Communicating Across Differences

05 Mar 2021

By Jaime Lewis and Virginia Shaffer

This blog entry is the second in a series of six blogs authored by members of the AWS Clinical Practice Committee writing in collaboration with our society liaisons throughout the year.  

Throughout our career, we will have heard or been a part of countless conversations – from mundane discourses, to heated debates, bitter diatribes, and cooperative dialogues. Many of us will spend our lives pondering and practicing ways to improve our ability to communicate.

In situations where opinions differ, we must approach them with an open mind and acknowledgement that we may not know the entire story. We should recognize stereotypes and biases and try to mitigate their  impact. We must have the courage to be uncomfortable,and we should always observe the platinum rule by treating others as they want to be treated! One can often approach a conversation with only our perspective, and we make assumptions about what the other person wants to say or how they want to be treated. We need to take a step back and ask our counterpart to help us see things from their point of view.

Once we have created space for the other person, we still may not communicate well because we have different styles. Understanding that different styles exist is the first step in improving our ability to have an effective conversation. Starting with the basics, there are four common “trip wires” in communication:

  1. Getting down to business versus relationship building – cut to the chase or get to know one another
  2. Direct versus indirect communication – blunt or vague
  3. Low versus high context – words or body language and facial expressions
  4. Informality versus formality – casual or ceremonial

While there may be obvious and somewhat predictable differences in communication between individuals from different countries, there may be more subtle but still important differences between individuals from the same geographic region. It is important to be aware of how these differences can significantly impact the words that are spoken.

It is then essential to develop your skills as a communicator.

  1. Understand how to adapt your communication style. Therefore, you must know your communication style and what other styles exist! There are numerous ways to learn your style, including reading and taking quizzes.
  2. Learn to actively listen. Stay in the moment. Avoid distractions and the urge to interrupt. This can be very hard. Practice, practice, practice RASA: Receive, Appreciate, Summarize, Ask
  3. Engage transparency.
  4. Be clear and specific.
  5. Ask open-ended questions using the TED acronym: “Tell me more.”, “Explain what you mean.”. “Define that term or concept for me.”
  6. Display empathy. Regardless of the outcome, acknowledge the other’s feelings and experiences.

In communicating across differences, whenever possible, we must also choose to be an ally. Being neutral does not make one an ally. An ally is one who learns by avoiding assumptions. An ally is one who listens more than (s)he speaks, even if (s)he disagrees. And an ally is one who acknowledges and yields any privilege (s)he has in the situation.

When communicating across differences, it is of utmost importance to understand the other’s point of view. Where are they coming from? What data are they using? What is their interpretation of that data? What is different about the data we are looking at? What is different about our interpretation and implicit rules of the data? We need to shift from “that’s wrong” to “tell me more”.

Each conversation we have is an opportunity to communicate across our differences.

Dr. Virginia Shaffer is an Associate Professor of Surgery at Emory University in Atlanta, GA and specializes in minimally invasive and open surgical treatment of diseases of the colon and rectum. She received her M.D. at the University of Texas Health Sciences Center San Antonio, and completed general surgery residency at Emory University. Dr. Shaffer did a research fellowship in Transplant Immunology and subsequently did a fellowship in Colon and Rectal Surgery at Cleveland Clinic Florida. She is board certified in both General Surgery and Colon and Rectal Surgery. She is a fellow in the American College of Surgeons and the American Society of Colon and Rectal Surgeons.  Her research interests include health services research, quality improvement, and clinical research.

Dr. Jaime D. Lewis is an Associate Professor in the Division of Surgery Oncology and a Career Advisor in Student Affairs at the University of Cincinnati College of Medicine in Cincinnati, Ohio, where she also completed her general surgery residency. After residency, she spent a year in Tampa, Florida training in breast surgical oncology at the Moffitt Cancer Center. Her practice is dedicated to the care of those with diseases of the breast. Dr. Lewis is also committed to improving wellness and professional development opportunities for those who pursue careers in surgery. Outside of the hospital, she enjoys road and trail (ultra)running and spending time with her family. You can find her on Twitter at @JaimeDLewisMD.


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

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