At the other end of a literature search: how was our information useful?

One of the things I have loved about my role has been the literature searching. Our learning and development team frequently use our services for this, and with a teaching background, for me it has always been a pleasure to undertake a search for information that will be used to build a course.

Some time ago, we were asked to run a search for information on communication, and a further one for difficult conversations. A lot of grey literature was explored, and I let my creative brain run this gig, so I will hasten to add, these searches most certainly have zero reproducibility.

We don’t always know exactly how our search results have been used or what difference they make to our colleagues, so when I found myself taking an early seat in the training room having booked a place on our Trust’s communication skills programme, it was a good feeling.

As the search was for a training programme, I made a point of digging around for some practical examples to support the theoretical material. One that I quickly recognised when the session got started was a classic illustration of the importance of intonation is the sentence: “I Didn’t say he stole the money”.

Depending on which word the emphasis is put on, the sentence has seven different meanings and illustrates how misunderstandings can arise, particularly in written communication:

1. I didn’t say he stole the money (someone else said it)
2. I didn’t say he stole the money (that’s not true at all)
3. I didn’t say he stole the money (I might have suggested it)
4. I didn’t say he stole the money (someone else took it)
5. I didn’t say he stole the money (but he does have it)
6. I didn’t say he stole the money (but maybe some other money?)
7. I didn’t say he stole the money (but he may have stolen something)

The literature search had found a lot of information on barriers to communication within healthcare; this was explored within the session to support learners’ reflection. Kwame and Petrucka (2021) suggest that achieving patient-centred care and communication in clinician-patient clinical interactions is complex as there are always institutional, communication, environmental, and personal barriers. They recommend that if we want to deliver patient-centred care, it is important to identify these barriers and what facilitates good communication. With reference to our Trust values and behaviours framework, the workshop facilitators had created reflection sheets to be useful as evidence to support clinician revalidation or discussed in appraisals.

Health literacy is a considerable factor in terms of barriers; one of my library colleagues supported the facilitation of the advanced communication skills workshop that was piloted the following week. In this workshop, learners were invited to explore how technical jargon and task-focused interaction can get in the way when interacting with patients, where lived experience has a different vocabulary to that of a clinician.

Robinson, Segal and Smith (n.d.) suggest that our stress levels and emotional state can impact our communication, and this was discussed throughout both workshops. When we’re stressed or overwhelmed, we are more likely to misread other people, send off the wrong vibes to others, and default into unhelpful habitual behaviours like shutting down. Conflict management can begin with using tools to invite calm even in the midst of a challenging situation:

• Giving yourself time to think. Ask for a question to be repeated or for clarification so that you can respond instead of reacting.
• Pausing to gather your thoughts as you speak can put you more in control of your words, emotions and tone.
• Summarising and allowing for silences. Summarise our understanding of what is being said and don’t feel the need to fill the silence by continuing to talk.

It was great to see how the underpinning theory supporting the workshop was evident during some active listening techniques throughout the session, and how the facilitators had translated this to inform experiential practices and built in pauses during the session for structured reflective writing.

Learners were invited to really think about examples of good and bad communication they had experienced. This led to people acknowledging how when we’re “listening” to someone, quite often we are distracted by our own thoughts, planning our own reply or thinking about our own experience. The questions asked by the facilitator echoed Lee (2014), inviting us to consider when we have walked away from a conversation feeling like we have really been listened to, and to think about the best listeners we have in our life.

It was fantastic to hear some of the delegate feedback at the end of the sessions:

• “Great tips, good content that is very relevant easy to take away and use in practice”
• “Covered good topics in a condensed time with relevant examples.”
• “The training was very interactive which made it easier to engage with each of the sections and allowed for easy learning. Will take away the value of empathetic language, and value of occasional silence”.

All in all, what a welcome opportunity to view ourselves as part of a “chain” distributing information to our colleagues and see the demonstrable value of the information we provide.

Andreya Bryn Davies

Assistant Clinical Librarian

Royal Lancaster Infirmary, University Hospitals Morecambe Bay Trust

References

Kwame, A., Petrucka, P.M. (2021) A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20, 158.

Lee, J. (2014) Listening: An Intervention – Part 1. Available at: Listening: An Intervention – Part 1 (Accessed 24 October 2025).

Robinson, L., Segal, J. & Smith, M. (n.d.) Effective Communication: Improving Your Interpersonal Skills. Available at: Effective Communication: Improving Your Interpersonal Skills (Accessed 24 October 2025).

Andreya B. Davies

Assistant Clinical Librarian

Library & Knowledge Services

University Hospitals of Morecambe Bay NHS Foundation Trust