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Silence A short story  about turning an unexpected corner  in communication research
Silence is more eloquent than words.   ~   Thomas Carlyle
Silence is a text easy to misread.    ~A.A. Attanasio
Better silent than stupid.   ~   German proverb
Silence is one of the hardest arguments to refute.   ~   Josh Billings
Silence at the proper season is wisdom, and better than any speech.    ~Plutarch
Silence is the most perfect expression of scorn. ~ George Bernard Shaw
Silence is the ultimate weapon  of power.   ~   Charles De Gaulle
In field research, there are moments when  you can literally hear a pin drop.  In fact, an observation session may contain as much silence as sound.  Are you listening for that?  What meaning do you make of it?
I study how healthcare teams communicate. My work has tended to focus on communication that is visible & audible. Recently, however, my data have revealed something I hadn’t paid any attention to before:
Team communication exists in a spectrum of speech and silence.
Sounds obvious, doesn’t it? In fact, you might wonder why I hadn’t noticed it before.  Now that it’s smacked me in the head, the role of silence seems absolutely critical to my work. Let me show you what I mean,  and why I think it matters.
[object Object],(Operating room fieldnote 672)
[object Object],(Operating room fieldnote 1103)
Methods point ,[object Object]
Methods point ,[object Object],[object Object]
Silence can influence  the quality of the care that teams provide  in both positive and negative ways.
[object Object],(Operating room fieldnote 1171)
What does this silence mean?
Nurse didn’t hear the request;  silence is not a communicative act.
Nurse did hear the request, but she’s busy.  Silence is a communicative act  that delays response.
Nurse did hear the request.  She seeks to delay wound closure  until the counting protocol is complete.  Silence acts  as  a conflict-avoidance mechanism in a situation of potential conflict.
[object Object],[object Object]
[object Object],[object Object]
For team communication research,  silence is a key piece of the puzzle. But most empirical work in this domain  focuses on communicative  presence  – what can be seen and heard.
Furthermore, observational and assessment tools in this domain emphasize concrete, audible bits of data:  “information gathered and exchanged” Silences, neither gathered nor exchanged, are elided by these tools.
We’ve only begun to grapple with  the problem of silence . One interesting place to start…
Her hearing was keener than his,  and she heard silences  he was unaware of.    ~D.M. Thomas
How do we educate novices  to hear – and correctly interpret –  silences in healthcare team practices?
[object Object],(Operating room fieldnote 893)
What does this nurse hear in the silence  that prompts her to act rather than wait?
[object Object],[object Object],[object Object],[object Object]
The use and the interpretation of silence are sophisticated communication skills  on a healthcare team.   We don’t know much about these skills; there’s a lot of research to be done here.
Ideas to pursue Silence and power Silence and decision-making Silence and persuasion Silence and socialization
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The Sound of Silence

  • 1.  
  • 2. Silence A short story about turning an unexpected corner in communication research
  • 3. Silence is more eloquent than words. ~ Thomas Carlyle
  • 4. Silence is a text easy to misread.  ~A.A. Attanasio
  • 5. Better silent than stupid. ~ German proverb
  • 6. Silence is one of the hardest arguments to refute.  ~ Josh Billings
  • 7. Silence at the proper season is wisdom, and better than any speech. ~Plutarch
  • 8. Silence is the most perfect expression of scorn. ~ George Bernard Shaw
  • 9. Silence is the ultimate weapon of power. ~ Charles De Gaulle
  • 10. In field research, there are moments when you can literally hear a pin drop. In fact, an observation session may contain as much silence as sound. Are you listening for that? What meaning do you make of it?
  • 11. I study how healthcare teams communicate. My work has tended to focus on communication that is visible & audible. Recently, however, my data have revealed something I hadn’t paid any attention to before:
  • 12. Team communication exists in a spectrum of speech and silence.
  • 13. Sounds obvious, doesn’t it? In fact, you might wonder why I hadn’t noticed it before. Now that it’s smacked me in the head, the role of silence seems absolutely critical to my work. Let me show you what I mean, and why I think it matters.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18. Silence can influence the quality of the care that teams provide in both positive and negative ways.
  • 19.
  • 20. What does this silence mean?
  • 21. Nurse didn’t hear the request; silence is not a communicative act.
  • 22. Nurse did hear the request, but she’s busy. Silence is a communicative act that delays response.
  • 23. Nurse did hear the request. She seeks to delay wound closure until the counting protocol is complete. Silence acts as a conflict-avoidance mechanism in a situation of potential conflict.
  • 24.
  • 25.
  • 26. For team communication research, silence is a key piece of the puzzle. But most empirical work in this domain focuses on communicative presence – what can be seen and heard.
  • 27. Furthermore, observational and assessment tools in this domain emphasize concrete, audible bits of data: “information gathered and exchanged” Silences, neither gathered nor exchanged, are elided by these tools.
  • 28. We’ve only begun to grapple with the problem of silence . One interesting place to start…
  • 29. Her hearing was keener than his, and she heard silences he was unaware of. ~D.M. Thomas
  • 30. How do we educate novices to hear – and correctly interpret – silences in healthcare team practices?
  • 31.
  • 32. What does this nurse hear in the silence that prompts her to act rather than wait?
  • 33.
  • 34. The use and the interpretation of silence are sophisticated communication skills on a healthcare team. We don’t know much about these skills; there’s a lot of research to be done here.
  • 35. Ideas to pursue Silence and power Silence and decision-making Silence and persuasion Silence and socialization

Notas del editor

  1. Silence (A brief reflection on turning an unexpected corner in communication research)
  2. Sometimes, when we’re studying how healthcare team communicate, you can literally hear a pin drop. Are we listening for that? What meaning do we make of it? My own research, and that of most scientists exploring features of teamwork, including communication, focuses on what we can see, and what we can hear. Fieldwork is like that, isn’t it? And evaluative instruments, for assessing team communication, for assessing trainees’ developing communication skills, are even more prone to privileging communicative ‘presence’ – what is said, and heard – and deflecting communicative ‘absence’ – what’s not said, what can’t be heard.
  3. Sometimes, when we’re studying how healthcare team communicate, you can literally hear a pin drop. Are we listening for that? What meaning do we make of it? My own research, and that of most scientists exploring features of teamwork, including communication, focuses on what we can see, and what we can hear. Fieldwork is like that, isn’t it? And evaluative instruments, for assessing team communication, for assessing trainees’ developing communication skills, are even more prone to privileging communicative ‘presence’ – what is said, and heard – and deflecting communicative ‘absence’ – what’s not said, what can’t be heard.
  4. Once I began to notice this in our fieldnotes (and it was like a smack in the forehead when I finally did!), I realized that, OF COURSE, team communication exists in a spectrum of speech and silence. Let me show you what I mean, and why I think it matters.
  5. This is from a study of Operating Room teams.
  6. Fieldnotes, interviews, and THEORY required to grapple with this issue analytically
  7. Fieldnotes, interviews, and THEORY required to grapple with this issue analytically