Introduction
Communication is the exchange of information and meaning between people. In medicine it underlies history taking, explanation, shared decision-making and adherence to treatment. Communication theories describe how messages are sent, received and interpreted, and why communication sometimes fails. This topic covers the main models and their practical use.
Linear transmission model
- The Shannon and Weaver model (1949) describes communication as a sender encoding a message, sending it through a channel, and a receiver decoding it. Noise can distort the message at any point.
- Berlo's SMCR model (source, message, channel, receiver) adds the skills, attitudes, knowledge and social-cultural background of both partners to the process.
- The linear model explains technical transmission well, but it ignores feedback, meaning and the mutual influence of the partners.
Interactive and transactional models
- Later models added feedback. Schramm described communication as an interaction in which each partner sends and interprets messages.
- The transactional model goes further. Both partners send and receive at the same time, and each message is shaped by the context and by everything said before.
- In a clinical encounter, the doctor's response changes what the patient says next. The transactional model describes this more accurately than a one-way transmission.