very important aspect of the relational space that both teacher and student enter, and occupy, when engaged in communication. Every culture has its own rules and norms in terms of the modes of conduct within this space. Teachers need to be aware of personal space, tone of voice, gestures, facial expressions, and choice of words.

4. The appeal aspect considers the effect the teacher wants to impart to the student. The main effect is to inform students so that their competencies, knowledge and attitudes are informed. In addition, the teacher requires feedback from students to ensure that they have understood the message to make certain learning has taken place. Accordingly teachers need to consider appropriate questioning techniques that can maximise the learning process, by using a variety of methods that fit the student's case. If working with a Pasifika student, for example, it is important to develop a sense of connection with the student by engaging at a deeper level of discourse by considering their family history and where they come from, and thus, ensuring that the student will be receptive to the information being imparted.

In this video Marcus Henning draws on personal experience and communication theory as he relates how he communicated with a student on an interpersonal level to facilitate engagement with the learning process.

 Click to play the video (requires Flash Player).

Betancourt, J. R. (2003). Cross-Cultural Medical Education: Conceptual Approaches and Frameworks for Evaluation. Academic Medicine, 78(6), 560-569.

Given that understanding the sociocultural dimensions underlying a patient's health values, beliefs, and behaviors is critical to a successful clinical encounter, cross-cultural curricula have been incorporated into undergraduate medical education. The goal of these curricula is to prepare students to care for patients from diverse social and cultural backgrounds, and to recognise and appropriately address racial, cultural, and gender biases in health care delivery. Despite progress in the field of cross-cultural medical education, several challenges exist. Foremost among these is the need to develop strategies to evaluate the impact of these curricular interventions. This article provides conceptual approaches for cross-cultural medical education, and describes a framework for student evaluation that focuses on strategies to assess attitudes, knowledge, and skills, and the impact of curricular interventions on health outcomes.

Dogra, N., & Karnik, N. (2004). Teaching Cultural Diversity to Medical Students. Medical Teacher, 26(8), 677-680.

The evidence presented in this review provides a range of perspectives on the place of ‘cultural diversity’ in the medical curriculum. The different perspectives also highlight the lack of any structure for a coherent debate about this issue; some papers assume that there is agreement about the place of ‘cultural diversity’ and what teaching in this subject actually entails. Staff perspectives are reviewed and contrasted with those of students to examine the place of ‘cultural diversity’ in medical education.

 C. Nagy. Communication. Every Message Has Four Sides

This is the first in a series of communication modules. Certainly, everyone can communicate, but are we always understood as we wish to be understood? Can we be sure that we are correctly interpreting the person opposite us? Why are there misunderstandings? Or, to put the question differently: why do we understand each other at all?

C. Nagy. “We Talk Even When We’re Not Saying Anything” – The Five Axioms of Communication According to Paul Watzlawick.

This is the second in a series of communication modules. The preceding article presented a model that attempts to explain how communication occurs, the model of the four sides of a message described by Schulz von Thun. This models proceeds from the assumption that every message contains four sides: factual information, a relationship aspect, self-disclosure, and an appeal. Thus the sender can have four intentions in every case, and the receiver has four possible ways to hear and interpret the message.

C. Nagy. Communication Difficulties, Misunderstandings and Conflicts

This is the third in a series of articles on communication. Situations of conflict always present a challenge and prompt us to take action. They represent, however, not only a risk or a negative situation; they also can bring about positive changes. Not for nothing do we also speak of constructive conflict resolution and of the ability to cope with conflict as an important social skill. But, what do we mean by the ability to cope with or tolerate conflict?

The Communication Model by Schulz von Thun

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How do I communicate with diverse student groups?

“A teaching philosophy can help you to reflect on how and why you teach. If you don’t have a teaching philosophy, you might want to consider writing one. You can take a look at What makes a good teacher? to get started. If you already have a teaching philosophy, you might want to reflect on how the work that you are doing here fits with that philosophy”.