Successful communication in healthcare settings matters : the salient role of intercultural nonverbal communication cannot be overestimated

This chapter conceptually examines the unique role intercultural nonverbal communication plays in healthcare settings. Nonverbal communication between healthcare providers and recipients are mutually constructed, culturally intricate, contextually dependent, and socially affective. In healthcare settings, both patients and physicians use nonverbal communication (e.g., paralinguistic, kinesic, and proxemics cues) to convey their thoughts apart from verbal questions and answers, with the former describing their medical history and health issues and the latter providing medical advice and helpful treatment plans (Gerwing & Landmark Dalby, 2014; Gorawara-Bhat & Cook, 2011; Hannawa, 2014; L. Martin et al., 2016; L. R. Martin & Friedman, 2005). When coming from different language and cultural backgrounds, they tend to use culturally different nonverbal empathy cues (Lorié, Reinero, Phillips, Zhang, & Riess, 2016). Nonverbal communication cues related to emotional expressions (e.g., smiling) used in healthcare settings can indicate different meaning depending on the specific context of interaction (Philippot, Douilliez, Pham, Foisy, & Kornreich, 2005). Using socially affective strategies in varied form of nonverbal communication can result in more positive communication outcomes for doctors and patients (Blanch-Hartigan, 2012; Cousin & Schmid Mast, 2013). Intercultural nonverbal communication competence includes intercultural nonverbal communication knowledge, intercultural nonverbal communication skills, and appropriate attitude towards diverse intercultural nonverbal communication styles (Yang, 2015). After reviewing relevant literature, I propose a research question that focuses on why intercultural nonverbal communication competence matters in the healthcare settings. The discussion is centred around paralinguistic cues, kinesic cues, and proxemic cues used by healthcare professionals and their clients in interaction. Two pedagogical implications are discussed. One implication is that the in-service healthcare professionals (e.g., doctors, nurses) undertake work-related intercultural nonverbal communication training through case studies and reflective practices so that they develop patient-centred accommodative communication knowledge, skills, and culturally appropriate attitude. It is particularly important when they and their patients with diverse linguistic and cultural backgrounds use different nonverbal communication styles (Singh, McKay, & Singh, 1998) due to differences between high-context and low context cultures, have different cognitive schema, and use diverse perceptive skills in reading their patients’ nonverbal cues and emotional status (Gorawara-Bhat & Cook, 2011). The other implication is that preservice healthcare professionals, particularly a large number of international students undertaking university coursework on healthcare (e.g., nursing) in English-speaking countries, are provided with formal training in intercultural nonverbal communication as part of their coursework, projects and placements so that they develop their intercultural nonverbal communication competence along the way and are ready to meet the needs for patient-centred healthcare services.