• - Google Chrome

Intended for healthcare professionals

  • Access provided by Google Indexer
  • My email alerts
  • BMA member login
  • Username * Password * Forgot your log in details? Need to activate BMA Member Log In Log in via OpenAthens Log in via your institution


Search form

  • Advanced search
  • Search responses
  • Search blogs
  • Improving your...

Improving your communication skills

  • Related content
  • Peer review
  • Matt Green , medical publishing director, BPP Learning Media, London ,
  • Teresa Parrott , consultant psychiatrist, Pluscarden Clinic, Dr Gray’s Hospital, Morayshire, Scotland, UK ,
  • Graham Crook , retired consultant general medical physician and chest physician, Spain
  • mattgreen{at}bpp.com

The authors of the book Effective Communication Skills for Doctors , Teresa Parrott and Graham Crook , explore, together with Matt Green of the BPP University College’s School of Health, the art of clear communication in medicine and the steps that doctors can take to improve their communication with patients, family, and colleagues

A large and compelling evidence base in communication science shows that communication is vitally important to doctors and patients. However, this research also shows that changes are needed in the attitudes and skills that underlie the way doctors communicate. For this reason, training in communication skills has become an increasingly prominent part of undergraduate and postgraduate medical training.

It has been found that the communication skills of medical students who have not had this training actually get worse as they progress through medical school. So, whether you are a specialty trainee, foundation doctor, or medical student, it is never too soon to start fine tuning your skills. Doing this will give you a head start in enhancing your personal development and in progressing your professional career.

What is effective communication all about?

In these times of austerity measures and efficiency drives, we’re getting good at making the most of what we have—we are all mindful of delivering efficient services with scarce resources. However, we are not so good at making the most of what we are. In terms of communication, this means being able to give people the information they need in a clear and concise manner and with the right attitude. Good communication leads to more satisfying interaction with colleagues, helps you to manage your time better, and makes you a more effective team member and leader.

Learning to communicate effectively means making the most of every opportunity to interact with others: to be positive and encouraging to your team, to show empathy and concern to your patients, and to be able to deal with demands and difficult emotions. Having an understanding of what type of communicator you are and being able to identify the ways in which better communication can lead to better outcomes will help you to maximise your personal effectiveness in many different situations, giving you the advantage in interviews, assessments, and in the day to day workplace.

When do you need to start thinking about your communication skills?

At no stage in our careers should we stop developing and learning about communication. Research has shown that poor communication can contribute to burnout among consultants, dissatisfaction among patients, lack of compliance, and medicolegal problems. Improved communication skills could have a positive effect on all these.

Curriculum changes at medical school have led to a much earlier focus on the teaching and assessment of communication skills. Throughout your medical career, your interactions with others will be observed and measured through exams, supervision, workplace based assessments, and appraisals. In the foundation years you will be expected to develop generic communication skills as outlined in Good Medical Practice . In your e-portfolio you will reflect on your own performance. At specialty training interviews you will be asked to describe examples of when you have failed to communicate appropriately. At interview, your leadership skills, initiative, empathy, and team playing will be tested—how you motivate others, negotiate, and deal with conflict.

How does patient feedback influence your practice? How do you manage stress? These are questions about communication skills. Knowing some of the theories and research in the field will help you to become more confident in discussing the underlying issues. In this way, improving your communication skills raises the profile of other areas of your portfolio.

At all stages of your medical training there is an expectation that you can identify your weaknesses and discuss plans for improvement. The Medical Leadership Competency Framework, introduced in 2008, encourages self awareness—that is, knowing your own strengths and weaknesses. It entails realising the effect of your behaviour on others and the influence of your own emotions and prejudices on your judgments and behaviour. The aim of increasing self awareness is to be able to manage the impact of your emotions in your day to day practice—and to improve your relationships overall.

Top tips for effective communication

Use clear language: Avoid jargon and tailor your language to your patients’ understanding and information needs.

Be conscious of your non-verbal communication: It is important to maintain eye contact—reading notes or looking at the computer screen may convey negative messages.

Negotiate an agenda: Ask patients what they need from the consultation, and explain what can be covered. Few doctors explain the purpose of the consultation or the time available, and less than one quarter negotiate over treatment.

Establish a dialogue: Determine whether your patient agrees with the diagnosis and management plan. Patients who disagree with the diagnosis probably won’t adhere to the treatment.

Be flexible in your consultation style: Tailor your approach to the individual patient. A more directive style may be appropriate for patients who want less involvement in decision making. A supportive style—listening attentively and asking questions about psychosocial issues—helps facilitate the disclosure of sensitive information.

Provide the information that patients want: Doctors tend to talk too much about drug treatment, whereas patients want to know about causes and the likely diagnosis and prognosis. They want more openness about side effects and advice on how to relieve pain and emotional distress and what they can do for themselves. Providing this information helps their symptoms, reduces distress, improves physiological status, reduces hospital stay and use of analgesia, and improves quality of life.

Reflect on the outcomes of your interactions with others: Why do some doctors work well and others not so well? Communication difficulties are one of the main reasons that patients complain about doctors. The most common criticism is not about the doctors’ competence but that they have failed to listen or to offer sufficient explanation.

Apologise when mistakes occur: Apologising and expressing regret at the suffering experienced by a patient is not an admission of liability. Ineffective communication is the single largest factor behind litigation by patients. Good communication, including effective apology, can avert or help end conflict, especially litigation. It never does any harm to apologise—for yourself or on behalf of colleagues.

Empathise and listen: Your relationship with the patient is vitally important. It facilitates therapeutic space in which patients can express their concerns and receive support and advice. Empathy is the ability to understand what another person is experiencing and to communicate that understanding to the person. As the patient begins to relate his or her story, it is necessary to silence our own internal talk, including the diagnostic reasoning process, which can interfere with our ability to listen.

Mindful practice: This is your ability to observe not only the patient but your own performance during the consultation. Mindful doctors can easily be identified by patients and colleagues—they are present, attentive, curious, and unhindered by preconception.

Establish rapport: Recognition and explicit acknowledgment of the emotional content in your patient’s story is particularly important in establishing rapport. Doctors often respond to emotional cues by offering premature reassurance, explaining away distress as normal, attending to physical aspects only, switching the topic, or “jollying” patients along.

Final thoughts

Communication is important in all aspects of your training, and learning more about communication skills will help you perform better in exams, assessments, interviews, and appraisals—as well as in your day to day practice. Maximising your effectiveness in communication not only enhances your personal performance in many different spheres but also improves your relationships with patients and facilitates career progression.

Background references

Balint M. The doctor, his patient and the illness. Churchill Livingstone, 1957.

Charon R. Narrative medicine: a model for empathy, reflection, profession and trust. JAMA 2001;286:1897-902.

DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 2004;42:200-9.

Disiker R, Michiellute A. An analysis of empathy in medical students before and following clinical experience. J Med Educ 1981;56:1004-10.

Fallowfield LJ, Hall A, Maguire P, Baum M, A’Hern, RP. Psychological effects of being offered choice of surgery for breast cancer. BMJ 1994;309:448.

Fallowfield L, Jenkins V, Farewell V, Saul J, Duffy A, Eves R. Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial. Lancet 2002;359:9307.

Frenkel DN, Liebman CB. Words that heal. Ann Intern Med 2004;140:482-3.

Haidet P, Paterniti DA. “Building” a history rather than “taking” one: a perspective on information sharing during the medical interview. Arch Intern Med 2003;163:1134-40.

Kaplan SK, Greenfield S, Gandek B, Rogers WH, Ware JE. Characteristics of physicians with participatory decision-making styles. Ann Intern Med 1996;124:497-504.

Kaplan SH, Greenfield S, Ware JE Jr. Impact of the doctor-patient relationship on the outcomes of chronic disease. In: Stewart M, Roter D (eds). Communicating with Medical Patients. Sage Publications, 1989:228-45.

Kindelan K, Kent G. Concordance between patients’ information preferences and general practitioners’ perceptions. Psychol Health 1987;1:399-409.

Kinnersely P, Edwards A, Hood K, Ryan R, Prout H, Cadbury N, et al. Interventions before consultations to help patients address their information needs by encouraging question asking: systematic review. BMJ 2008;337:a485.

Maguire P, Fairbairn S, Fletcher C. Consultation skills of young doctors: benefits of undergraduate feedback training in interviewing. In: Stewart M, Roter D (eds). Communicating with medical patients. Sage Publications, 1989:124-37.

Maguire P, Pitceathly C. Key communication skills and how to acquire them. BMJ 2002;325:697-700.

Matthews DA, Suchman AL, Branch WT Jr. Making “connexions”: enhancing the therapeutic potential of patient-clinician relationships. Ann Internal Med 1993;118:973-7.

Meryn S. Improving doctor patient communication. BMJ 1998;316:1922.

NHS Institute for Innovation and Improvement, Academy of Medical Royal Colleges. Medical leadership competency framework. 2008. www.institute.nhs.uk/assessment_tool/general/medical_leadership_competency_framework_-_homepage.html .

Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP. Improving physicians interviewing skills and reducing patients’ emotional distress: a randomized clinical trial. Arch Intern Med 1995;155:1877-84.

Royal College of Physicians. Improving communication between doctors and patients. RCP, 1997.

Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ 1995;152:1423-33.

Stewart M, Brown JB, Boon H, Galajda J, Meredith L, Sangster M. Evidence on patient-doctor communication. Cancer Prev Control 1999;3:25-30.

Tomm K. Interventive interviewing: part III. Intending to ask lineal, circular, strategic, or reflexive questions? Fam Proc 1988;27:1-15.

Wissow LS, Roter DL, Wilson MEH. Pediatrician interview style and mothers’ disclosure of psychosocial issues. Pediatrics 1994;93:289-95.

Zoppi K, Epstein RM. Is communication a skill? Communication behaviors and being in relation. Family Med 2002;34:319-24.

Competing interests: TP and GC’s book Effective Communication Skills for Doctors is published by BPP Learning Media, whose medical publishing director is Matt Green ( mattgreen{at}bpp.com ).

communication skills research


  • The Magazine
  • Newsletters
  • Managing Yourself
  • Managing Teams
  • Work-life Balance
  • The Big Idea
  • Data & Visuals
  • Reading Lists
  • Case Selections
  • HBR Learning
  • Topic Feeds
  • Account Settings
  • Email Preferences

How Great Leaders Communicate

  • Carmine Gallo

communication skills research

Four strategies to motivate and inspire your team.

Transformational leaders are exceptional communicators. In this piece, the author outlines four communication strategies to help motivate and inspire your team: 1) Use short words to talk about hard things. 2) Choose sticky metaphors to reinforce key concepts. 3) Humanize data to create value. 4). Make mission your mantra to align teams.

In the age of knowledge, ideas are the foundation of success in almost every field. You can have the greatest idea in the world, but if you can’t persuade anyone else to follow your vision, your influence and impact will be greatly diminished. And that’s why communication is no longer considered a “soft skill” among the world’s top business leaders. Leaders who reach the top do not simply pay lip service to the importance of effective communication. Instead, they study the art in all its forms — writing, speaking, presenting — and constantly strive to improve on those skills.

communication skills research

  • Carmine Gallo is a Harvard University instructor, keynote speaker, and author of 10 books translated into 40 languages. Gallo is the author of The Bezos Blueprint: Communication Secrets of the World’s Greatest Salesman  (St. Martin’s Press).

Partner Center

  • Getting Published
  • Open Research
  • Communicating Research
  • Life in Research
  • For Editors
  • For Peer Reviewers
  • Research Integrity

How to communicate your research more effectively

Author: guest contributor.

steve hall nyu_166x233

by Angie Voyles Askham, Content Marketing Intern

"Scientists need to excite the public about their work in part because the public is paying for it, and in part because science has very important things to say about some of the biggest problems society faces."

Stephen S. Hall has been reporting and writing about science for decades. For the past ten years, he's also been helping researchers at New York University improve their writing skills through the school's unique  Science Communication Workshops . In our interview below, he explains why the public deserves good science communication and offers some tips for how researchers can make their writing clear and engaging.

How would you descr ibe your role as a science journalist?

I’ve always made a distinction between "science writer" and a writer who happens to be interested in science. That may sound like wordplay, but I think it captures what we aspire to do. Even as specialists, science journalists wear several hats: we explain, we report, we investigate, we step back and provide historical context to scientific developments to help people understand what’s new, why something is controversial, who drove a major innovation. And like any writer, we look for interesting, provocative, and deeply reported ways to tell these stories.

I know you from the science communication workshop that’s offered to NYU graduate students. One of the most important things that I got out of the workshop, at least initially, was training myself out of the stuffy academic voice that I think a lot researchers fall into when writing academic papers. Why do you think scientists fall into this particular trap, and how do you help them get out of it?

Scientists are trained—and rightly so—to describe their work in neutral, objective terms, qualifying all observations and openly acknowledging experimental limitations. Those qualities play very well in scientific papers and talks, but are terrible for effective communication to the general public. In our Science Communication workshops at NYU, we typically see that scientists tend to communicate in dense, formal and cautious language; they tell their audiences too much; they mimic the scientific literature’s affinity for passive voice; and they slip into jargon and what I call “jargonish,” defensive language. Over ten years of conducting workshops, we’ve learned to attack these problems on two fronts: pattern recognition (training people to recognize bad writing/speaking habits and fixing them) and psychological "deprogramming" (it’s okay to leave some details and qualifications out!). And a key ingredient to successful communication is understanding your audience; there is no such thing as the "general public," but rather a bunch of different potential audiences, with different needs and different levels of expertise. We try to educate scientists to recognize the exact audience they're trying to reach—what they need to know and, just as important, what they don't need to know.

What are some other common mistakes that you see researchers making when they’re trying to communicate about their work, either with each other or with the public?

We see the same tendencies over and over again: vocabulary (not simply jargon, but common expressions—such as gene “expression”—that are second-hand within a field, but not clear to non-experts); abstract, complicated explanations rather than using everyday language; sentences that are too long; and “optics” (paragraphs that are too long and appear monolithic to readers). We’ve found that workshops are the perfect setting to play out the process of using everyday language to explain something without sacrificing scientific accuracy.

Why is it important for researchers to be better communicators?

Scientists need to learn to tell their own stories, first and foremost, because society needs their expertise, their perspective, their evidence-based problem solving skills for the future. But the lay public, especially in an era where every fact seems up for grabs, needs to be reminded of what the scientific method is: using critical thinking and rigorous analysis of facts to reach evidence-based conclusions. Scientists need to excite the public about their work in part because the public is paying for it, and in part because science has very important things to say about some of the biggest problems society faces—climate change, medical care, advanced technologies like artificial intelligence, among many other issues. As climate scientist Michael Mann said in a celebrated 2014 New York Times OpEd, scientists can no longer stay on the sidelines in these important public debates.

As a science journalist, part of your job is to hunt for interesting stories to tell. How can scientists make their work more accessible to people like you—or to other people outside of their specific area of research—so that their stories are told more widely?

The key word in your question is “stories.” Think like a writer. What’s the story behind your discovery? What were the ups and downs on the way to the finding? Where does this fit into a larger history of science narrative? Was there a funny incident or episode in the work (humor is a great way to draw and sustain public interest)? Was there a conflict or competition that makes the work even more interesting? Is there a compelling historical or contemporary figure involved that will help you humanize the science? It's been our-longstanding belief that scientists have a great intuitive feel for good storytelling (we incorporate narrative training in our workshops), but just don’t think about it when it comes to describing their own work. The other key thing is to explain why your research matters.

One of the ways that many researchers try to share their work is through Twitter, but I noticed that on the NYU website it says you’re a Twitter conscientious objector. Why is that? What effect do you think Twitter has had on science communication and journalism in general?

I actually think Twitter can be a great tool for science communication, and many of my colleagues use it deftly. I tend to gravitate toward stories that everyone is not talking about, so Twitter doesn’t help much in that regard. The larger reason I’m a Twitter “refusenik,” as my colleague Dan Fagin sometimes calls me, is that I think the technology has been widely abused to disseminate misinformation, intimidate enemies, and subvert democratic norms; I don’t use it primarily for those reasons.

Are there any other tips that you can offer researchers who want to be better communicators and just aren’t sure where to start?

One first step might be to see if your institution offers any communication training and to take advantage of those programs; if not, think about how you might establish a program. We’ve posted a few of the things we’ve learned at NYU on our website ; we’ve also established a publishing platform for science communicators at NYU called the Cooper Square Review , which is a good way for scientists to get experience publishing their own work and reaching a larger public.

Stephen S. Hall  has been reporting and writing about science for nearly 30 years. In addition to numerous cover stories in the New York Times Magazine, where he also served as a Story Editor and Contributing Writer, his work has appeared in The New Yorker, The Atlantic Monthly, and a number of other outlets. He is also the author of six non-fiction books about contemporary science. In addition to teaching the Science Communication Workshops at NYU, he also teaches for NYU's Science, Health and Environmental Reporting Program (SHERP) and has taught graduate seminars in science writing and explanatory journalism at Columbia University.

Click here to learn how Springer Nature continues to support the needs of Early Career Researchers.

111119_angie askham_150x200

Guest Contributors include Springer Nature staff and authors, industry experts, society partners, and many others. If you are interested in being a Guest Contributor, please contact us via email: [email protected] .

  • early career researchers
  • research communication
  • Tools & Services
  • Account Development
  • Sales and account contacts
  • Professional
  • Press office
  • Locations & Contact

We are a world leading research, educational and professional publisher. Visit our main website for more information.

  • © 2024 Springer Nature
  • General terms and conditions
  • Your US State Privacy Rights
  • Your Privacy Choices / Manage Cookies
  • Accessibility
  • Legal notice
  • Help us to improve this site, send feedback.

Body Language and Nonverbal Communication

Improving emotional intelligence (eq), conflict resolution skills.

  • Empathy: How to Feel and Respond to the Emotions of Others

Anger Management: Help for Anger Issues

Managing conflict with humor.

  • The 5 Love Languages and Their Influence on Relationships
  • Gaslighting: Turning Off the Gas on Your Gaslighter
  • Online Therapy: Is it Right for You?
  • Mental Health
  • Health & Wellness
  • Children & Family
  • Relationships

Are you or someone you know in crisis?

  • Bipolar Disorder
  • Eating Disorders
  • Grief & Loss
  • Personality Disorders
  • PTSD & Trauma
  • Schizophrenia
  • Therapy & Medication
  • Exercise & Fitness
  • Healthy Eating
  • Well-being & Happiness
  • Weight Loss
  • Work & Career
  • Illness & Disability
  • Heart Health
  • Childhood Issues
  • Learning Disabilities
  • Family Caregiving
  • Teen Issues
  • Communication
  • Emotional Intelligence
  • Love & Friendship
  • Domestic Abuse
  • Healthy Aging
  • Aging Issues
  • Alzheimer’s Disease & Dementia
  • Senior Housing
  • End of Life
  • Meet Our Team

What is effective communication?

Tips for improving your communication skills.

  • Tip 1: Understand the barriers to effective communication

Tip 2: Become an engaged listener

Tip 3: pay attention to nonverbal signals, tip 4: keep stress in check, tip 5: assert yourself, effective communication improving your interpersonal skills.

Want better communication skills? These tips will help you avoid misunderstandings, grasp the real meaning of what’s being communicated, and greatly improve your work and personal relationships.

communication skills research

Effective communication is about more than just exchanging information. It’s about understanding the emotion and intentions behind the information. As well as being able to clearly convey a message, you need to also listen in a way that gains the full meaning of what’s being said and makes the other person feel heard and understood.

Effective communication sounds like it should be instinctive. But all too often, when we try to communicate with others something goes astray. We say one thing, the other person hears something else, and misunderstandings, frustration, and conflicts ensue. This can cause problems in your home, school, and work relationships.

But by learning effective communication skills, you can deepen your connections to others, build greater trust and respect, and improve teamwork, problem solving, and your overall social and emotional health

Whether you’re trying to improve communication with your romantic partner, kids, boss, or coworkers, learning the following communication skills can help strengthen your interpersonal relationships.

Tip 1: Understand what’s stopping you from communicating well

Common barriers to effective communication include:

Stress and out-of-control emotion.  When you’re stressed or emotionally overwhelmed, you’re more likely to misread other people, send confusing or off-putting nonverbal signals, and lapse into unhealthy knee-jerk patterns of behavior. To avoid conflict and misunderstandings, you can learn how to quickly calm down before continuing a conversation.

Lack of focus.  You can’t communicate effectively when you’re multitasking. If you’re checking your phone , planning what you’re going to say next, or daydreaming, you’re almost certain to miss nonverbal cues in the conversation. To communicate effectively, you need to avoid distractions and stay focused.

Inconsistent body language.  Nonverbal communication should reinforce what is being said, not contradict it. If you say one thing, but your body language says something else, your listener will likely feel that you’re being dishonest. For example, you can’t say “yes” while shaking your head no.

[Read: Nonverbal Communication and Body Language]

Negative body language.  If you disagree with or dislike what’s being said, you might use negative body language to rebuff the other person’s message, such as crossing your arms, avoiding eye contact, or tapping your feet. You don’t have to agree with, or even like what’s being said, but to communicate effectively and not put the other person on the defensive, it’s important to avoid sending negative signals.

When communicating with others, we often focus on what we should say. However, effective communication is less about talking and more about listening. Listening well means not just understanding the words or the information being communicated, but also understanding the emotions the speaker is trying to convey.

There’s a big difference between engaged listening and simply hearing. When you really listen—when you’re engaged with what’s being said—you’ll hear the subtle intonations in someone’s voice that tell you how that person is feeling and the emotions they’re trying to communicate. When you’re an engaged listener, not only will you better understand the other person, you’ll also make that person feel heard and understood, which can help build a stronger, deeper connection between you.

By communicating in this way, you’ll also experience a process that  lowers stress and supports physical and emotional well-being. If the person you’re talking to is calm, for example, listening in an engaged way will help to calm you, too. Similarly, if the person is agitated, you can help calm them by listening in an attentive way and making the person feel understood.

If your goal is to fully understand and connect with the other person, listening in an engaged way will often come naturally. If it doesn’t, try the following tips. The more you practice them, the more satisfying and rewarding your interactions with others will become.

Tips for becoming an engaged listener

Focus fully on the speaker.  You can’t listen in an engaged way if you’re  constantly checking your phone or thinking about something else. You need to stay focused on the moment-to-moment experience in order to pick up the subtle nuances and important nonverbal cues in a conversation. If you find it hard to concentrate on some speakers, try repeating their words over in your head—it’ll reinforce their message and help you stay focused.

Favor your right ear.  As strange as it sounds, the left side of the brain contains the primary processing centers for both speech comprehension and emotions. Since the left side of the brain is connected to the right side of the body, favoring your right ear can help you better detect the emotional nuances of what someone is saying.

Avoid interrupting or trying to redirect the conversation to your concerns.  By saying something like, “If you think that’s bad, let me tell you what happened to me.” Listening is not the same as waiting for your turn to talk. You can’t concentrate on what someone’s saying if you’re forming what you’re going to say next. Often, the speaker can read your facial expressions and know that your mind’s elsewhere.

Show your interest in what’s being said.  Nod occasionally, smile at the person, and make sure your posture is open and inviting. Encourage the speaker to continue with small verbal comments like “yes” or “uh huh.”

Try to set aside judgment.  In order to communicate effectively with someone, you don’t have to like them or agree with their ideas, values, or opinions. However, you do need to set aside your judgment and withhold blame and criticism in order to fully understand them. The most difficult communication, when successfully executed, can often lead to an unlikely connection with someone.

[Read: Improving Emotional Intelligence (EQ)]

Provide feedback. If there seems to be a disconnect, reflect what has been said by paraphrasing. “What I’m hearing is,” or “Sounds like you are saying,” are great ways to reflect back. Don’t simply repeat what the speaker has said verbatim, though—you’ll sound insincere or unintelligent. Instead, express what the speaker’s words mean to you. Ask questions to clarify certain points: “What do you mean when you say…” or “Is this what you mean?”

Hear the emotion behind the words . It’s the higher frequencies of human speech that impart emotion. You can become more attuned to these frequencies—and thus better able to understand what others are really saying—by exercising the tiny muscles of your middle ear (the smallest in the body). You can do this by singing, playing a wind instrument, or listening to certain types of high-frequency music (a Mozart symphony or violin concerto, for example, rather than low-frequency rock, pop, or hip-hop).

The way you look, listen, move, and react to another person tells them more about how you’re feeling than words alone ever can. Nonverbal communication, or body language, includes facial expressions, body movement and gestures, eye contact, posture, the tone of your voice, and even your muscle tension and breathing.

Developing the ability to understand and use nonverbal communication can help you connect with others, express what you really mean, navigate challenging situations, and build better relationships at home and work.

  • You can enhance effective communication by using open body language—arms uncrossed, standing with an open stance or sitting on the edge of your seat, and maintaining eye contact with the person you’re talking to.
  • You can also use body language to emphasize or enhance your verbal message—patting a friend on the back while complimenting him on his success, for example, or pounding your fists to underline your message.

Improve how you  read nonverbal communication

Be aware of individual differences. People from different countries and cultures tend to use different nonverbal communication gestures, so it’s important to take age, culture, religion, gender, and emotional state into account when reading body language signals. An American teen, a grieving widow, and an Asian businessman, for example, are likely to use nonverbal signals differently.

Look at nonverbal communication signals as a group. Don’t read too much into a single gesture or nonverbal cue. Consider all of the nonverbal signals you receive, from eye contact to tone of voice to body language. Anyone can slip up occasionally and let eye contact go, for example, or briefly cross their arms without meaning to. Consider the signals as a whole to get a better “read” on a person.

Improve how you  deliver nonverbal communication

Use nonverbal signals that match up with your words rather than contradict them. If you say one thing, but your body language says something else, your listener will feel confused or suspect that you’re being dishonest. For example, sitting with your arms crossed and shaking your head doesn’t match words telling the other person that you agree with what they’re saying.

Adjust your nonverbal signals according to the context. The tone of your voice, for example, should be different when you’re addressing a child than when you’re addressing a group of adults. Similarly, take into account the emotional state and cultural background of the person you’re interacting with.

Avoid negative body language. Instead, use body language to convey positive feelings, even when you’re not actually experiencing them. If you’re nervous about a situation—a job interview, important presentation, or first date, for example—you can use positive body language to signal confidence, even though you’re not feeling it. Instead of tentatively entering a room with your head down, eyes averted, and sliding into a chair, try standing tall with your shoulders back, smiling and maintaining eye contact, and delivering a firm handshake. It will make you feel more self-confident and help to put the other person at ease.

How many times have you felt stressed during a disagreement with your spouse, kids, boss, friends, or coworkers and then said or done something you later regretted? If you can quickly relieve stress and return to a calm state, you’ll not only avoid such regrets, but in many cases you’ll also help to calm the other person as well. It’s only when you’re in a calm, relaxed state that you’ll be able to know whether the situation requires a response, or whether the other person’s signals indicate it would be better to remain silent.

In situations such as a job interview, business presentation, high-pressure meeting, or introduction to a loved one’s family, for example, it’s important to manage your emotions, think on your feet, and effectively communicate under pressure.

Communicate effectively by staying calm under pressure

Use stalling tactics to give yourself time to think. Ask for a question to be repeated or for clarification of a statement before you respond.

Pause to collect your thoughts. Silence isn’t necessarily a bad thing—pausing can make you seem more in control than rushing your response.

Make one point and provide an example or supporting piece of information. If your response is too long or you waffle about a number of points, you risk losing the listener’s interest. Follow one point with an example and then gauge the listener’s reaction to tell if you should make a second point.

Deliver your words clearly. In many cases, how you say something can be as important as what you say. Speak clearly, maintain an even tone, and make eye contact. Keep your body language relaxed and open.

Wrap up with a summary and then stop. Summarize your response and then stop talking, even if it leaves a silence in the room. You don’t have to fill the silence by continuing to talk.

Quick stress relief for effective communication

When a conversation starts to get heated, you need something quick and immediate to bring down the emotional intensity. By learning to quickly reduce stress in the moment, you can safely take stock of any strong emotions you’re experiencing, regulate your feelings, and behave appropriately.

Recognize when you’re becoming stressed. Your body will let you know if you’re stressed as you communicate. Are your muscles or stomach tight? Are your hands clenched? Is your breath shallow? Are you “forgetting” to breathe?

Take a moment to calm down before deciding to continue a conversation or postpone it.

Bring your senses to the rescue. The best way to rapidly and reliably relieve stress is through the senses—sight, sound, touch, taste, smell—or movement. For example, you could pop a peppermint in your mouth, squeeze a stress ball in your pocket, take a few deep breaths, clench and relax your muscles, or simply recall a soothing, sensory-rich image. Each person responds differently to sensory input, so you need to find a coping mechanism that is soothing to you.

[Read: Quick Stress Relief]

Look for humor in the situation. When used appropriately, humor is a great way to relieve stress when communicating . When you or those around you start taking things too seriously, find a way to lighten the mood by sharing a joke or an amusing story.

Be willing to compromise. Sometimes, if you can both bend a little, you’ll be able to find a happy middle ground that reduces the stress levels for everyone concerned. If you realize that the other person cares much more about an issue than you do, compromise may be easier for you and a good investment for the future of the relationship.

Agree to disagree, if necessary, and take time away from the situation so everyone can calm down. Go for a stroll outside if possible, or spend a few minutes meditating. Physical movement or finding a quiet place to regain your balance can quickly reduce stress.

Find your space for healing and growth

Regain is an online couples counseling service. Whether you’re facing problems with communication, intimacy, or trust, Regain’s licensed, accredited therapists can help you improve your relationship.

Direct, assertive expression makes for clear communication and can help boost your self-esteem and decision-making skills. Being assertive means expressing your thoughts, feelings, and needs in an open and honest way, while standing up for yourself and respecting others. It does NOT mean being hostile, aggressive, or demanding. Effective communication is always about understanding the other person, not about winning an argument or forcing your opinions on others.

To improve your assertiveness

Value yourself and your options. They are as important as anyone else’s.

Know your needs and wants. Learn to express them without infringing on the rights of others.

Express negative thoughts in a positive way. It’s  okay to be angry , but you must remain respectful as well.

Receive feedback positively. Accept compliments graciously, learn from your mistakes, ask for help when needed.

Learn to say “no.” Know your limits and don’t let others take advantage of you. Look for alternatives so everyone feels good about the outcome.

Developing assertive communication techniques

Empathetic assertion conveys sensitivity to the other person. First, recognize the other person’s situation or feelings, then state your needs or opinion. “I know you’ve been very busy at work, but I want you to make time for us as well.”

Escalating assertion can be employed when your first attempts are not successful. You become increasingly firm as time progresses, which may include outlining consequences if your needs are not met. For example, “If you don’t abide by the contract, I’ll be forced to pursue legal action.”

Practice assertiveness in lower risk situations to help build up your confidence. Or ask friends or family if you can practice assertiveness techniques on them first.

More Information

  • Effective Communication: Improving Your Social Skills - Communicate more effectively, improve your conversation skills, and become more assertive. (AnxietyCanada)
  • Core Listening Skills - How to be a better listener. (SucceedSocially.com)
  • Effective Communication - How to communicate in groups using nonverbal communication and active listening techniques. (University of Maine)
  • Some Common Communication Mistakes - And how to avoid them. (SucceedSocially.com)
  • 3aPPa3 – When cognitive demand increases, does the right ear have an advantage? – Danielle Sacchinell | Acoustics.org . (n.d.). Retrieved May 22, 2022, from Link
  • How to Behave More Assertively . (n.d.). 10. Weger, H., Castle Bell, G., Minei, E. M., & Robinson, M. C. (2014). The Relative Effectiveness of Active Listening in Initial Interactions.  International Journal of Listening , 28(1), 13–31. Link

More in Communication

How to read body language to build better relationships at home and work

communication skills research

Boost your EQ to help find happiness and success

communication skills research

Tips for handling conflicts, arguments, and disagreements

communication skills research

How to feel and respond to the emotions of others

communication skills research

Tips and techniques for getting anger under control

communication skills research

Using laughter and play to resolve disagreements

communication skills research

The 5 Love Languages

What they are and how they influence relationships

communication skills research

Turning Off the Gas on Your Gaslighter

5 ways to deal with gaslighting

communication skills research

Professional therapy, done online

BetterHelp makes starting therapy easy. Take the assessment and get matched with a professional, licensed therapist.

Help us help others

Millions of readers rely on HelpGuide.org for free, evidence-based resources to understand and navigate mental health challenges. Please donate today to help us save, support, and change lives.

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

  • Advanced Search
  • Journal List
  • v.1; 2022 Dec
  • PMC10194302

Novel approaches to communication skills development: The untapped potential of qualitative research immersion

Amy s. porter.

a St. Jude Children’s Research Hospital, Memphis, TN, USA

Cameka Woods

Erica c. kaye, associated data.

Participation in qualitative research, particularly analysis of recorded medical dialogue, offers real-time, longitudinal immersion that can strengthen clinical trainee communication skills. The study objective was to explore how qualitative research participation impacts clinical trainees’ self-perceived communication skills development and practice.

In this study, a 17-member multidisciplinary working group of child life specialists, advanced practice providers, undergraduate/medical students, residents, fellows, attending physicians, social scientists, and career researchers with recent qualitative and communication research experience assembled to discuss this topic using a structured discussion guide. Content analysis was used to identify concepts and themes.

Three key themes characterizing the impact of qualitative research participation on aspiring clinicians’ communication skills development and practice arose – the 3Cs: (1) C onnection, therapeutic alliance, and accompaniment; (2) C larity and prognostic communication; (3) C ompassion, empathy, and understanding. Participants emphasized that qualitative research learning improved their understanding of patient/family lived experiences, preparing them for future clinical encounters, strengthening their emotional intelligence, and promoting self-care, resilience, and professional affirmation.


Immersion in clinical communication through participation in qualitative research is an under-utilized resource for supporting clinical trainees in communication skills development.

The process of collaborative knowledge production through the collective exploration of an a priori question related to group members’ collective experiences is methodologically innovative. Further, re-thinking qualitative research participation as an underutilized educational opportunity is pedagogically novel, and leaders in medical education and qualitative research should collaborate to realize the potential of this teaching tool.

  • • Qualitative research participation offers immersion in clinical communication.
  • • Participation impact characterized by the 3 C’s: 1) Connection, 2) Clarity, 3) Compassion.
  • • This is an under-utilized medical education resource for communication skills development.
  • • Medical education and qualitative research leaders should collaborate.

1. Introduction

Communication training for clinical trainees often involves single timepoint simulation as a “gold standard” for practicing navigation of challenging conversations [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] ]. Due to time, staffing, and resource constraints, medical educators face challenges realizing high volume of real-time communication learning opportunities [ 1 ]. Clinicians-in-training are exposed infrequently and inconsistently to in-depth, communication-heavy encounters between clinicians and patients and their families during difficult moments in the illness course [ 5 , 13 , 14 ]. As a result, trainees lack robust opportunities to witness communication and consider which modeled approaches they want to integrate into their own communication toolboxes. Further, depending on supervisory ratios, trainees may not have sufficient opportunities to observe clinicians with a range of emotional dexterity skills to learn and reflect on how (or how not) to communicate during challenging medical encounters.

Healthcare communication science researchers have amassed large repositories of recorded medical dialogue to answer questions about best practices for communication between patients, families, and healthcare professionals; however, little precedent exists for collaboration between communication researchers and medical education leaders to optimize use of this under-utilized resource to offer learners opportunities for developing communication skills through participation in communication research. Existing literature explores how guided reflection activities such as “The Healer’s Art” and other self-contemplative didactics positively impact trainees’ communication skills, empathy, self-awareness, and overall clinical practice [ [15] , [16] , [17] ], yet the potential educational value and impact of qualitative research experiences on trainees’ learning and communication skills remains understudied and poorly understood.

To address this knowledge gap, we convened a multidisciplinary working group of students, clinicians, and researchers to consider the question: “How does engaging in qualitative communication research (i.e., listening to audio recordings and/or reading transcripts of recorded clinical encounters) impact trainees as professionals (both clinicians and researchers) and as individuals holistically?” The Qu alitative research as E ducation for S tudents and clinicians-in- Tr aining (QUEST) working group comprised individuals affiliated with a communication research lab within an academic institution who each had recent experiences participating in qualitative research on topics related to communication. The working group examined whether engaging in qualitative research involving patients and families could influence the way students and clinicians-in-training learn and practice communication. In this article, we summarize findings from the QUEST working group and propose immersion in qualitative research datasets as an innovative alternative or complement to standardized simulated communication skills training.

In this study, we used an adaptation of autoethnography to bring together a team of authors with common experiences related to qualitative research participation, collectively share our perceptions and generate reflective data about our experiences with qualitative research, and collaborate with one another to analyze the data and present our insights. In traditional autoethnographic methods, an individual uses a reliable process to generate data from their own experience, observations, and reflections and then reflects on and synthesizes these data to inform a larger context [ 18 ]. Koopman et al describes autoethnography as the ultimate form of reflexivity, a mechanism by which to explore personal perceptions, values, and beliefs through the lens of lived experience, culture, and self-other interactions [ 19 ]. In this project, our authorship team wished to gain deeper insights into the potential influence of qualitative research participation on communication education for students and clinicians. In deciding to study ourselves, we developed a modified form of autoethnography, which we describe below. This paper reports the findings from the QUEST working group with all group members represented as authors; there were not separate groups representing “researchers” and “study participants,” but rather one collaborative group working together to explore an a priori question related to our collective experiences. As such, the project did not require IRB approval.

The authorship team convened as the QUEST working group, comprising a 17-member group of students, staff, and faculty with recent qualitative communication research experience, including undergraduate/medical students, residents, fellows, child life specialists, advanced practice providers, and clinical research staff. Within the Quality of Life and Palliative Care Research Division, all learners who had participated in communication research by listening to recorded medical dialogue or reading transcripts of interviews with patients, families, and clinicians at a particular academic institution over the past 3 years were invited via email to participate (n = 21). No exclusionary requirements were applied. Though all invited individuals expressed interest in joining the QUEST working group, a total of 17 people ultimately participated. Individuals agreed to participate in working group conversations by responding in writing to the email invitation. All working group members had participated in analysis of at least one qualitative data set related to communication, with most participating in qualitative research for at least one year (although outliers included 1 member with a 2-month qualitative research elective and 1 member with 5+ years of qualitative research participation). Most of the group was comprised of nursing/medical trainees (e.g., undergraduate, graduate, nursing, and medical students; fellows; n=13); the group also included 2 clinical research staff who engage in communication with patients and families, 1 child life specialist who participated in qualitative research, and 1 clinician-researcher who oversees qualitative research studies. Members’ training, roles, and experiences interfacing with different types of qualitative data are presented in Table 1 .

QUEST working group member characteristics.

The three lead authors crafted a semi-structured working group discussion guide, with iterative revisions to refine questions for content and language. Supplemental Figure presents the guide, encompassing a semi-structured outline of questions prompts and probes to organize and support cooperative conversation. Working group members were encouraged via email to join a virtual 120-minute discussion; those who could not attend were given an opportunity to respond to the questions in writing. A physician-medical anthropologist with training and expertise in group engagement facilitated the virtual discussion. Twelve QUEST working group members, including the three lead authors, attended the recorded virtual session using WebEx (an online platform for virtual group meetings). The conversation introduction included reminders about the importance of reflexivity and how participants’ positionality influences (and may bias) perspectives. Throughout the virtual discussion session, each participant remained engaged and interacted with most question probes, yielding multiple responses for each question. A working group format was used intentionally to explore the targeted question, given the positive potential for group dynamics to help with idea generativity and allow reflections to build upon others’ thoughts and observations [ 20 , 21 ]. Most working group members were students and trainees or clinical research staff, interacting within similar hierarchical tiers. Recognizing the potential for hierarchy to constrain conversation, the one faculty member in a supervisory position observed quietly, engaging only when asked a direct question by another working group member.

Five working group members were unable to attend the virtual discussion due to their training schedules, and they wished to participate in the exploratory question. To ensure inclusion of their voices and perspectives, they were given an opportunity to provide written reflection responses to each item in the structured discussion guide; these lengthy responses were shared via email to contribute their perspectives to the conversation.

Following data generation, the three lead authors initially conducted memo-writing of the recorded discussion and written responses to begin reflecting on and discussing emerging patterns in working group conversation content [ 22 ]. Memo-writers purposefully represented different perspectives from a current clinical trainee, a research staff member, and a faculty member, with iterative discussions held in person and via email to explore how different viewpoints influenced reflections in memos and examine internal biases shaping thoughts and assessments. Content analysis was used to synthesize working group transcripts as this method provides a rigorous process for identification of concepts and themes within text. As concepts were inductively generated via memo-writing, findings were shared with all QUEST members for iterative reflection and input. The QUEST working group collaborated to synthesize and review key themes, with cycles of review and refinement among authors [ 23 , 24 ]. The final report was presented to the working group for member-checking [ 25 ], with confirmation from all authors that thematic findings reflected the comprehensive content of working group discussions.

Working group members consistently emphasized the value of immersion in qualitative research, highlighting the utility of engagement with audio recorded and/or transcribed clinical encounters that included challenging communication scenarios ( Fig. 1 ). Nearly all members described the impact of qualitative research experiences on their personal communication skills and practice, and two driving themes emerged to characterize the “value added” by qualitative research: 1) the tangible benefits of exposure to difficult medical communication prior to real-life encounters; and 2) the potential for long-lasting impact and sustained influence of qualitative research experiences on future clinical practice, including three specific impacts on communication skills (“the 3Cs”).

Fig. 1

Influences of qualitative research immersion on learner communication skills.

3.1. Immersive learning prior to real-life training and practice

For many working group members, communication challenges in healthcare were largely hypothetical prior to their participation in qualitative research. Coding real clinical encounters as part of qualitative research revealed the complexity of interpersonal communication and offered lessons for how to navigate difficult conversations with actual patients and families: “I really saw models of what this actually looks like and how do patients and their families respond to different styles.” Authors with limited previous exposure to clinical encounters also shared how immersion in raw qualitative data helped them recognize the emotional intensity experienced by patients, families, and clinicians:

“Listening [to audio-recorded medical dialogue] really helped me to understand how much tension there can be in a room… Just listening to long pauses of silence helped me understand that [prognostic communication] can be really challenging emotionally, both on the clinician side and the family and patient side, how challenging it can be to navigate that both as a parent and as a clinician.”

Another member described how her participation in qualitative research as a medical student informed her future practice as a resident:

“I began intern year in the intensive care unit and had several patients die within my first two to three weeks of residency. Communicating with these families about the goals or priorities of their loved one and then having to tell them when that person had died required attention to detail, meticulous word choice, and rapport building. All of these skills were taught or honed by the coding experience.”

Universally, working group members highlighted how exposure to “real” clinical encounters offered them unique experiences to observe communication skills and reflect on interpersonal dynamics that they could carry forward into their future clinical practice.

3.2. Sustained influence on future clinical practice

Overall, working group members agreed that participating in qualitative research had a greater impact than they anticipated on the way that they provide clinical care. One child life specialist explained specifically how real clinical encounters still shape her everyday clinical practice:

“I was not anticipating the coding experience [would] play such an influential role in my day-to-day clinical practice. The process has made me more reflective in my everyday interactions with patients and families, as I have various narratives to refer back to, and [they] are typically at the forefront of my thoughts when interacting with families now.”

A palliative care physician explained how specific clinician-patient or clinician-family interactions persist in a clinician’s mind through years of clinical practice: “Some of the quotes stick with you and influence your practice.” Many working group members echoed this idea of staying power – conversations witnessed through reading transcripts or listening to audio recordings remained impressed on their minds as reference points for choosing language, reflecting on clinical encounters, and remembering the complexities of patients’ and families’ experiences.

The working group also identified three key themes characterizing how immersion in qualitative communication research influenced aspiring clinicians’ self-perceived communication skills development – the 3Cs ( Table 2 ): 1) C onnection, therapeutic alliance, and accompaniment; 2) C larity and prognostic communication; and 3) C ompassion, empathy, and understanding.

3Cs: Key themes characterizing the impact of qualitative research participation on learners’ communication skills development.

3.3. Skills for aspiring clinicians: connection

Working group members described how witnessing clinicians’ approaches for establishing connection and building therapeutic alliance with patients and families helped them learn how to develop their own skills. Many mentioned the importance of listening carefully to patients and families, as well as the value of silence:

“This experience helped me further develop active listening skills. I think silence is something that often makes people uncomfortable; however, this experience made me realize how many families…want and need a space to process and have others actively listen to their thoughts and emotions. It was very humbling to be a part of that process.”

As detailed in Table 2 , others discussed how they came to realize that affirming patients’ and families’ emotions is essential to establishing therapeutic alliance and how witnessing clinicians establish rapport with families led them to aspire to do the same in their own clinical practice.

Several working group members contemplated the sensation of privilege upon entering what felt like experiencing prognostic communication with the patient and family – accompanying them through the illness trajectory. One nurse practitioner explained that, despite having been a bedside oncology nurse prior to participating in qualitative research, listening to recorded conversations was the first time she had been “in the room” during prognostic disclosure:

“What really struck me was how you do feel like you’re living through the process with the family… Living all those intense moments with the family feels extremely different than even what the providers themselves might feel.”

Some participants felt the emotion of experiencing disease reevaluation discussions with the families so intensely that they became uncomfortable and concerned they might be intruding: “In a way, it almost feels like you are listening to a private conversation, like you’re impinging on their privacy.” All participants agreed that reviewing transcripts and recordings represented more than a research task – for many, it felt like an honor to witness families most challenging moments.

3.4. Skills for aspiring clinicians: clarity

One working group member, who began qualitative research as an undergraduate student and is currently a medical resident, explained how her prior experiences with qualitative research actively motivate her to be clearer in her communication with patients and families:

“My experience with [reading transcripts] has…informed core beliefs I have regarding communication with patients, especially related to giving bad news… Remembering how [a particular] family felt from not discussing the full extent of the truth encourages me to…talk about all possible outcomes early… It also motivates me to be honest, even when it is hard. So many parents [in interviews]…said they didn’t want someone to ‘beat around the bush.’ I want to tell the truth in a kind way and set the scene for success.”

Another member, who was exposed to qualitative research while practicing as a child life specialist, also underscored how qualitative research training has helped her better understand the value of intentionality when communicating bad news, including exploring and accepting patients’ and families’ reactions to the news conveyed:

“The experience of coding has definitely influenced my clinical practice. One parent…shared that her first thought when our team offered legacy building interventions was: ‘Are you f***ing kidding me?’ I find myself actively thinking about this parent and her reaction every time that I am about to offer these types of interventions – and furthermore thinking about the themes that emerged when coding this data that reiterated the various ways our introduction of these interventions may be improved.”

Several working group members also explained that clinical communication research projects led them to develop heightened awareness of the impact of language on patients/families: “[I developed] awareness that the words that we use can have these long-lasting ramifications and impact. It gives you a heightened cognizance of how important the language and interactions are.”

3.5. Skills for aspiring clinicians: compassion

Compassion through understanding and empathy was a pervasive theme across working group members’ reflections on participating in qualitative research: “I think [participation in qualitative research] helps foster empathy and compassion. Medicine can be very draining; there are many systemic barriers to providing care in a patient-centered, thoughtful, and kind way.” Many articulated how qualitative research participation helped them to dig deeper into patients’ and families’ stories, not just limited to clinical encounters in clinical spaces: “Seeing the stories, not just the patients. This work inherently teaches you about the value of the story.” One author explained that this sense of walking with patients and families helped foster patience: “I think [patience] comes from having more perspective into their narrative and giving them the benefit of the doubt because you have not just the hospital, clinical side – you have more insight into the other side of things.” Working group members emphasized how more complex understandings of patients’ and families’ lives generated deeper understanding and compassion, which they recognized as skills integral to provision of high-quality medical care in their future careers.

3.6. Unanticipated impact: Self-care and professional affirmation

Working group members identified various unexpected positive outcomes from participation in qualitative research, including how it influenced perceptions of self-care and professional affirmation. Witnessing the strength and wisdom of parents of children with serious illness and/or bereaved parents inspired many learners. One member explained that studying communication through qualitative research methods allowed her to be less harsh on herself in evaluating her own communication: “This experience has provided me with the space to allow myself grace when I know I could have completed an intervention in a different way.” Several also shared that the research experience has affirmed their decisions into go into healthcare professions:

“I remember sitting down and really listening to one of the conversations, and immediately, I was so filled with emotion that tears really filled my eyes, partly because of the emotion of the conversation but also because I had been longing for this viewpoint, as it addressed why I had become really passionate about nursing. It reignited my passion for nursing and healthcare.”

Another echoed this same idea, explaining that the work reinvigorated her medical studies: “Seeing how this life experience affects these parents each and every day really allowed me to see the gravity of the situation and gave me the motivation to continue on this journey towards becoming a doctor.”

An additional unexpected benefit of qualitative research participation was deconstruction of hierarchy in clinical medicine. The process through which team members from various roles and statuses came together to reach consensus in coding belied self-perceived hierarchical identities:

“I was surprised by the richness of diligence and detail involved in the work, including check mechanisms that produced consensus. I found the reconciliation process to be a perfect example of this. The meetings were equal parts presentation of fact and defense of personal standpoint that involved everyone as an equal partnered contributor.”

An author who participated in this research as an undergraduate emphasized the power of connection among team members that overrode the difference of education level or training experience: “We connected on raw emotion that we felt from the conversation – even though we may be at very different stages of life, we still felt the same responses to some scenarios.”

Working group members emphasized that qualitative research participation also helped them develop skills in teaching and mentoring, as well as influenced how they approached the development of communications training programs and curricula in the future. Finally, they explained that it inspired them to continue self-reflection on communication, driving them to develop their practices of life-long learning. Table 3 articulates both benefits in more detail. Alongside these positive benefits, working group members also identified unexpected challenges, acknowledging the emotional weight of accompanying families, bearing witness, and feeling responsible for empathetic and compassionate communication, detailed in Table 4 .

Benefits of qualitative research participation as educators and life-long learners.

Unexpected challenges of participation in qualitative research: the emotional weight of accompanying families, bearing witness, and feeling responsible for empathetic and compassionate communication.

4. Discussion and conclusion

4.1. discussion.

Clinician-researchers with immersive experience in qualitative research identified the value of research participation on gaining and sustaining important communication skills. Key lessons from the working group are summarized in Fig. 2 .

Fig. 2

Key takeaway lessons from exploratory investigation of influences of participation in qualitative research on clinicians-in-training.

These findings raise the possibility that opportunities for participation in qualitative research alongside communication scientists may be an under-utilized resource for medical educators seeking to support trainees in developing important communication skills. Theories of experiential learning [ 26 , 27 ] and reflexive learning [ 28 , 29 ] underscore the potential educational benefit of qualitative research participation [ 30 ], in that they suggest that learning through doing and informally and formally reflecting on experiences may be more effective at conveying key lessons in clinical communication than didactics, small group discussions, or other instruction on the topic. We encourage medical educators and communication researchers to explore strategies for collaboration through engagement of undergraduate, graduate, medical, and post-graduate clinicians- and researchers-in-training. Rethinking the potential of qualitative research to improve clinical education may be bidirectionally beneficial, strengthening communication skills training while also reinforcing the value of qualitative research.

Further, these data preliminarily suggest that regular immersion in qualitative data may support resilience building for learners, and future research is needed to explore this potential. Listening to recordings or reading transcripts from clinical encounters offers trainees a unique opportunity to bear witness and experience diagnostic or prognostic communication, metaphorically standing alongside the patient and family, while still maintaining space to reflect, question, cry, otherwise respond, pause, discuss, and debrief the encounter. DIPEx International and other similar resources amalgamating qualitative research data can be incorporated into learning opportunities that enable more clinical trainees to conduct qualitative research.

The research team functions as a support group within which researchers can process the emotional weight and lessons learned from the encounter. This “practice run” prior to driving difficult conversations offers trainees the chance to develop communications skills and bolster both their approach and confidence prior to patient encounters [ 31 ]. Prior qualitative research experiences enable trainees to avoid feeling overwhelmed, hitting the ground running, prepared for the emotional burden and capable of listening, leaving room for silence, building empathy, and prioritizing compassion. Working group members felt prepared not only to practice skillful communication, but also to teach strategies.

Findings from the work should be interpreted in the context of limitations. Working group members all had participated in qualitative research previously and thus likely had a predisposition for engagement with and enthusiasm for communication research and qualitative methodology. It is possible that a different group of learners – perhaps those who tend toward a more positivist sensibility – may not find participation in qualitative research as useful for communication skills development. Additionally, not all QUEST working group members had an opportunity to participate in collective, generative dialogue to build upon ideas in real time. Several members participated by sharing their perspectives in writing, and although this allowed for enrichment of perspectives and experiences, it is not possible to know how additional interaction may have shaped the collective message.

Innovation: We offer two innovative approaches to healthcare professions education. First, we offer an innovative research methodology – an adaptation of autoethnography that involves collaboration among a group of people who share an experience (i.e., qualitative research participation), generate reflective data about that experience, and then work together to analyze those data. The methodology carried out by the collaborative working group to explore an a priori question related to our collective experiences is innovative, in that there was no division between “researchers” and “study participants” and thus the process was not traditional “research” but rather collaborative generation of knowledge. Inspired by autoethnographic methods, in which one person generates data from their own experiences, observations, and reflections and then analyzes those data, we have embarked upon a modified autoethnographic endeavor in which we collected data from ourselves as a working group made up of people with shared qualitative communication research participation experience and then analyzed and interpreted those data collectively. Different members of the working group participated in different ways to generate and analyze the data; we generated our own data and then studied our own experiences by analyzing the data. This methodology enables and may even empower health professions educators to study their own educational innovations.

Second, we offer a pedagogical innovation for health professions education, in which participation in qualitative research provides a learning experience for students in the health professions. We found that experience in qualitative research about communication facilitated learning about how to connect with patients and families, communicate clearly, and practice with empathy and compassion. Beyond the communication domain, additional applications of qualitative research experience as a learning opportunity might involve topics such as resilience, mindfulness, meaning-making, and self-reflection as tools to combat burnout or compassion fatigue.

With regards to application of findings, rethinking qualitative research participation as an underutilized educational opportunity is pedagogically innovative and should inspire medical education leaders to collaborate with communication researchers in engagement of undergraduate, graduate, medical, and post-graduate trainees. Collaborations between health professions educators and qualitative researchers could lead beyond communication, expanding to teaching about self-awareness, humility, active listening, quiet observation, and the critical importance of triangulating data to deepen information synthesis and interpretation. Rich opportunities exist to further probe how students immersed in qualitative research gain knowledge and skills. Further research also is needed to explore the benefits of partnerships between medical education and qualitative research teams in development of immersion-based communication learning.

4.2. Conclusion

Exposing clinical trainees to communication through participation in qualitative research has the potential to enhance self-perceived communication competency in three key domains: (1) Connection, (2) Clarity, and (3) Compassion, preparing them for future clinical encounters. Further, such exposure may have the potential to strengthen emotional intelligence and promote self-care, professional affirmation, and resilience.

Funding sources

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Credit author statement

Amy Porter: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – original draftWriting

Cameka Woods: Data curation, Formal analysis, Investigation, Methodology, Project administration, Writing – review & editing.

Erica Kaye: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Writing – original draft

All other authors: Data curation, Formal analysis, Investigation, Methodology, Writing – review & editing

Declaration of Competing Interest


We thank working group members’ qualitative research mentors and collaborators for providing teaching and support throughout their qualitative research experiences.

Appendix A Supplementary data to this article can be found online at https://doi.org/10.1016/j.pecinn.2022.100079 .

Contributor Information

Taylor aglio, jacob applegarth.

b Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA (Jacob)

Tharwa Bilbeisi

c University of Memphis, Memphis, TN, USA

d Rhodes College, Memphis, TN, USA

Katie Greer

e University of California Davis Children’s Hospital, Sacramento, CA, USA

Rachel Huber

Ashley kiefer autrey.

f Children’s Hospital of New Orleans, New Orleans, LA, USA

Sarah Rockwell

g Emory University, Atlanta, GA, USA

Marta Salek

Melanie stall.

h University of Texas Southwestern Medical Center, Dallas, TX, USA

Mariela Trejo

i University of Maryland School of Medicine, Baltimore, MD, USA

j University of Tennessee Health Sciences Center, Memphis, TN, USA

Kristina Zalud

k St. Louis Children’s Hospital, St. Louis, MO, USA

Appendix A. Supplementary data

QUEST Working Group Discussion Guide

  • Search Menu
  • Sign in through your institution
  • Advance Articles
  • Author Guidelines
  • Submission Site
  • Open Access
  • Self-Archiving Policy
  • Why Submit?
  • About Human Communication Research
  • About International Communication Association
  • Editorial Board
  • Advertising & Corporate Services
  • Journals Career Network
  • Journals on Oxford Academic
  • Books on Oxford Academic

Browse issues

Issue Cover

Cover image

issue cover

Volume 50, Issue 2, April 2024

Special issue: reflecting on 50 years of theory in human communication research: where do we go from here, original research, reflecting on 50 years of theory in human communication research : where do we go from here.

  • View article

Fifty-years of theory-driven research in HCR : prominence, progress, and opportunities

The role of theory in researching and understanding human communication, quantitative criticalism for social justice and equity-oriented communication research, the code^shift model: a data justice framework for collective impact and social transformation, minding the source: toward an integrative theory of human–machine communication, trust but verify a social epistemology framework of knowledge acquisition and verification practices for fictional entertainment.

  • Supplementary data

Eudaimonic entertainment overcoming resistance: an update and expansion of narrative persuasion models

The misinformation recognition and response model: an emerging theoretical framework for investigating antecedents to and consequences of misinformation recognition, the labor of communicatively coping: toward an integrative theory of communication work, pulling the field out of a “one variable, one role” mindset: maximizing the theoretical value of interaction terms in communication’s mediation models, the media use model: a metatheoretical framework for media processes and effects, consider the time dimension: theorizing and formalizing sequential media selection, ushering in an age of scientific principles for communication research, a framework of moderators in social norm-based message persuasiveness based on a systematic review, persuasive message effects via activated and modified belief clusters: toward a general theory, email alerts.

  • Recommend to Your Librarian
  • Advertising and Corporate Services


  • Online ISSN 1468-2958
  • Copyright © 2024 International Communication Association
  • About Oxford Academic
  • Publish journals with us
  • University press partners
  • What we publish
  • New features  
  • Open access
  • Institutional account management
  • Rights and permissions
  • Get help with access
  • Accessibility
  • Advertising
  • Media enquiries
  • Oxford University Press
  • Oxford Languages
  • University of Oxford

Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide

  • Copyright © 2024 Oxford University Press
  • Cookie settings
  • Cookie policy
  • Privacy policy
  • Legal notice

This Feature Is Available To Subscribers Only

Sign In or Create an Account

This PDF is available to Subscribers Only

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

AIP Publishing Logo

Implementation of research oriented collaborative inquiry learning model in science learning: A relation between critical thinking skills and communication skills

[email protected]

[email protected]

  • Split-Screen
  • Article contents
  • Figures & tables
  • Supplementary Data
  • Peer Review
  • Open the PDF for in another window
  • Reprints and Permissions
  • Cite Icon Cite
  • Search Site

Adilah Afikah , Jumadi Jumadi , Eli Rohaeti; Implementation of research oriented collaborative inquiry learning model in science learning: A relation between critical thinking skills and communication skills. AIP Conf. Proc. 24 May 2024; 3106 (1): 070010. https://doi.org/10.1063/5.0214810

Download citation file:

  • Ris (Zotero)
  • Reference Manager

Learning in the 21st century requires students to have various skills to face new challenges and novelties. This study investigates the relationship between students’ critical thinking oral and written communication skills through implementing the Research Oriented Collaborative Inquiry Learning (REORCILEA) model in science learning. This research was concerned with determining whether students with good critical thinking skills have better oral and written communication skills. This research was descriptive and quantitative, with a sample of 49 junior high school students in class IX. Observation sheets and student activity sheets became instruments in this study. The data were about critical thinking skills oral and written communication skills that were gathered during learning, presentation, and on student activity sheets. The data were analysed using a correlation test and linear regression test. The current study’s findings revealed a significant effect between critical thinking skills and written communication skills. However, there was no significant effect between critical thinking and oral communication skills and between oral and written communication skills. Students with good critical thinking skills can better express their thoughts in written form than in oral form, and students with good writing skills do not always have good speaking skills.

Citing articles via

Publish with us - request a quote.

communication skills research

Sign up for alerts

  • Online ISSN 1551-7616
  • Print ISSN 0094-243X
  • For Researchers
  • For Librarians
  • For Advertisers
  • Our Publishing Partners  
  • Physics Today
  • Conference Proceedings
  • Special Topics


  • Privacy Policy
  • Terms of Use

Connect with AIP Publishing

This feature is available to subscribers only.

Sign In or Create an Account

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • View all journals
  • Explore content
  • About the journal
  • Publish with us
  • Sign up for alerts
  • 21 May 2024

Lack of effective intercultural communication is hobbling academia — fix it for research equity

  • Shoumit Dey   ORCID: http://orcid.org/0000-0003-2655-9921 0 &
  • Pooja Sharma 1

Hull York Medical School, York, UK.

You can also search for this author in PubMed   Google Scholar

New Delhi, India.

Across cultures and geographies, effective communication drives progress in business and elsewhere. Yet, in academia, little attention seems to be paid to the issue — despite the well-documented biases and inequities experienced by scholars from marginalized communities and lower-income countries (see, for example, Nature 608 , 437–439; 2022 ).

Access options

Access Nature and 54 other Nature Portfolio journals

Get Nature+, our best-value online-access subscription

24,99 € / 30 days

cancel any time

Subscribe to this journal

Receive 51 print issues and online access

185,98 € per year

only 3,65 € per issue

Rent or buy this article

Prices vary by article type

Prices may be subject to local taxes which are calculated during checkout

Nature 629 , 757 (2024)

doi: https://doi.org/10.1038/d41586-024-01490-x

Competing Interests

The authors declare no competing interests.

Related Articles

See more letters to the editor

  • Scientific community

What steps to take when funding starts to run out

What steps to take when funding starts to run out

Career Feature 24 MAY 24

How researchers in remote regions handle the isolation

How researchers in remote regions handle the isolation

Ozempic keeps wowing: trial data show benefits for kidney disease

Ozempic keeps wowing: trial data show benefits for kidney disease

News 24 MAY 24

Harassment of scientists is surging — institutions aren’t sure how to help

Harassment of scientists is surging — institutions aren’t sure how to help

News Feature 21 MAY 24

How to set up your new lab space

How to set up your new lab space

Career Column 20 MAY 24

Can mathematicians help to solve social-justice problems?

Can mathematicians help to solve social-justice problems?

Career Feature 22 MAY 24

Why role-playing games can spur climate action

Why role-playing games can spur climate action

World View 22 MAY 24

Internet use and teen mental health: it’s about more than just screen time

Correspondence 21 MAY 24

Associate Editor, Nature Briefing

Associate Editor, Nature Briefing Permanent, full time Location: London, UK Closing date: 10th June 2024   Nature, the world’s most authoritative s...

London (Central), London (Greater) (GB)

Springer Nature Ltd

communication skills research

Professor, Division Director, Translational and Clinical Pharmacology

Cincinnati Children’s seeks a director of the Division of Translational and Clinical Pharmacology.

Cincinnati, Ohio

Cincinnati Children's Hospital & Medical Center

communication skills research

Data Analyst for Gene Regulation as an Academic Functional Specialist

The Rheinische Friedrich-Wilhelms-Universität Bonn is an international research university with a broad spectrum of subjects. With 200 years of his...

53113, Bonn (DE)

Rheinische Friedrich-Wilhelms-Universität

communication skills research

Recruitment of Global Talent at the Institute of Zoology, Chinese Academy of Sciences (IOZ, CAS)

The Institute of Zoology (IOZ), Chinese Academy of Sciences (CAS), is seeking global talents around the world.

Beijing, China

Institute of Zoology, Chinese Academy of Sciences (IOZ, CAS)

communication skills research

Full Professorship (W3) in “Organic Environmental Geochemistry (f/m/d)

The Institute of Earth Sciences within the Faculty of Chemistry and Earth Sciences at Heidelberg University invites applications for a   FULL PROFE...

Heidelberg, Brandenburg (DE)

Universität Heidelberg

communication skills research

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Quick links

  • Explore articles by subject
  • Guide to authors
  • Editorial policies
  • Open access
  • Published: 21 May 2024

Effectively teaching cultural competence in a pre-professional healthcare curriculum

  • Karen R. Bottenfield 1 ,
  • Maura A. Kelley 2 ,
  • Shelby Ferebee 3 ,
  • Andrew N. Best 1 ,
  • David Flynn 2 &
  • Theresa A. Davies 1 , 2  

BMC Medical Education volume  24 , Article number:  553 ( 2024 ) Cite this article

208 Accesses

Metrics details

There has been research documenting the rising numbers of racial and ethnic minority groups in the United States. With this rise, there is increasing concern over the health disparities that often affect these populations. Attention has turned to how clinicians can improve health outcomes and how the need exists to educate healthcare professionals on the practice of cultural competence. Here we present one successful approach for teaching cultural competence in the healthcare curriculum with the development of an educational session on cultural competence consisting of case-based, role-play exercises, class group discussions, online discussion boards, and a lecture PowerPoint presentation.

Cultural competence sessions were delivered in a pre-dental master’s program to 178 students between 2017 and 2020. From 2017 to 2019, the sessions were implemented as in-person, case-based, role-play exercises. In 2020, due to in-person limitations caused by the COVID-19 pandemic, students were asked to read the role-play cases and provide a reflection response using the online Blackboard Learn discussion board platform. Evaluation of each session was performed using post-session survey data.

Self-reported results from 2017 to 2020 revealed that the role-play exercises improved participant’s understanding of components of cultural competence such as communication in patient encounters (95%), building rapport with patients (94%), improving patient interview skills (95%), and recognition of students own cultural biases when working with patients (93%).


Students were able to expand their cultural awareness and humility after completion of both iterations of the course session from 2017 to 2019 and 2020. This session can be an effective method for training healthcare professionals on cultural competence.

Peer Review reports

It is projected that by the year 2050, racial and ethnic minority groups will make up over 50% of the United States population [ 1 ]. With a more multicultural society, growing concern has emerged over how to address the health disparities that effect these populations and the ways in which healthcare professionals can increase positive health outcomes. Continuing evidence suggests that many patients from racial and ethnic minority groups are not satisfied with the current state of healthcare which has been attributed to implicit bias on the part of physicians and current challenges faced by practitioners who feel underprepared to address these issues due to differences in language, financial status, and healthcare practice [ 2 , 3 , 4 ].

To contend with health disparities and the challenges faced by practitioners working with a more diverse population, healthcare educators have begun to emphasize the importance of educating healthcare workforce on the practice of cultural competence and developing a skilled-based set of behaviors, attitudes and policies that effectively provides care in the wake of cross-cultural situations and differences [ 4 , 5 , 6 ]. There are several curricular mandates from both medical and dental accreditation bodies to address this issue [ 7 , 8 , 9 ], and large amounts of resources, ideas, and frameworks that exist for implementing and training future and current healthcare providers on the inadequacies of the healthcare system and cultural competence [ 10 , 11 , 12 ]. These current institutional guidelines for accreditation and the numerous amounts of resources for training cultural competence, continue to evolve with work documenting the need for blended curriculum that is continuous throughout student education, starting early as we have done here with pre-dental students, including in-person didactic or online sessions, a service learning component, community engagement and a reflective component [ 4 , 5 , 13 , 14 ].

This study investigates teaching cultural competence in a healthcare curriculum. We hypothesized that early educational exposure to cultural competence through role playing case studies, can serve as an effective mechanism for training early pre-doctoral students the practice of cultural competence. Utilizing student self-reported survey data conducted in a predental master’s curriculum, in which two iterations of role-playing case studies were used to teach components of cultural competence, this study aims to evaluate and support research that suggests role-playing case studies as effective means for educating future clinical professionals on the practice of cultural competence.

This study was determined to be exempt by the Institutional Review Board of Boston University Medical Campus, Protocol # H-37,232. Informed consent was received from all subjects.

Data collection

The role-playing, case-based simulated patient encounter exercises were developed and administered at Boston University Chobanian & Avedisian School of Medicine to predental students in the Master of Science in Oral Health Sciences Program (see Table  1 ). From 2017 to 2020, we administered patient encounter cases [see Additional File 1 ] to students ( n  = 178) in the program as a portion of a case-based, role-playing exercise to teach the importance of cultural competence and cultural awareness during patient encounters. During years 2017–2019, real actors portrayed the patient and physician. In 2020, the session was conducted online via a discussion board through a Blackboard Course Site. The original case was published as part of a master’s students thesis work in 2021 [ 15 ].

Description of patient encounter cases 1 and 2

Patient Encounter Case 1 [see Additional file 1 ] is composed of two subsections, scenario 1 A and scenario 1B, and is centered around a patient/physician interaction in which a patient who is pregnant presents with pain upon urination. The physician in 1 A is short and terse with the patient, immediately looking at a urine sample, prescribing medication for a urinary tract infection, and telling the patient to return for a follow-up in 2 weeks. In scenario 1B, a similar situation ensues; however, in this scenario the physician takes more time with the patient providing similar care as the physician in 1 A, but asking for more information about the patients personal and medical history. At the conclusion of the scenario, the patient is offered resources for an obstetrician and a dentist based on the information that is provided about the patient’s background. The patient is then sent on their way and asked to follow-up in 2 weeks. The patient does not return.

Patient Encounter Case 2 [see Additional file 1 ] follows a similar format to the Patient Encounter Case 1. In scenario 2 A, the same patient from Case 1 returns with tooth pain after giving birth. The physician in 2 A, like 1 A, is short with the patient and quickly refers the patient to a dentist. In 2B, the physician again takes more time with the patient to receive background information on the patient, make a connection, and provides an antibiotic and dental referral.

Each Patient Encounter Case explored topics such as the importance of building a trusting physician/patient relationship, the importance of asking a patient for patient history, making a connection, and the importance of a physician taking all facets of a patient’s circumstances into consideration [ 15 ].

Session outline

The sessions conducted between 2017 and 2019 were composed of three parts: (1) enactment of an abridged patient encounter facilitated by session administrators, (2) group discussion and reflection during which time students were asked to critically reflect and discuss the theme and key take-aways from the role play exercise, and (3) a PowerPoint presentation emphasizing take-away points from the role-play exercise. At the conclusion of the cultural competence training sessions, students participated in a post-session Qualtrics generated survey administered electronically to assess each student’s feelings about the session [see Additional file 3 ].

Role-play enactment

Facilitators dressed-up in clothing to mimic both the physician and patient for all case scenarios in Patient Encounter Case 1 and Case 2. At the conclusion of the role play portion of each of the cases, the facilitators paused to lead students in a real-time class group discussion. After Case 1, students were asked questions such as: What did you think ? Were the patient’s needs met? Did you expect the patient to return? Following Case 2, similar questions were asked by the facilitators, including: What did you think ? Were the patient’s needs met? Did you expect the patient to accept help?

At the conclusion of this portion of the session, the facilitators led a larger general discussion about both cases and how they related to one another. Finally, the course session concluded with a PowerPoint presentation that reinforced the take-home points from the session [see Additional file 2 ] [ 15 ].

Change in session modality due to COVID-19 pandemic

In Fall 2020, due to the COVID-19 pandemic, the course modality moved to an online platform and consisted of three parts on a Blackboard Discussion Board (Blackboard, Inc.). Students were required to: (1) read each of the Patient Encounter Cases and add a brief reflection comparing the scenarios, (2) then comment on at least two peer’s posts in the discussion forum and (3) attend class to hear a PowerPoint presentation by a course session facilitator on the key take-aways from each scenario [ 15 ].

Student surveys

At the conclusion of the cultural competence training sessions, students participated in a post-session Qualtrics ( https://www.qualtrics.com ) generated survey administered electronically to assess each student’s feelings about the sessions [see Additional file 3 ]. The format of the survey included 5 questions with the following Likert scale response options: strongly agree, agree, disagree, strongly disagree. These post-session surveys were not required but rather optional [ 15 ].

A total of 178 students completed the cultural competence sessions between 2017 and 2020. Of these participants, 112 voluntarily completed a post-session survey on the effectiveness of the course in teaching cultural competence and cultural awareness during patient encounters. Between 2017 and 2019, 99 students completed post-session surveys following sessions with role play exercises. In 2020, 13 students completed post-session surveys following discussion board sessions.

Role-play exercises enhanced cultural competence

In responding to post-session survey questions following cultural competence sessions that included role-play exercises (2017–2019), 71% of students surveyed strongly agreed and 24% agreed that the role-play exercises helped them to identify the importance of communication in patient encounters. In asking participants if the role-play exercises made them more aware of different strategies to improve their patient interview skills, 72% strongly agreed and 23% agreed. Also, 68% of the students strongly agreed and 26% agreed that the exercises helped them to better identify the importance of building rapport and trust during patient encounters. When asked if the exercises helped the students to better understand their own bias and/or cultural awareness when working with patients, the results of the survey showed that 62% of students strongly agreed and 31% agreed with this statement. In addition, most students found the role-play exercises to be enjoyable (72% strongly agreed and 22% agreed). See results shown in Fig.  1 .

figure 1

Cultural Competence Session Survey Data from the Year 2017–2019. Survey data from students at Boston University’s Oral Health Sciences Program for the years 2017–2019. Data is presented as percent of respondents ( n  = 99)

Discussion boards and reflections enhanced cultural competence

Cultural competence sessions held during 2020 did not include role-play exercises due to the Covid-19 pandemic. Instead, students participated in discussion boards and reflections on Blackboard. In response to the post-session survey question asking if the discussion board exercises were helpful in identifying the importance of communication during patient encounters, 67% of students strongly agreed and 25% agreed with this statement. Also, 75% of students strongly agreed and 17% agreed that the discussion board exercises helped them identify the importance of building rapport and trust during patient contact. When asked if the exercises helped the students to better understand their own bias and/or cultural awareness when working with patients, the results of the survey showed that 67% of students strongly agreed and 25% agreed with this statement. In addition, most students found the discussion board exercises to be enjoyable (67% strongly agreed and 22% agreed). See results shown in Fig.  2 .

figure 2

Cultural competence session survey data from the Year 2020. Survey data from students at Boston University’s Oral Health Sciences Program for the year 2020. Data is presented as percent of respondents ( n  = 13)

Student responses to the reflection portion of the online cultural competency sessions were recorded and categorized. Five themes were selected and 441 reflection responses were coded using NVivo (Version 12). The results showed that 29% of reflections demonstrated student’s ability to understand a holistic approach to clinical care, 24.3% understood the importance of collecting a patient history, 6.8% recognized the socioeconomic factors during a patient encounter, 27.9% reflected on the importance of the patient clinical relationship, and 12% on the effects on improving health outcomes (Table  1 ). Representative student responses to these themes are shown in Table  1 .

There exists a need to develop novel and effective means for teaching and training the next generation of healthcare professionals the practice of cultural competence. Thus, two iterations of a course session using case-based patient centered encounters were developed to teach these skills to pre-professional dentals students. Overall, the results of this study demonstrated that participation in the course, subsequent group discussion sessions, and take-away PowerPoint sessions significantly improved the participant’s understanding of the importance of communication skills and understanding of socioeconomic, environmental, and cultural disparities that can affect a patient’s health outcome.

According to results from the course session implemented in-person from 2017 to 2019, the role-playing exercise significantly improved participants understanding of important components that can be used to improve health outcomes that may be affected due to health disparities. Students were strongly able to identify the importance of communication in patient encounters, to understand strategies such as communication and compassionate care in patient encounters, identify the importance of building a patient-physician relationship with patients, and were able to recognize their own cultural biases. Similarly, in 2020, even with a change in course modality to on-line learning due to COVID-19, students were able to understand the same key take-aways from the course session as demonstrated by reflections using the discussion board regarding the need for a holistic approach to care, importance of the patient clinician relationship, and importance of taking a patient history. Despite promising implications of both iterations of the session, students completing the session online did not find the same success in “understanding my own bias/and or cultural awareness when working with patients.” This decrease may be attributed to change in course modality and the strengths of the role-play enactment of the patient encounter. It is important to recognize that additional learning components, including video recordings of the role-play enactment, may be necessary if the discussion board is used as the primary learning method in the future.

In contrast to previous studies that attempted to determine the effectiveness of cultural competence training methods, this session had many unique characteristics. The simulated role-playing exercise enabled student participants to see first-hand an interactive patient scenario that could be used as an example for when students begin working with patients or communicating with patients who are culturally diverse. Additionally, the nature of the cases created for the course session which were divided into a part A in which the patient physician was more straightforward when diagnosing and treating the patient and a part B with a more comprehensive and nurturing approach to care, allowed the students to compare the scenarios and make their own assumptions and comments on the effectiveness of each portion of the case. Another strength of this training, was the faculty with cultural competence training were uniquely involved in case creation and facilitation of the course session. According to previous studies with similar aims, it was noted that direct observation and feedback from a faculty member who had cultural competence training and direct contact with patients can provide students with a more memorable and useful experience when educating students [ 12 ]. The facilitators of this session were able to emphasize from their own personal experiences how to work with culturally diverse populations.

An important aspect of the 2020 iteration of the course session in which a discussion board format was used, was that it allowed students who may feel uncomfortable with sharing their thoughts on a case and their own biases, the opportunity to share in a space that may feel safer than in person [ 4 ]. Previous studies have mentioned challenges with online discussion boards [ 4 ] but here we had robust participation, albeit required. Students often contributed more than the required number of comments and they were often lengthy and engaging when responding to peers. Finally, in contrast to previous studies, this course session took place in a pre-professional master’s program, the M.S. in Oral Health Sciences Program at Boston University Chobanian & Avedisian School of Medicine. This program, in which students are given the opportunity to enhance their credentials for professional school, provided students with early exposure to cultural competence training. Students that completed this session in their early pre-professional curriculum should be better prepared than peers who did not receive any cultural competence training until they entered their designated professional school. This session is part of an Evidence Based Dentistry course, which incorporates a larger component of personal reflection that serves to engage students in critical thinking as they begin to develop the skills to be future clinicians. Students that understand different cultures, society and themselves through self-assessments will grow and be best suited in time to treat future patients [ 4 , 16 , 17 ].

One limitation of the present study was the number of survey participants that competed the post-session surveys, as survey completion was not required. Thus, the number of student participants declined over the years, reaching its lowest number of participants in 2020 when the discussion board course session was implemented, and students may have been over surveyed due to the pandemic. Another limitation to this study, was the lack of both a pre and post survey that could be used to determine how student’s understanding of cultural competence had evolved from their entry into the course to the conclusion of the course as well as individual bias and self-reporting measures.

In the future, the course should implement both a role-playing format and subsequent discussion board reflections within the same course session. Studies have shown that alternatives ways of drawing students to reflect whether role play, personal narratives, etc. can be extremely advantageous in developing personal reflection and awareness building competency [ 4 , 16 , 17 , 18 ]. It is noted that role-playing exercises that allow students to provide feedback with student colleagues can provide students with more insight into their own behaviors. It has also been shown in previous studies that student writing and reflection activities can also facilitate student’s reflections on their own beliefs and biases [ 4 , 11 ]. Reflective writing skills are an important and effective means for students to continue to gauge their cultural competence throughout the remainder of their academic training and as future clinicians [ 4 , 17 , 19 ]. Further, students may experience emotional responses through the process of reflective writing as they recognize personal bias or stereotypes, creating a profound and impactful response resulting in enhanced understanding of cultural differences and beliefs [ 4 ]. By combining both learning techniques, students would be able to understand their own bias and their classmates and create a dialogue that could be more beneficial than just one learning method alone. Furthermore, by implementing the discussion board into the role-playing session, as stated previously, students that are more cautious about sharing their point of view or about their own implicit bias in a traditional classroom setting would be able to express their opinions and facilitate a more comprehensive discussion more thoroughly.

Here we show an effective means to utilize role-play of a multi-scenario case-based patient encounter to teach pre-professional healthcare student’s components of cultural competence, emphasizing the importance of provider-patient interactions, holistic patient care, and patient history and socioeconomic factors in provider care. This study contributes to the larger body of work that seeks to address this important aspect of education as it relates to enhancing patient health care outcomes.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Albino JEN, Inglehart MR, Tedesco LA. Dental education and changing oral health care needs: disparities and demands. J Dent Educ. 2012;76(1):75–88.

Article   Google Scholar  

Constantinou CS, Papageorgiou A, Samoutis G, McCrorie P. Acquire, apply, and activate knowledge: a pyramid model for teaching and integrating cultural competence in medical curricula. Patient Educ Couns. 2018;101(6):1147–51.

DallaPiazza M, Padilla-Register M, Dwarakanath M, Obamedo E, Hill J, Soto-Greene ML. Exploring racism and health: an intensive interactive session for medical students. MedEdPORTAL. 2018;14:10783.

Forsyth CJ, Irving MJ, Tennant M, Short SD, Gilroy JA. Teaching Cultural competence in Dental Education: a systematic review and exploration of implications for indigenous populations in Australia. J Dent Educ. 2017;81(8):956–68.

Betancourt JR. Cultural competence and medical education: many names, many perspectives, one goal. Acad Med. 2006;81(6):499–501.

Jernigan VBB, Hearod JB, Tran K, Norris KC, Buchwald D. An examination of cultural competence training in US medical education guided by the tool for assessing cultural competence training. J Health Disparities Res Pract. 2016;9(3):150–67.

Google Scholar  

Behar-Horenstein LS, Warren RC, Dodd VJ, Catalanotto FA. Addressing oral Health disparities Via Educational Foci on Cultural competence. Am J Public Health. 2017;107(S1):S18–23.

Lie D, Boker J, Cleveland E. Using the tool for assessing cultural competence training (TACCT) to measure faculty and medical student perceptions of cultural competence instruction in the first three years of the curriculum. Acad Med. 2006;81(6):557–64.

Holyfield LJ, Miller BH. A tool for assessing cultural competence training in dental education. J Dent Educ. 2013;77(8):990–7.

Vasquez Guzman CE, Sussman AL, Kano M, Getrich CM, Williams RL. A comparative case study analysis of cultural competence training at 15 U.S. medical schools. Acad Med. 2021;96(6):894–9.

Jernigan VB, Hearod JB, Tran K, Norris KC, Buchwald D. An examination of cultural competence training in US medical education guided by the tool for assessing cultural competence training. J Health Dispar Res Pract. 2016;9(3):150–67.

Kripalani S, Bussey-Jones J, Katz MG, Genao I. A prescription for cultural competence in medical education. J Gen Intern Med. 2006;21(10):1116–20.

Mariño R, Satur J, Tuncer E, Tran M, Milford E, Tran VMTH, Tran PQ, Tsai RP. Cultural competence of Australian dental students. BMC Med Educ. 2021;21(1):155.

Beagan BL. Teaching social and cultural awareness to medical students: it’s all very nice to talk about it in theory, but ultimately it makes no difference. Acad Med. 2003;78(6):605–14.

Ferrebee S, Boston University School of Medicine Master’s Thesis. (2021). Effectively Teaching Cultural Competence in Healthcare Education. Available at Boston University Libraries: Open BU: https://open.bu.edu/handle/2144/43838 .

Crosson JC, Deng W, Brazeau C, Boyd L, Soto-Greene M. Evaluating the effect of cultural competency training on medical student attitudes. Fam Med. 2004;36(3):199–203.

Cathryn F, Michelle I, Short S, Tennant M, Gilroy J. Strengthening indigenous cultural competence in dentistry and oral health education: academic perspectives. Eur J Dent Educ. 2019;23(1). https://doi.org/10.1111/eje.12398

DasGupta S, Meyer D, Calero-Breckheimer A, Costley AW, Guillen S. Teaching cultural competency through narrative medicine: intersections of classroom and community. Teach Learn Med. 2006;18(1):14–7.

Woldt JL, Nenad MW. Reflective writing in dental education to improve critical thinking and learning: A systematic review. J Dent Educ. 2021;85(6):778–785. https://doi.org/10.1002/jdd.12561 . Epub 2021 Feb 11. PMID: 33576055.

Download references


We would like to acknowledge Boston University’s Chobanian & Avedisian School of Medicine’s Graduate Medical Science students and study participants.

No funding was used for the completion of this study.

Author information

Authors and affiliations.

Graduate Medical Sciences, Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street, L317, R-1017, Boston, MA, 02118, USA

Karen R. Bottenfield, Andrew N. Best & Theresa A. Davies

Department of Medical Sciences & Education, Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street, Boston, MA, 02118, USA

Maura A. Kelley, David Flynn & Theresa A. Davies

University of Maryland School of Dentistry, 650 W Baltimore Street, Baltimore, MD, 21201, USA

Shelby Ferebee

You can also search for this author in PubMed   Google Scholar


TAD designed the original study concept, taught the classes (roleplay), conducted the surveys, and collected data; MAK designed the original case and PowerPoint, and performed roleplay; DBF and SF evaluated data and drafted original figures; ANB assisted in drafting the manuscript; KRB finalized figures and the manuscript.

Corresponding author

Correspondence to Theresa A. Davies .

Ethics declarations

Ethics approval and consent to participate.

This study was determined to be EXEMPT by the Institutional Review Board of Boston University Medical Campus, Protocol # H-37232.

Consent for publication

Not applicable.

Informed consent

Informed consent was received from all subjects.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary material 2, supplementary material 3, rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Bottenfield, K.R., Kelley, M.A., Ferebee, S. et al. Effectively teaching cultural competence in a pre-professional healthcare curriculum. BMC Med Educ 24 , 553 (2024). https://doi.org/10.1186/s12909-024-05507-x

Download citation

Received : 27 October 2023

Accepted : 02 May 2024

Published : 21 May 2024

DOI : https://doi.org/10.1186/s12909-024-05507-x

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Communication

BMC Medical Education

ISSN: 1472-6920

communication skills research

Leveraging collective action and environmental literacy to address complex sustainability challenges

  • Perspective
  • Open access
  • Published: 09 August 2022
  • Volume 52 , pages 30–44, ( 2023 )

Cite this article

You have full access to this open access article

communication skills research

  • Nicole M. Ardoin   ORCID: orcid.org/0000-0002-3290-8211 1 ,
  • Alison W. Bowers 2 &
  • Mele Wheaton 3  

8310 Accesses

18 Citations

20 Altmetric

Explore all metrics

Developing and enhancing societal capacity to understand, debate elements of, and take actionable steps toward a sustainable future at a scale beyond the individual are critical when addressing sustainability challenges such as climate change, resource scarcity, biodiversity loss, and zoonotic disease. Although mounting evidence exists for how to facilitate individual action to address sustainability challenges, there is less understanding of how to foster collective action in this realm. To support research and practice promoting collective action to address sustainability issues, we define the term “collective environmental literacy” by delineating four key potent aspects: scale, dynamic processes, shared resources, and synergy. Building on existing collective constructs and thought, we highlight areas where researchers, practitioners, and policymakers can support individuals and communities as they come together to identify, develop, and implement solutions to wicked problems. We close by discussing limitations of this work and future directions in studying collective environmental literacy.

Similar content being viewed by others

communication skills research

Bridge over troubled water: managing compatibility and conflict among thought collectives in sustainability science

communication skills research

“Salomone Sostenibile”: An Award to ‘Communicate’ the University’s Leading Role in Sustainable Development

communication skills research

Engaging with Ethnically Diverse Community Groups

Avoid common mistakes on your manuscript.


For socio-ecologically intertwined issues—such as climate change, land conversion, biodiversity loss, resource scarcity, and zoonotic diseases—and their associated multi-decadal timeframes, individual action is necessary, yet not sufficient, for systemic, sustained change (Amel et al. 2017 ; Bodin 2017 ; Niemiec et al. 2020 ; Spitzer and Fraser 2020 ). Instead, collective action, or individuals working together toward a common good, is essential for achieving the scope and scale of solutions to current sustainability challenges. To support communities as they engage in policy and action for socio-environmental change, communicators, land managers, policymakers, and other practitioners need an understanding of how communities coalesce and leverage their shared knowledge, skills, connections, and experiences.

Engagement efforts, such as those grounded in behavior-change approaches or community-based social marketing initiatives, that address socio-environmental issues have often emphasized individuals as the pathway to change. Such efforts address a range of domains including, but not limited to, residential energy use, personal transportation choices, and workplace recycling efforts, often doing so in a stepwise fashion, envisioning each setting or suite of behaviors as discrete spheres of action and influence (Heimlich and Ardoin 2008 ; McKenzie-Mohr 2011 ). In this way, specific actions are treated incrementally and linearly, considering first the individual barriers to be removed and then the motivations to be activated (and, sometimes, sustained; Monroe 2003 ; Gifford et al. 2011 ). Once each behavior is successfully instantiated, the next barrier is then addressed. Proceeding methodically from one action to the next, such initiatives often quite successfully alter a series of actions or group of related behaviors (at least initially) by addressing them incrementally, one at a time (Byerly et al. 2018 ). Following this aspirational logic chain, many resources have been channeled into such programs under the assumption that, by raising awareness and knowledge, such information, communication, and educational outreach efforts will shift attitudes and behaviors to an extent that, ultimately, mass-scale change will follow. (See discussion in Wals et al. 2014 .)

Numerous studies have demonstrated, however, that challenges arise with these stepwise approaches, particularly with regard to their ability to address complex issues and persist over time (Heimlich and Ardoin 2008 ; Wals et al. 2014 ). Such approaches place a tremendous—and unrealistic—burden on individuals, ignoring key aspects not only of behavioral science but also of social science more broadly, including the view that humans exist nested within socio-ecological systems and, thus, are most successful at achieving lasting change when it is meaningful, relevant, and undertaken within a supportive context (Swim et al. 2011 ; Feola 2015 ). Individualized approaches often require multiple steps or nudges (Byerly et al. 2018 ), or ongoing reminders to retain their salience (Stern et al. 2008 ). Because of the emphasis on decontextualized action, such approaches can miss, ignore, obfuscate, or minimize the importance of the bigger picture, which includes the sociocultural, biophysical, and political economic contexts (Ardoin 2006 ; Amel et al. 2017 ). Although the tightly trained focus on small, actionable steps and reliance on individual willpower may help in initially achieving success with initial habit formation (Carden and Wood 2018 ), it becomes questionable in terms of bringing about a wave of transformation on larger scales in the longer term. For those decontextualized actions to persist, they require continued prompting, constancy, and support in the social and biophysical context (Schultz 2014 ; Manfredo et al. 2016 ; Wood and Rünger 2016 ).

Less common in practice are theoretically based initiatives that embrace the holistic nature of the human experience, which occurs within complex systems spanning time and space in a multidimensional, weblike fashion (Bronfenbrenner 1979 ; Rogoff 2003 ; Barron 2006 ; DeCaro and Stokes 2008 ; Gould et al. 2019 ; Hovardas 2020 ). These systems-thinking approaches, while varying across disciplines and epistemological perspectives, envision human experiences, including learning and behavior, as occurring within a milieu that include the social, political, cultural, and historical contexts (Rogoff 2003 ; Roth and Lee 2007 ; Swim et al. 2011 ; Gordon 2019 ). In such a view, people’s everyday practices continuously reflect and grow out of past learning and experiences, not only at the individual, but also at the collective level (Lave 1991 ; Gutiérrez and Rogoff 2003 ; Nasir et al. 2020 ; Ardoin and Heimlich 2021 ). The multidimensional context in which we exist—including the broader temporal and spatial ecosystem—both facilitates and constrains our actions.

Scholars across diverse areas of study discuss the need for and power of collective thought and action, using various conceptual frames, models, and terms, such as collective action, behavior, impact, and intelligence; collaborative governance; communities of practice; crowdsourcing; and social movement theory; among many others (Table 1 ). These scholars acknowledge and explore the influence of our multidimensional context on collective thought and action. In this paper, we explore the elements and processes that constitute collective environmental literacy . We draw on the vast, relevant literature and, in so doing, we attempt to invoke the power of the collective: by reviewing and synthesizing ideas from a variety of fields, we strive to leverage existing constructs and perspectives that explore notions of the “collective” (see Table 1 for a summary of constructs and theories reviewed to develop our working definition of collective environmental literacy). A primary goal of this paper is to dialogue with other researchers and practitioners working in this arena who are eager to uncover and further explore related avenues.

First, we present a formal definition of collective environmental literacy. Next, we briefly review the dominant view of environmental literacy at the individual level and, in support of a collective take on environmental literacy, we examine various collective constructs. We then delve more deeply into the definition of collective environmental literacy by outlining four key aspects: scale, dynamic processes, shared resources, and synergy. We conclude by providing suggestions for future directions in studying collective environmental literacy.

Defining collective environmental literacy

Decades of research in political science, economics, anthropology, sociology, psychology, and the learning sciences, among other fields (Chawla and Cushing 2007 ; Ostrom 2009 ; Sawyer 2014 ; Bamberg et al. 2015 ; Chan 2016 ; Jost et al. 2017 ) repeatedly demonstrates the effectiveness, and indeed necessity of, collective action when addressing problems that are inherently social in nature. Yet theoretical frameworks and empirical documentation emphasize that such collective activities rarely arise spontaneously and, when they do, are a result of preconditions that have sown fertile ground (van Zomeren et al. 2008 ; Duncan 2018 ). Persistent and effective collective action then requires scaffolding in the form of institutional, sociocultural, and political economic structure that provides ongoing support. To facilitate discussions of how to effectively support collective action around sustainability issues, we suggest the concept of “collective environmental literacy.” We conceptualize collective environmental literacy as more than collective action; rather, we suggest that the term encapsulates action along with its various supporting structures and resources. Additionally, we employ the word “literacy” as it connotes learning, intention, and the idea that knowledge, skills, attitudes, and behaviors can be enhanced iteratively over time. By using “literacy,” we strive to highlight the efforts, often unseen, that lead to effective collective action in communities. We draw on scholarship in science and health education, areas that have begun over the past two decades to theorize about related areas of collective science literacy (Roth and Lee 2002 , 2004 ; Lee and Roth 2003 ; Feinstein 2018 ) and health literacy (Freedman et al. 2009 ; Papen 2009 ; Chinn 2011 ; Guzys et al. 2015 ). Although these evolving constructs lack consensus definitions, they illuminate affordances and constraints that exist when conceptualizing collective environmental literacy (National Academies of Sciences, Engineering, and Medicine [NASEM] 2016 ).

Some of the key necessary—but not sufficient—conditions that facilitate aligned, collective actions include a common body of decision-making information; shared attitudes, values, and beliefs toward a motivating issue or concern; and efficacy skills that facilitate change-making (Sturmer and Simon 2004 ; van Zomeren et al. 2008 ; Jagers et al. 2020 ). In addition, other contextual factors are essential, such as trust, reciprocity, collective efficacy, and communication among group members and societal-level facilitators, such as social norms, institutions, and technology (Bandura 2000 ; Ostrom 2010 ; McAdam and Boudet 2012 ; Jagers et al. 2020 ). Taken together, we term this body of knowledge, dispositions, skills, and the context in which they flourish collective environmental literacy . More formally, we define collective environmental literacy as: a dynamic, synergistic process that occurs as group members develop and leverage shared resources to undertake individual and aggregate actions over time to address sustainability issues within the multi-scalar context of a socio-environmental system (Fig.  1 ).

figure 1

Key elements of collective environmental literacy

Environmental literacy: Historically individual, increasingly collective

Over the past five decades, the term “environmental literacy” has come into increasingly frequent use. Breaking from the traditional association of “literacy” with reading and writing in formal school contexts, environmental literacy emphasizes associations with character and behavior, often in the form of responsible environmental stewardship (Roth 1992 ). Footnote 1 Such perspectives define the concept as including affective (attitudinal), cognitive (knowledge-based), and behavioral domains, emphasizing that environmental literacy is both a process and outcome that develops, builds, and morphs over time (Hollweg et al. 2011 ; Wheaton et al. 2018 ; Clark et al. 2020 ).

The emphasis on defining, measuring, and developing interventions to bring about environmental literacy has primarily remained at the individual scale, as evidenced by frequent descriptions of an environmentally literate person (Roth 1992 ; Hollweg et al. 2011 among others) rather than community or community member. In most understandings, discussions, and manifestations of environmental literacy, the implicit assumption remains that the unit of action, intervention, and therefore analysis occurs at the individual level. Yet instinctively and perhaps by nature, community members often seek information and, as a result, take action collectively, sharing what some scholars call “the hive mind” or “group mind,” relying on each other for distributed knowledge, expertise, motivation, and support (Surowiecki 2005 ; Sunstein 2008 ; Sloman and Fernbach 2017 ; Paul 2021 ).

As with the proverbial elephant (Saxe, n.d.), each person, household, or neighborhood group may understand or “see” a different part of an issue or challenge, bring a novel understanding to the table, and have a certain perspective or skill to contribute. Although some environmental literacy discussions allude to a collective lens (e.g., Hollweg et al. 2011 ; Ardoin et al. 2013 ; Wheaton et al. 2018 ; Bey et al. 2020 ), defining, developing frameworks, and creating measures to assess the efficacy of such collective-scale sustainability-related endeavors has remained elusive. Footnote 2 Looking to related fields and disciplines—such as ecosystem theory, epidemiology and public health, sociology, network theory, and urban planning, among others—can provide insight, theoretical frames, and empirical examples to assist in such conceptualizations (McAdam and Boudet 2012 ; National Research Council 2015 ) (See Table 1 for an overview of some of the many areas of study that informed our conceptualization of collective environmental literacy).

Seeking the essence of the collective: Looking to and learning from others

The social sciences have long focused on “the kinds of activities engaged in by sizable but loosely organized groups of people” (Turner et al. 2020 , para. 1) and addressed various collective constructs, such as collective behavior, action, intelligence, and memory (Table 1 ). Although related constructs in both the social and natural sciences—such as communities of practice (Wenger and Snyder 2000 ), collaborative governance (Ansell and Gash 2008 ; Emerson et al. 2012 ), and the collaboration–coordination continuum (Sadoff and Grey 2005 ; Prager 2015 ), as well as those from social movement theory and related areas (McAdam and Boudet 2012 ; de Moor and Wahlström 2019 )—lack the word “collective” in name, they too leverage the benefits of collectivity. A central tenet connects all of these areas: powerful processes, actions, and outcomes can arise when individuals coalesce around a common purpose or cause. This notion of a dynamic, potent force transcending the individual to enhance the efficacy of outcomes motivates the application of a collective lens to the environmental literacy concept.

Dating to the 1800s, discussions of collective behavior have explored connections to social order, structures, and norms (Park 1927 ; Smelser 2011 /1962; Turner and Killian 1987 ). Initially, the focus emphasized spontaneous, often violent crowd behaviors, such as riots, mobs, and rebellions. More contemporarily, sociologists, political scientists, and others who study social movements and collective behaviors acknowledge that such phenomena may take many forms, including those occurring in natural ecosystems, such as ant colonies, bird flocks, and even the human brain (Gordon 2019 ). In sociology, collective action represents a paradigm shift highlighting coordinated, purposeful pro-social movements, while de-emphasizing aroused emotions and crowd behavior (Miller 2014 ). In political science, Ostrom’s ( 1990 , 2000 , 2010 ) theory of collective action in the context of the management of shared resources extends the concept’s reach to economics and other fields. In education and the learning sciences, social learning and sociocultural theories tap into the idea of learning as a social-cognitive-cultural endeavor (Vygotsky 1980 ; Lave and Wenger 1991 ; Tudge and Winterhoff 1993 ; Rogoff 2003 ; Reed et al. 2010 ).

Collective action, specifically, and collective constructs, generally, have found their way into the research and practice in the fields of conservation, natural resources, and environmental management. Collective action theory has been applied in a range of settings and scenarios, including agriculture (Mills et al. 2011 ), invasive species management (Marshall et al. 2016 ; Sullivan et al. 2017 ; Lubeck et al. 2019 ; Clarke et al. 2021 ), fire management (Canadas et al. 2016 ; Charnley et al. 2020 ), habitat conservation (Raymond 2006 ; Niemiec et al. 2020 ), and water governance (Lopez-Gunn 2003 ; Baldwin et al. 2018 ), among others. Frameworks and methods that emphasize other collective-related ideas—like collaboration, co-production, and group learning—are also ubiquitous in natural resource and environmental management. These constructs include community-based conservation (DeCaro and Stokes 2008 ; Niemiec et al. 2016 ), community natural resource management (Kellert et al. 2000 ; Dale et al. 2020 ), collaboration/coordination (Sadoff and Grey 2005 ; Prager 2015 ), polycentricity (Galaz et al. 2012 ; Heikkila et al. 2018 ), knowledge co-production (Armitage et al. 2011 ; Singh et al. 2021 ), and social learning (Reed et al. 2010 ; Hovardas 2020 ). Many writings on collective efforts in the social sciences broadly, and applied in the area of environment specifically, provide insights into collective action’s necessary preconditions, which prove invaluable to further defining and later operationalizing collective environmental literacy.

Unpacking the definition of collective environmental literacy: Anchoring principles

As described, we propose the following working definition of collective environmental literacy drawing on our analysis of related literatures and informed by scholarly and professional experience in the sustainability and conservation fields: a dynamic, synergistic process that occurs as group members develop and leverage shared resources to undertake individual and aggregate actions over time to address sustainability issues within the multi-scalar context of a socio-environmental system (Fig.  1 ). This definition centers on four core, intertwined ideas: the scale of the group involved; the dynamic nature of the process; shared resources brought by, available to, and needed by the group; and the synergy that arises from group interaction.


When transitioning from the focus on individual to collective actions—and, herein, principles of environmental literacy—the most obvious and primary requisite shift is one of scale. Yet, moving to a collective scale does not mean abandoning action at the individual scale; rather, success at the collective level is intrinsically tied to what occurs at an individual level. Such collective-scale impacts leverage the power of the hive, harnessing people’s willingness, ability, and motivation to take action alongside others, share their ideas and resources to build collective ideas and resources, contribute to making a difference in an impactful way, and participate communally in pro-social activities.

Collective environmental literacy is likely dynamic in its orientation to scale, incorporating place-based notions, such as ecoregional or community-level environmental literacy (with an emphasis on geographic boundaries). On the other hand, it may encapsulate environmental literacy of a group or organization united by a common identity (e.g., organizational membership) or cause (e.g., old-growth forests, coastal protection), rather than solely or even primarily by geography. Although shifting scales can make measuring collective environmental literacy more difficult, dynamic levels may be a benefit when addressing planetary boundary issues such as climate change, biodiversity, and ocean acidification (Galaz et al. 2012 ). Some scholars have called for a polycentric approach to these large-scale issues in response to a perceived failure of global-wide, top-down solutions (Ostrom 2010 , 2012 ; Jordan et al. 2018 ). Conceptualizing and consequently supporting collective environmental literacy at multiple scales can facilitate such desired polycentricity.

Rather than representing a static outcome, environmental literacy is a dynamic process that is fluctuating and complex, reflective of iterative interactions among community members, whose discussions and negotiations reflect the changing context of sustainability issues. Footnote 3 Such open-minded processes allow for, and indeed welcome, adaptation in a way that builds social-ecological resilience (Berkes and Jolly 2002 ; Adger et al. 2005 ; Berkes 2007 ). Additionally, this dynamism allows for collective development and maturation, supporting community growth in collective knowledge, attitudes, skills, and actions via new experiences, interactions, and efforts (Berkman et al. 2010 ). With this mindset, and within a sociocultural perspective, collective environmental literacy evolves through drawing on and contributing to the community’s funds of knowledge (González et al. 2006 ). Movement and actions within and among groups impact collective literacy, as members share knowledge and other resources, shifting individuals and the group in the course of their shared practices (Samerski 2019 ).

In a collective mode, effectiveness is heightened as shared resources are streamlined, waste is minimized, and innovation maximized. Rather than each group member developing individual expertise in every matter of concern, the shared knowledge, skills, and behaviors can be distributed, pursued, and amplified among group members efficiently and effectively, with collective literacy emerging from the process of pooling diverse forms of capital and aggregating resources. This perspective builds on ideas of social capital as a collective good (Ostrom 1990 ; Putnam 2020 ), wherein relationships of trust and reciprocity are both inputs and outcomes (Pretty and Ward 2001 ). The shared resources then catalyze and sustain action as they are reassembled and coalesced at the group level for collective impact.

The pooled resources—likely vast—may include, but are not limited to, physical and human resources, funding, time, energy, and space and place (physical or digital). Shared resources may also include forms of theorized capital, such as intellectual and social (Putnam 2020 ). Also of note is the recognition that these resources extend far beyond information and knowledge. Of particular interest when building collective environmental literacy are resources previously ignored or overlooked by those in power in prior sustainability efforts. For example, collective environmental literacy can draw strength from shared resources unique to the community or even subgroups within the larger community. Discussions of Indigenous knowledge (Gadgil et al. 1993 ) and funds of knowledge (González et al. 2006 ; Cruz et al. 2018 ) suggest critical, shared resources that highlight strengths of an individual community and its members. Another dimension of shared resources relates to the strength of institutional connections, such as the benefits that accrue from leveraging the collective knowledge, expertise, and resources of organizational collaborators working in adjacent areas to further and amplify each other’s impact (Wojcik et al. 2021 ).


Finally, given the inherent complexities related to defining, deploying, implementing, and measuring these dynamic, at-times ephemeral processes, resources, and outcomes at a collective scale, working in such a manner must be clearly advantageous to pressing sustainability issues at hand. Numerous related constructs and approaches from a range of fields emphasize the benefits of diverse collaboration to collective thought and action, including improved solutions, more effective and fair processes, and more socioculturally just outcomes (Klein 1990 ; Jörg 2011 ; Wenger and Snyder 2000 ; Djenontin and Meadow 2018 ). These benefits go beyond efficient aggregation and distribution of resources, invoking an almost magical quality that defines synergy, resulting in robust processes and outcomes that are more than the sum of the parts.

This synergy relies on the diversity of a group across various dimensions, bringing power, strength, and insight to a decision-making process (Bear and Woolley 2011 ; Curşeu and Pluut 2013 ; Freeman and Huang 2015 ; Lu et al. 2017 ; Bendor and Page 2019 ). Individuals are limited not only to singular knowledge-perspectives and skillsets, but also to their own experiences, which influence their self-affirming viewpoints and tendencies to seek out confirmatory information for existing beliefs (Kahan et al. 2011 ). Although the coming together of those from different racial, cultural, social, and economic backgrounds facilitates a collective literacy process that draws on a wider range of resources and equips a gestalt, it also sets up the need to consider issues of power, privilege, voice, and representation (Bäckstrand 2006 ) and the role of social capital, leading to questions related to trust and reciprocity in effective collectives (Pretty and Ward 2001 ; Folke et al. 2005 ).

Leveraging the ‘Hive’: Proceeding with collective environmental literacy

This paper presents one conceptualization of collective environmental literacy, with the understanding that numerous ways exist to envision its definition, formation, deployment, and measurement. Characterized by a collective effort, such literacies at scale offer a way to imagine, measure, and support the synergy that occurs when the emphasis moves from an individual to a larger whole. By expanding the scale and focusing on shared responsibility among actors at the systems level, opportunities arise for inspiring and enabling a broader contribution to a sustainable future. These evolving notions serve to invite ongoing conversation, both in research and practice, about how to enact our collective responsibility toward, as well as vision of, a thriving future.

Emerging from the many discussions of shared and collaborative efforts to address socio-environmental issues, our conceptualization of collective environmental literacy is a first step toward supporting communities as they work to identify, address, and solve sustainability problems. We urge continued discussions on this topic, with the goal of understanding the concept of collective environmental literacy, how to measure it, and the implications of this work for practitioners. The conceptual roots of collective environmental literacy reach into countless fields of study and, as such, a transdisciplinary approach, which includes an eye toward practice, is necessary to fully capture and maximize the tremendous amount of knowledge, wisdom, and experience around this topic. Specifically, next steps to evolve the concept include engaging sustainability researchers and practitioners in discussions of the saliency of the presented definition of collective environmental literacy. These discussions include verifying the completeness of the definition and ensuring a thorough review of relevant research: Are parts of the definition missing or unclear? What are the “blank, blind, bald, and bright spots” in the literature (Reid 2019 p. 158)? Additionally, recognizing and leveraging literacy at a collective scale most certainly is not unique to environmental work, nor is adopting literacy-related language to conceptualize and measure process outcomes, although the former has consistently proven more challenging. Moreover, although we (the authors) appreciate the connotations and structures gained by using a literacy framework, we struggle with whether “environmental literacy” is the most appropriate and useful term for the conceptualizations as described herein; we, thus, welcome lively discussions about the need for new terminology.

Even at this early stage of conceptualization, this work has implications for practitioners. For scientists, communicators, policymakers, land managers, and other professionals desiring to work with communities to address sustainability issues, a primary take-away message concerns the holistic nature of what is needed for effective collective action in the environmental realm. Many previous efforts have focused on conveying information and, while a lack of knowledge and awareness may be a barrier to action in some cases, the need for a more holistic lens is increasingly clear. This move beyond an individually focused, information-deficit model is essential for effective impact (Bolderdijk et al. 2013 ; van der Linden 2014 ; Geiger et al. 2019 ). The concept of collective environmental literacy suggests a role for developing shared resources that can foster effective collective action. When working with communities, a critical early step includes some form of needs assessment—a systematic, in-depth process that allows for meaningfully gauging gaps in shared resources required to tackle sustainability issues (Braus 2011). Following this initial, evaluative step, an understanding of the components of collective environmental literacy, as outlined in this paper, can be used to guide the development of interventions to support communities in their efforts to address those issues.

Growing discussion of collective literacy constructs, and related areas, suggests researchers, practitioners, and policymakers working in pro-social areas recognize and value collective efforts, despite the need for clearer definitions and effective measures. This definitional and measurement work, in both research and practice, is not easy. The ever-changing, dynamic contexts in which collective environmental literacy exists make defining the concept a moving target, compounded by a need to draw upon work in countless, often distinct academic fields of study. Furthermore, the hard-to-see, inner workings of collective constructs make measurement difficult. Yet, the “power of the hive” is intriguing, as the synergism that arises from communities working in an aligned manner toward a unified vision suggests a potency and wave of motivated action essential to coalescing and leveraging individual goodwill, harnessing its power and potential toward effective sustainability solutions.

See Stables and Bishop’s ( 2001 ) idea of defining environmental literacy by viewing the environment as “text.”

The climate change education literature also includes a nascent, but growing, discussion of collective-lens thinking and literacy. See, for example, Waldron et al. ( 2019 ), Mochizuki and Bryan ( 2015 ), and Kopnina ( 2016 ).

This conceptualization is similar to how some scholars describe collective health literacy (Berkman et al., 2010 ; Mårtensson and Hensing, 2012 ).

Adger, W.N. 2003. Social capital, collective action, and adaptation to climate change. Economic Geography 79: 387–404.

Article   Google Scholar  

Adger, W.N., T.P. Hughes, C. Folke, S.R. Carpenter, and J. Rockström. 2005. Social-ecological resilience to coastal disasters. Science 309: 1036–1039. https://doi.org/10.1126/science.1112122 .

Article   CAS   Google Scholar  

Adler, P.S., and S.-W. Kwon. 2002. Social capital: Prospects for a new concept. Academy of Management Review 27: 17–40. https://doi.org/10.5465/amr.2002.5922314 .

Agrawal, A. 1995. Dismantling the divide between Indigenous and scientific knowledge. Development and Change 26: 413–439. https://doi.org/10.1111/j.1467-7660.1995.tb00560.x .

Aguilar, O.M. 2018. Examining the literature to reveal the nature of community EE/ESD programs and research. Environmental Education Research 24: 26–49. https://doi.org/10.1080/13504622.2016.1244658 .

Aguilar, O., A. Price, and M. Krasny. 2015. Perspectives on community environmental education. In M.C. Monroe & M.E. Krasny (Eds.), Across the spectrum: Resources for environmental educators (3rd edn., pp. 235–249). North American Association for Environmental Education.

Aldrich, D.P., and M.A. Meyer. 2015. Social capital and community resilience. American Behavioral Scientist 59: 254–269. https://doi.org/10.1177/0002764214550299 .

Amel, E., C. Manning, B. Scott, and S. Koger. 2017. Beyond the roots of human inaction: Fostering collective effort toward ecosystem conservation. Science 356: 275–279. https://doi.org/10.1126/science.aal1931 .

Ansell, C., and A. Gash. 2008. Collaborative governance in theory and practice. Journal of Public Administration Research and Theory 18: 543–571. https://doi.org/10.1093/jopart/mum032 .

Ardoin, N.M. 2006. Toward an interdisciplinary understanding of place: Lessons for environmental education. Canadian Journal of Environmental Education 11: 112–126.

Google Scholar  

Ardoin, N.M., and J.E. Heimlich. 2021. Environmental learning in everyday life: Foundations of meaning and a context for change. Environmental Education Research 27: 1681–1699. https://doi.org/10.1080/13504622.2021.1992354 .

Ardoin, N.M., C. Clark, and E. Kelsey. 2013. An exploration of future trends in environmental education research. Environmental Education Research 19: 499–520. https://doi.org/10.1080/13504622.2012.709823 .

Armitage, D., F. Berkes, A. Dale, E. Kocho-Schellenberg, and E. Patton. 2011. Co-management and the co-production of knowledge: Learning to adapt in Canada’s Arctic. Global Environmental Change 21: 995–1004. https://doi.org/10.1016/j.gloenvcha.2011.04.006 .

Assis Neto, F.R., and C.A.S. Santos. 2018. Understanding crowdsourcing projects: A systematic review of tendencies, workflow, and quality management. Information Processing & Management 54: 490–506. https://doi.org/10.1016/j.ipm.2018.03.006 .

Bäckstrand, K. 2006. Multi-stakeholder partnerships for sustainable development: Rethinking legitimacy, accountability and effectiveness. European Environment 16: 290–306. https://doi.org/10.1002/eet.425 .

Baldwin, E., P. McCord, J. Dell’Angelo, and T. Evans. 2018. Collective action in a polycentric water governance system. Environmental Policy and Governance 28: 212–222. https://doi.org/10.1002/eet.1810 .

Bamberg, S., J. Rees, and S. Seebauer. 2015. Collective climate action: Determinants of participation intention in community-based pro-environmental initiatives. Journal of Environmental Psychology 43: 155–165. https://doi.org/10.1016/j.jenvp.2015.06.006 .

Bandura, A. 1977. Social learning theory . Englewood Cliffs: Prentice Hall.

Bandura, A. 2000. Exercise of human agency through collective efficacy. Current Directions in Psychological Science 9: 75–78. https://doi.org/10.1111/1467-8721.00064 .

Barron, B. 2006. Interest and self-sustained learning as catalysts of development: A learning ecology perspective. Human Development 49: 193–224. https://doi.org/10.1159/000094368 .

Barry, M.M., M. D’Eath, and J. Sixsmith. 2013. Interventions for improving population health literacy: Insights from a rapid review of the evidence. Journal of Health Communication 18: 1507–1522. https://doi.org/10.1080/10810730.2013.840699 .

Barton, A.C., and E. Tan. 2009. Funds of knowledge and discourses and hybrid space. Journal of Research in Science Teaching 46: 50–73. https://doi.org/10.1002/tea.20269 .

Bear, J.B., and A.W. Woolley. 2011. The role of gender in team collaboration and performance. Interdisciplinary Science Reviews 36: 146–153. https://doi.org/10.1179/030801811X13013181961473 .

Bendor, J., and S.E. Page. 2019. Optimal team composition for tool-based problem solving. Journal of Economics & Management Strategy 28: 734–764. https://doi.org/10.1111/jems.12295 .

Berkes, F. 2007. Understanding uncertainty and reducing vulnerability: Lessons from resilience thinking. Natural Hazards 41: 283–295. https://doi.org/10.1007/s11069-006-9036-7 .

Berkes, F., and D. Jolly. 2002. Adapting to climate change: Social-ecological resilience in a Canadian western Arctic community. Conservation Ecology 5: 45.

Berkes, F., and H. Ross. 2013. Community resilience: Toward an integrated approach. Society & Natural Resources 26: 5–20. https://doi.org/10.1080/08941920.2012.736605 .

Berkes, F., M.K. Berkes, and H. Fast. 2007. Collaborative integrated management in Canada’s north: The role of local and traditional knowledge and community-based monitoring. Coastal Management 35: 143–162.

Berkman, N.D., T.C. Davis, and L. McCormack. 2010. Health literacy: What is it? Journal of Health Communication 15: 9–19. https://doi.org/10.1080/10810730.2010.499985 .

Bey, G., C. McDougall, and S. Schoedinger. 2020. Report on the NOAA office of education environmental literacy program community resilience education theory of change. National Oceanic and Atmospheric Administration . https://doi.org/10.25923/mh0g-5q69 .

Blumer, H. 1971. Social problems as collective behavior. Social Problems 18: 298–306.

Bodin, Ö. 2017. Collaborative environmental governance: Achieving collective action in social-ecological systems. Science . https://doi.org/10.1126/science.aan1114 .

Bolderdijk, J.W., M. Gorsira, K. Keizer, and L. Steg. 2013. Values determine the (in)effectiveness of informational interventions in promoting pro-environmental behavior. PLoS ONE 8: e83911. https://doi.org/10.1371/journal.pone.0083911 .

Brabham, D.C. 2013. Crowdsourcing . Cambridge: MIT Press.

Book   Google Scholar  

Braus, J. (Ed.). 2011. Tools of engagement: A toolkit for engaging people in conservation. NAAEE/Audubon. https://cdn.naaee.org/sites/default/files/eepro/resource/files/toolsofengagement.pdf .

Brieger, S.A. 2019. Social identity and environmental concern: The importance of contextual effects. Environment and Behavior 51: 828–855. https://doi.org/10.1177/0013916518756988 .

Briggs, J. 2005. The use of Indigenous knowledge in development: Problems and challenges. Progress in Development Studies 5: 99–114. https://doi.org/10.1191/1464993405ps105oa .

Briggs, J., and J. Sharp. 2004. Indigenous knowledges and development: A postcolonial caution. Third World Quarterly 25: 661–676. https://doi.org/10.1080/01436590410001678915 .

Bronfenbrenner, U. 1979. The ecology of human development: Experiments by nature and design . Cambridge: Harvard University Press.

Bruce, C., and P. Chesterton. 2002. Constituting collective consciousness: Information literacy in university curricula. International Journal for Academic Development 7: 31–40. https://doi.org/10.1080/13601440210156457 .

Byerly, H., A. Balmford, P.J. Ferraro, C.H. Wagner, E. Palchak, S. Polasky, T.H. Ricketts, A.J. Schwartz, et al. 2018. Nudging pro-environmental behavior: Evidence and opportunities. Frontiers in Ecology and the Environment 16: 159–168. https://doi.org/10.1002/fee.1777 .

Canadas, M.J., A. Novais, and M. Marques. 2016. Wildfires, forest management and landowners’ collective action: A comparative approach at the local level. Land Use Policy 56: 179–188. https://doi.org/10.1016/j.landusepol.2016.04.035 .

Carden, L., and W. Wood. 2018. Habit formation and change. Current Opinion in Behavioral Sciences 20: 117–122. https://doi.org/10.1016/j.cobeha.2017.12.009 .

Chan, M. 2016. Psychological antecedents and motivational models of collective action: Examining the role of perceived effectiveness in political protest participation. Social Movement Studies 15: 305–321. https://doi.org/10.1080/14742837.2015.1096192 .

Charnley, S., E.C. Kelly, and A.P. Fischer. 2020. Fostering collective action to reduce wildfire risk across property boundaries in the American West. Environmental Research Letters 15: 025007. https://doi.org/10.1088/1748-9326/ab639a .

Chawla, L., and D.F. Cushing. 2007. Education for strategic environmental behavior. Environmental Education Research 13: 437–452. https://doi.org/10.1080/13504620701581539 .

Chinn, D. 2011. Critical health literacy: A review and critical analysis. Social Science & Medicine 73: 60–67. https://doi.org/10.1016/j.socscimed.2011.04.004 .

Clark, C.R., J.E. Heimlich, N.M. Ardoin, and J. Braus. 2020. Using a Delphi study to clarify the landscape and core outcomes in environmental education. Environmental Education Research 26: 381–399. https://doi.org/10.1080/13504622.2020.1727859 .

Clarke, M., Z. Ma, S.A. Snyder, and K. Floress. 2021. Factors influencing family forest owners’ interest in community-led collective invasive plant management. Environmental Management 67: 1088–1099. https://doi.org/10.1007/s00267-021-01454-1 .

Cruz, A.R., S.T. Selby, and W.H. Durham. 2018. Place-based education for environmental behavior: A ‘funds of knowledge’ and social capital approach. Environmental Education Research 24: 627–647. https://doi.org/10.1080/13504622.2017.1311842 .

Curşeu, P.L., and H. Pluut. 2013. Student groups as learning entities: The effect of group diversity and teamwork quality on groups’ cognitive complexity. Studies in Higher Education 38: 87–103. https://doi.org/10.1080/03075079.2011.565122 .

Cutter, S.L., L. Barnes, M. Berry, C. Burton, E. Evans, E. Tate, and J. Webb. 2008. A place-based model for understanding community resilience to natural disasters. Global Environmental Change 18: 598–606. https://doi.org/10.1016/j.gloenvcha.2008.07.013 .

Dale, A., K. Vella, S. Ryan, K. Broderick, R. Hill, R. Potts, and T. Brewer. 2020. Governing community-based natural resource management in Australia: International implications. Land 9: 234. https://doi.org/10.3390/land9070234 .

de Moor, J., and M. Wahlström. 2019. Narrating political opportunities: Explaining strategic adaptation in the climate movement. Theory and Society 48: 419–451. https://doi.org/10.1007/s11186-019-09347-3 .

DeCaro, D., and M. Stokes. 2008. Social-psychological principles of community-based conservation and conservancy motivation: Attaining goals within an autonomy-supportive environment. Conservation Biology 22: 1443–1451.

Djenontin, I.N.S., and A.M. Meadow. 2018. The art of co-production of knowledge in environmental sciences and management: Lessons from international practice. Environmental Management 61: 885–903. https://doi.org/10.1007/s00267-018-1028-3 .

Duncan, L.E. 2018. The psychology of collective action. In The Oxford handbook of personality and social psychology , ed. K. Deaux and M. Snyder. Oxford: Oxford University Press.

Edwards, M., F. Wood, M. Davies, and A. Edwards. 2015. ‘Distributed health literacy’: Longitudinal qualitative analysis of the roles of health literacy mediators and social networks of people living with a long-term health condition. Health Expectations 18: 1180–1193. https://doi.org/10.1111/hex.12093 .

Emerson, K., T. Nabatchi, and S. Balogh. 2012. An integrative framework for collaborative governance. Journal of Public Administration Research and Theory 22: 1–29.

Engeström, Y. 2001. Expansive learning at work: Toward an activity theoretical reconceptualization. Journal of Education and Work 14: 133–156. https://doi.org/10.1080/13639080020028747 .

Ensor, J., and B. Harvey. 2015. Social learning and climate change adaptation: Evidence for international development practice. Wires Climate Change 6: 509–522. https://doi.org/10.1002/wcc.348 .

Fanta, V., M. Šálek, and P. Sklenicka. 2019. How long do floods throughout the millennium remain in the collective memory? Nature Communications 10: 1105. https://doi.org/10.1038/s41467-019-09102-3 .

Feinstein, N.W. 2018. Collective science literacy: A key to community science capacity [Conference session]. American Association for the Advancement of Science Annual Meeting, Austin, TX, USA https://d32ogoqmya1dw8.cloudfront.net/files/earthconnections/collective_science_literacy_key.pdf .

Feola, G. 2015. Societal transformation in response to global environmental change: A review of emerging concepts. Ambio 44: 376–390. https://doi.org/10.2139/ssrn.2689741 .

Fernandez-Gimenez, M.E., H.L. Ballard, and V.E. Sturtevant. 2008. Adaptive management and social learning in collaborative and community-based monitoring: A study of five community-based forestry organizations in the western USA. Ecology and Society 13: 15.

Folke, C., T. Hahn, P. Olsson, and J. Norberg. 2005. Adaptive governance of social-ecological systems. Annual Review of Environment and Resources 30: 441–473. https://doi.org/10.1146/annurev.energy.30.050504.144511 .

Freedman, D.A., K.D. Bess, H.A. Tucker, D.L. Boyd, A.M. Tuchman, and K.A. Wallston. 2009. Public health literacy defined. American Journal of Preventive Medicine 36: 446–451. https://doi.org/10.1016/j.amepre.2009.02.001 .

Freeman, R.B., and W. Huang. 2015. Collaborating with people like me: Ethnic coauthorship within the United States. Journal of Labor Economics 33: S289–S318.

Gadgil, M., F. Berkes, and C. Folke. 1993. Indigenous knowledge for biodiversity conservation. Ambio 22: 151–156.

Galaz, V., B. Crona, H. Österblom, P. Olsson, and C. Folke. 2012. Polycentric systems and interacting planetary boundaries—Emerging governance of climate change–ocean acidification–marine biodiversity. Ecological Economics 81: 21–32. https://doi.org/10.1016/j.ecolecon.2011.11.012 .

Geiger, S.M., M. Geiger, and O. Wilhelm. 2019. Environment-specific vs general knowledge and their role in pro-environmental behavior. Frontiers in Psychology 10: 718. https://doi.org/10.3389/fpsyg.2019.00718 .

Gifford, R., C. Kormos, and A. McIntyre. 2011. Behavioral dimensions of climate change: Drivers, responses, barriers, and interventions. Wires Climate Change 2: 801–827. https://doi.org/10.1002/wcc.143 .

González, N., L.C. Moll, and C. Amanti. 2006. Funds of knowledge: Theorizing practices in households, communities, and classrooms . New York: Routledge.

Gordon, D.M. 2019. Measuring collective behavior: An ecological approach. Theory in Biosciences . https://doi.org/10.1007/s12064-019-00302-5 .

Gould, R.K., N.M. Ardoin, J.M. Thomsen, and N. Wyman Roth. 2019. Exploring connections between environmental learning and behavior through four everyday-life case studies. Environmental Education Research 25: 314–340.

Graham, S., A.L. Metcalf, N. Gill, R. Niemiec, C. Moreno, T. Bach, V. Ikutegbe, L. Hallstrom, et al. 2019. Opportunities for better use of collective action theory in research and governance for invasive species management. Conservation Biology 33: 275–287. https://doi.org/10.1111/cobi.13266 .

Granovetter, M. 1978. Threshold models of collective behavior. American Journal of Sociology 83: 1420–1443.

Groulx, M., M.C. Brisbois, C.J. Lemieux, A. Winegardner, and L. Fishback. 2017. A role for nature-based citizen science in promoting individual and collective climate change action? A systematic review of learning outcomes. Science Communication 39: 45–76. https://doi.org/10.1177/1075547016688324 .

Gutiérrez, K.D., and B. Rogoff. 2003. Cultural ways of learning: Individual traits or repertoires of practice. Educational Researcher 32: 19–25. https://doi.org/10.3102/0013189X032005019 .

Guzys, D., A. Kenny, V. Dickson-Swift, and G. Threlkeld. 2015. A critical review of population health literacy assessment. BMC Public Health 15: 1–7. https://doi.org/10.1186/s12889-015-1551-6 .

Halbwachs, M. 1992. On collective memory (L. A. Coser, Ed. & Trans.). University of Chicago Press. (Original works published 1941 and 1952).

Heikkila, T., S. Villamayor-Tomas, and D. Garrick. 2018. Bringing polycentric systems into focus for environmental governance. Environmental Policy and Governance 28: 207–211. https://doi.org/10.1002/eet.1809 .

Heimlich, J.E., and N.M. Ardoin. 2008. Understanding behavior to understand behavior change: A literature review. Environmental Education Research 14: 215–237. https://doi.org/10.1080/13504620802148881 .

Hill, R., F.J. Walsh, J. Davies, A. Sparrow, M. Mooney, R.M. Wise, and M. Tengö. 2020. Knowledge co-production for Indigenous adaptation pathways: Transform post-colonial articulation complexes to empower local decision-making. Global Environmental Change 65: 102161. https://doi.org/10.1016/j.gloenvcha.2020.102161 .

Hollweg, K.S., J. Taylor, R.W. Bybee, T.J. Marcinkowski, W.C. McBeth, and P. Zoido. 2011. Developing a framework for assessing environmental literacy: Executive summary . North American Association for Environmental Education. https://cdn.naaee.org/sites/default/files/envliteracyexesummary.pdf .

Hovardas, T. 2020. A social learning approach for stakeholder engagement in large carnivore conservation and management. Frontiers in Ecology and Evolution 8: 436. https://doi.org/10.3389/fevo.2020.525278 .

Jagers, S.C., N. Harring, Å. Löfgren, M. Sjöstedt, F. Alpizar, B. Brülde, D. Langlet, A. Nilsson, et al. 2020. On the preconditions for large-scale collective action. Ambio 49: 1282–1296. https://doi.org/10.1007/s13280-019-01284-w .

Jordan, A., D. Huitema, H. van Asselt, and J. Forster. 2018. Governing climate change: Polycentricity in action? Cambridge: Cambridge University Press.

Jörg, T. 2011. New thinking in complexity for the social sciences and humanities: A generative, transdisciplinary approach . New York: Springer Science & Business Media.

Jost, J.T., J. Becker, D. Osborne, and V. Badaan. 2017. Missing in (collective) action: Ideology, system justification, and the motivational antecedents of two types of protest behavior. Current Directions in Psychological Science 26: 99–108. https://doi.org/10.1177/0963721417690633 .

Jull, J., A. Giles, and I.D. Graham. 2017. Community-based participatory research and integrated knowledge translation: Advancing the co-creation of knowledge. Implementation Science 12: 150. https://doi.org/10.1186/s13012-017-0696-3 .

Kahan, D.M., H. Jenkins-Smith, and D. Braman. 2011. Cultural cognition of scientific consensus. Journal of Risk Research 14: 147–174. https://doi.org/10.1080/13669877.2010.511246 .

Kania, J., and M. Kramer. 2011. Collective impact. Stanford Social Innovation Review 9: 36–41.

Karachiwalla, R., and F. Pinkow. 2021. Understanding crowdsourcing projects: A review on the key design elements of a crowdsourcing initiative. Creativity and Innovation Management 30: 563–584. https://doi.org/10.1111/caim.12454 .

Kellert, S.R., J.N. Mehta, S.A. Ebbin, and L.L. Lichtenfeld. 2000. Community natural resource management: Promise, rhetoric, and reality. Society & Natural Resources 13: 705–715.

Klein, J.T. 1990. Interdisciplinarity: History, theory, and practice . Detroit: Wayne State University Press.

Knapp, C.N., R.S. Reid, M.E. Fernández-Giménez, J.A. Klein, and K.A. Galvin. 2019. Placing transdisciplinarity in context: A review of approaches to connect scholars, society and action. Sustainability 11: 4899. https://doi.org/10.3390/su11184899 .

Koliou, M., J.W. van de Lindt, T.P. McAllister, B.R. Ellingwood, M. Dillard, and H. Cutler. 2020. State of the research in community resilience: Progress and challenges. Sustainable and Resilient Infrastructure 5: 131–151. https://doi.org/10.1080/23789689.2017.1418547 .

Kopnina, H. 2016. Of big hegemonies and little tigers: Ecocentrism and environmental justice. The Journal of Environmental Education 47: 139–150. https://doi.org/10.1080/00958964.2015.1048502 .

Krasny, M.E., M. Mukute, O. Aguilar, M.P. Masilela, and L. Olvitt. 2017. Community environmental education. In Urban environmental education review , ed. A. Russ and M.E. Krasny, 124–132. Ithaca: Cornell University Press.

Chapter   Google Scholar  

Lave, J. 1991. Situating learning in communities of practice.

Lave, J., and E. Wenger. 1991. Situated learning: Legitimate peripheral participation . Cambridge: Cambridge University Press.

Lee, S., and W.-M. Roth. 2003. Science and the “good citizen”: Community-based scientific literacy. Science, Technology, & Human Values 28: 403–424. https://doi.org/10.1177/0162243903028003003 .

Lévy, P., and R. Bononno. 1997. Collective intelligence: Mankind’s emerging world in cyberspace . New York: Perseus Books.

Lloyd, A. 2005. No man (or woman) is an island: Information literacy, affordances and communities of practice. The Australian Library Journal 54: 230–237. https://doi.org/10.1080/00049670.2005.10721760 .

Lopez-Gunn, E. 2003. The role of collective action in water governance: A comparative study of groundwater user associations in La Mancha aquifers in Spain. Water International 28: 367–378. https://doi.org/10.1080/02508060308691711 .

Lu, J.G., A.C. Hafenbrack, P.W. Eastwick, D.J. Wang, W.W. Maddux, and A.D. Galinsky. 2017. “Going out” of the box: Close intercultural friendships and romantic relationships spark creativity, workplace innovation, and entrepreneurship. Journal of Applied Psychology 102: 1091–1108. https://doi.org/10.1037/apl0000212 .

Lubeck, A., A. Metcalf, C. Beckman, L. Yung, and J. Angle. 2019. Collective factors drive individual invasive species control behaviors: Evidence from private lands in Montana, USA. Ecology and Society . https://doi.org/10.5751/ES-10897-240232 .

Mackay, C.M.L., M.T. Schmitt, A.E. Lutz, and J. Mendel. 2021. Recent developments in the social identity approach to the psychology of climate change. Current Opinion in Psychology 42: 95–101. https://doi.org/10.1016/j.copsyc.2021.04.009 .

Magis, K. 2010. Community resilience: An indicator of social sustainability. Society & Natural Resources 23: 401–416. https://doi.org/10.1080/08941920903305674 .

Manfredo, M.J., T.L. Teel, and A.M. Dietsch. 2016. Implications of human value shift and persistence for biodiversity conservation. Conservation Biology 30: 287–296. https://doi.org/10.1111/cobi.12619 .

Marshall, G.R., M.J. Coleman, B.M. Sindel, I.J. Reeve, and P.J. Berney. 2016. Collective action in invasive species control, and prospects for community-based governance: The case of serrated tussock ( Nassella trichotoma ) in New South Wales, Australia. Land Use Policy 56: 100–111. https://doi.org/10.1016/j.landusepol.2016.04.028 .

Mårtensson, L., and G. Hensing. 2012. Health literacy: A heterogeneous phenomenon: A literature review. Scandinavian Journal of Caring Sciences 26: 151–160. https://doi.org/10.1111/j.1471-6712.2011.00900.x .

Martin, C., and C. Steinkuehler. 2010. Collective information literacy in massively multiplayer online games. E-Learning and Digital Media 7: 355–365. https://doi.org/10.2304/elea.2010.7.4.355 .

Masson, T., and I. Fritsche. 2021. We need climate change mitigation and climate change mitigation needs the ‘We’: A state-of-the-art review of social identity effects motivating climate change action. Current Opinion in Behavioral Sciences 42: 89–96. https://doi.org/10.1016/j.cobeha.2021.04.006 .

Massung, E., D. Coyle, K.F. Cater, M. Jay, and C. Preist. 2013. Using crowdsourcing to support pro-environmental community activism. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems . https://doi.org/10.1145/2470654.2470708 .

McAdam, D. 2017. Social movement theory and the prospects for climate change activism in the United States. Annual Review of Political Science 20: 189–208. https://doi.org/10.1146/annurev-polisci-052615-025801 .

McAdam, D., and H. Boudet. 2012. Putting social movements in their place: Explaining opposition to energy projects in the United States, 2000–2005 . Cambridge University Press.

McKenzie-Mohr, D. 2011. Fostering sustainable behavior: An introduction to community-based social marketing (3rd edn.). New Society Publishers.

McKinley, D.C., A.J. Miller-Rushing, H.L. Ballard, R. Bonney, H. Brown, S.C. Cook-Patton, D.M. Evans, R.A. French, et al. 2017. Citizen science can improve conservation science, natural resource management, and environmental protection. Biological Conservation 208: 15–28.

Miller, D.L. 2014. Introduction to collective behavior and collective action (3rd ed.). Waveland Press.

Mills, J., D. Gibbon, J. Ingram, M. Reed, C. Short, and J. Dwyer. 2011. Organising collective action for effective environmental management and social learning in Wales. The Journal of Agricultural Education and Extension 17: 69–83. https://doi.org/10.1080/1389224X.2011.536356 .

Mistry, J., and A. Berardi. 2016. Bridging Indigenous and scientific knowledge. Science 352: 1274–1275. https://doi.org/10.1126/science.aaf1160 .

Mochizuki, Y., and A. Bryan. 2015. Climate change education in the context of education for sustainable development: Rationale and principles. Journal of Education for Sustainable Development 9: 4–26. https://doi.org/10.1177/0973408215569109 .

Monroe, M.C. 2003. Two avenues for encouraging conservation behaviors. Human Ecology Review 10: 113–125.

Nasir, N.S., M.M. de Royston, B. Barron, P. Bell, R. Pea, R. Stevens, and S. Goldman. 2020. Learning pathways: How learning is culturally organized. In Handbook of the cultural foundations of learning , ed. N.S. Nasir, C.D. Lee, R. Pea, and M.M. de Royston, 195–211. Routledge.

National Academies of Sciences, Engineering, and Medicine. 2016. Science literacy: Concepts, contexts, and consequences . https://doi.org/10.17226/23595

National Research Council. 2015. Collective behavior: From cells to societies: Interdisciplinary research team summaries . National Academies Press. https://doi.org/10.17226/21737

Niemiec, R.M., N.M. Ardoin, C.B. Wharton, and G.P. Asner G.P. 2016. Motivating residents to combat invasive species on private lands: Social norms and community reciprocity. Ecology and Society , 21. https://doi.org/10.5751/ES-08362-210230

Niemiec, R.M., S. McCaffrey, and M.S. Jones. 2020. Clarifying the degree and type of public good collective action problem posed by natural resource management challenges. Ecology and Society 25: 30. https://doi.org/10.5751/ES-11483-250130 .

Norström, A.V., C. Cvitanovic, M.F. Löf, S. West, C. Wyborn, P. Balvanera, A.T. Bednarek, E.M. Bennett, et al. 2020. Principles for knowledge co-production in sustainability research. Nature Sustainability 3: 182–190. https://doi.org/10.1038/s41893-019-0448-2 .

Olick, J.K. 1999. Collective memory: The two cultures. Sociological Theory 17: 333–348. https://doi.org/10.1111/0735-2751.00083 .

Ostrom, E. 1990. Governing the commons: The evolution of institutions for collective action . Cambridge University Press.

Ostrom, E. 2000. Collective action and the evolution of social norms. Journal of Economic Perspectives 14: 137–158. https://doi.org/10.1257/jep.14.3.137 .

Ostrom, E. 2009. A general framework for analyzing sustainability of social-ecological systems. Science 325: 419–422. https://doi.org/10.1126/science.1172133 .

Ostrom, E. 2010. Polycentric systems for coping with collective action and global environmental change. Global Environmental Change 20: 550–557. https://doi.org/10.1016/j.gloenvcha.2010.07.004 .

Ostrom, E. 2012. Nested externalities and polycentric institutions: Must we wait for global solutions to climate change before taking actions at other scales? Economic Theory 49: 353–369. https://doi.org/10.1007/s00199-010-0558-6 .

Ostrom, E., and T.K. Ahn. 2009. The meaning of social capital and its link to collective action. In Handbook of social capital: The troika of sociology, political science and economics , ed. G.T. Svendsen and G.L.H. Svendsen, 17–35. Edward Elgar Publishing.

Papen, U. 2009. Literacy, learning and health: A social practices view of health literacy. Literacy and Numeracy Studies . https://doi.org/10.5130/lns.v0i0.1275 .

Park, R.E. 1927. Human nature and collective behavior. American Journal of Sociology 32: 733–741.

Paul, A.M. 2021. The extended mind: The power of thinking outside the brain . Boston: Mariner Books.

Pawilen, G.T. 2021. Integrating Indigenous knowledge in the Philippine elementary science curriculum: Integrating Indigenous knowledge. International Journal of Curriculum and Instruction 13: 1148–1160.

Prager, K. 2015. Agri-environmental collaboratives for landscape management in Europe. Current Opinion in Environmental Sustainability 12: 59–66. https://doi.org/10.1016/j.cosust.2014.10.009 .

Pretty, J., and H. Ward. 2001. Social capital and the environment. World Development 29: 209–227. https://doi.org/10.1016/S0305-750X(00)00098-X .

Putnam, R.D. 2020. Bowling alone: Revised and updated: The collapse and revival of American community . Anniversary. New York: Simon & Schuster.

Raymond, L. 2006. Cooperation without trust: Overcoming collective action barriers to endangered species protection. Policy Studies Journal 34: 37–57. https://doi.org/10.1111/j.1541-0072.2006.00144.x .

Reed, M.S., A.C. Evely, G. Cundill, I. Fazey, J. Glass, A. Laing, J. Newig, B. Parrish, et al. 2010. What is social learning? Ecology and Society 15: 12.

Reicher, S., R. Spears, and S.A. Haslam. 2010. The social identity approach in social psychology. In The SAGE handbook of identities (pp. 45–62). SAGE. https://doi.org/10.4135/9781446200889

Reid, A. 2019. Blank, blind, bald and bright spots in environmental education research. Environmental Education Research 25: 157–171. https://doi.org/10.1080/13504622.2019.1615735 .

Rogoff, B. 2003. The cultural nature of human development (Reprint edition) . Oxford: Oxford University Press.

Roth, C.E. 1992. Environmental literacy: Its roots, evolution and directions in the 1990s . http://eric.ed.gov/?id=ED348235

Roth, W.-M. 2003. Scientific literacy as an emergent feature of collective human praxis. Journal of Curriculum Studies 35: 9–23. https://doi.org/10.1080/00220270210134600 .

Roth, W.-M., and A.C. Barton. 2004. Rethinking scientific literacy . London: Psychology Press.

Roth, W.-M., and S. Lee. 2002. Scientific literacy as collective praxis. Public Understanding of Science 11: 33–56. https://doi.org/10.1088/0963-6625/11/1/302 .

Roth, W.-M., and S. Lee. 2004. Science education as/for participation in the community. Science Education 88: 263–291.

Roth, W.-M., and Y.-J. Lee. 2007. “Vygotsky’s neglected legacy”: Cultural-historical activity theory. Review of Educational Research 77: 186–232.

Sadoff, C.W., and D. Grey. 2005. Cooperation on international rivers: A continuum for securing and sharing benefits. Water International 30: 420–427.

Samerski, S. 2019. Health literacy as a social practice: Social and empirical dimensions of knowledge on health and healthcare. Social Science & Medicine 226: 1–8. https://doi.org/10.1016/j.socscimed.2019.02.024 .

Sawyer, R.K. 2014. The future of learning: Grounding educational innovation in the learning sciences. In The Cambridge handbook of the learning sciences , ed. R.K. Sawyer, 726–746. Cambridge: Cambridge University Press.

Saxe, J.G. n.d.. The blind man and the elephant . All Poetry. Retrieved October 6, 2020, from https://allpoetry.com/The-Blind-Man-And-The-Elephant .

Scheepers, D., and N. Ellemers. 2019. Social identity theory. In Social psychology in action: Evidence-based interventions from theory to practice , ed. K. Sassenberg and M.L.W. Vliek, 129–143. New York: Springer International Publishing.

Schipper, E.L.F., N.K. Dubash, and Y. Mulugetta. 2021. Climate change research and the search for solutions: Rethinking interdisciplinarity. Climatic Change 168: 18. https://doi.org/10.1007/s10584-021-03237-3 .

Schoerning, E. 2018. A no-conflict approach to informal science education increases community science literacy and engagement. Journal of Science Communication, Doi 10: 17030205.

Schultz, P.W. 2014. Strategies for promoting proenvironmental behavior: Lots of tools but few instructions. European Psychologist 19: 107–117. https://doi.org/10.1027/1016-9040/a000163 .

Sharifi, A. 2016. A critical review of selected tools for assessing community resilience. Ecological Indicators 69: 629–647. https://doi.org/10.1016/j.ecolind.2016.05.023 .

Sherrieb, K., F.H. Norris, and S. Galea. 2010. Measuring capacities for community resilience. Social Indicators Research 99: 227–247. https://doi.org/10.1007/s11205-010-9576-9 .

Singh, R.K., A. Singh, K.K. Zander, S. Mathew, and A. Kumar. 2021. Measuring successful processes of knowledge co-production for managing climate change and associated environmental stressors: Adaptation policies and practices to support Indian farmers. Journal of Environmental Management 282: 111679. https://doi.org/10.1016/j.jenvman.2020.111679 .

Sloman, S., and P. Fernbach. 2017. The knowledge illusion: Why we never think alone . New York: Riverhead Books.

Smelser, N.J. 2011. Theory of collective behavior . Quid Pro Books. (Original work published 1962).

Sørensen, K., S. Van den Broucke, J. Fullam, G. Doyle, J. Pelikan, Z. Slonska, H. Brand, and (HLS-EU) Consortium Health Literacy Project European. 2012. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health 12: 80. https://doi.org/10.1186/1471-2458-12-80 .

Spitzer, W., and J. Fraser. 2020. Advancing community science literacy. Journal of Museum Education 45: 5–15. https://doi.org/10.1080/10598650.2020.1720403 .

Stables, A., and K. Bishop. 2001. Weak and strong conceptions of environmental literacy: Implications for environmental education. Environmental Education Research 7: 89. https://doi.org/10.1080/13504620125643 .

Stern, M.J., R.B. Powell, and N.M. Ardoin. 2008. What difference does it make? Assessing outcomes from participation in a residential environmental education program. The Journal of Environmental Education 39: 31–43. https://doi.org/10.3200/JOEE.39.4.31-43 .

Stets, J.E., and P.J. Burke. 2000. Identity theory and social identity theory. Social Psychology Quarterly 63: 224–237. https://doi.org/10.2307/2695870 .

Sturmer, S., and B. Simon. 2004. Collective action: Towards a dual-pathway model. European Review of Social Psychology 15: 59–99. https://doi.org/10.1080/10463280340000117 .

Sullivan, A., A. York, D. White, S. Hall, and S. Yabiku. 2017. De jure versus de facto institutions: Trust, information, and collective efforts to manage the invasive mile-a-minute weed (Mikania micrantha). International Journal of the Commons 11: 171–199. https://doi.org/10.18352/ijc.676 .

Sunstein, C.R. 2008. Infotopia: How many minds produce knowledge . Oxford: Oxford University Press.

Surowiecki, J. 2005. The wisdom of crowds . New York: Anchor.

Swim, J.K., S. Clayton, and G.S. Howard. 2011. Human behavioral contributions to climate change: Psychological and contextual drivers. American Psychologist 66: 251–264.

Thaker, J., P. Howe, A. Leiserowitz, and E. Maibach. 2019. Perceived collective efficacy and trust in government influence public engagement with climate change-related water conservation policies. Environmental Communication 13: 681–699. https://doi.org/10.1080/17524032.2018.1438302 .

Tudge, J.R.H., and P.A. Winterhoff. 1993. Vygotsky, Piaget, and Bandura: Perspectives on the relations between the social world and cognitive development. Human Development 36: 61–81. https://doi.org/10.1159/000277297 .

Turner, R.H., and L.M. Killian. 1987. Collective behavior , 3rd ed. Englewood Cliffs: Prentice Hall.

Turner, R.H., N.J. Smelser, and L.M. Killian. 2020. Collective behaviour. In Encyclopedia Britannica . Encyclopedia Britannica, Inc. https://www.britannica.com/science/collective-behaviour .

van der Linden, S. 2014. Towards a new model for communicating climate change. In Understanding and governing sustainable tourism mobility , ed. S. Cohen, J. Higham, P. Peeters, and S. Gössling, 263–295. Milton Park: Routledge.

van Zomeren, M., T. Postmes, and R. Spears. 2008. Toward an integrative social identity model of collective action: A quantitative research synthesis of three socio-psychological perspectives. Psychological Bulletin 134: 504–535. https://doi.org/10.1037/0033-2909.134.4.504 .

Vygotsky, L.S. 1980. Mind in society: The development of higher psychological processes . Cambridge: Harvard University Press.

Waldron, F., B. Ruane, R. Oberman, and S. Morris. 2019. Geographical process or global injustice? Contrasting educational perspectives on climate change. Environmental Education Research 25: 895–911. https://doi.org/10.1080/13504622.2016.1255876 .

Wals, A.E.J., M. Brody, J. Dillon, and R.B. Stevenson. 2014. Convergence between science and environmental education. Science 344: 583–584.

Wenger, E.C., and W.M. Snyder. 2000. Communities of practice: The organizational frontier. Harvard Business Review 78: 139–146.

Weschsler, D. 1971. Concept of collective intelligence. American Psychologist 26: 904–907. https://doi.org/10.1037/h0032223 .

Wheaton, M., A. Kannan, and N.M. Ardoin. 2018. Environmental literacy: Setting the stage (Environmental Literacy Brief, Vol. 1). Social Ecology Lab, Stanford University. https://ed.stanford.edu/sites/default/files/news/images/stanfordsocialecologylab-brief-1.pdf .

Wojcik, D.J., N.M. Ardoin, and R.K. Gould. 2021. Using social network analysis to explore and expand our understanding of a robust environmental learning landscape. Environmental Education Research 27: 1263–1283.

Wood, W., and D. Rünger. 2016. Psychology of habit. Annual Review of Psychology 67: 289–314. https://doi.org/10.1146/annurev-psych-122414-033417 .

Woolley, A.W., C.F. Chabris, A. Pentland, N. Hashmi, and T.W. Malone. 2010. Evidence for a collective intelligence factor in the performance of human groups. Science 330: 686–688. https://doi.org/10.1126/science.1193147 .

Download references


We are grateful to Maria DiGiano, Anna Lee, and Becca Shareff for their feedback and contributions to early drafts of this paper. We appreciate the research and writing assistance supporting this paper provided by various members of the Stanford Social Ecology Lab, especially: Brennecke Gale, Pari Ghorbani, Regina Kong, Naomi Ray, and Austin Stack.

This work was supported by a grant from the Pisces Foundation.

Author information

Authors and affiliations.

Emmett Interdisciplinary Program in Environment and Resources, Graduate School of Education, and Woods Institute for the Environment, Stanford University, 233 Littlefield Hall, Stanford, CA, 94305, USA

Nicole M. Ardoin

Social Ecology Lab, Graduate School of Education and Woods Institute for the Environment, Stanford University, 233 Littlefield Hall, Stanford, CA, 94305, USA

Alison W. Bowers

Emmett Interdisciplinary Program in Environment and Resources, School of Earth, Energy and Environmental Sciences, Stanford University, 473 Via Ortega, Suite 226, Stanford, CA, 94305, USA

Mele Wheaton

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Nicole M. Ardoin .

Ethics declarations

Conflict of interest.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Ardoin, N.M., Bowers, A.W. & Wheaton, M. Leveraging collective action and environmental literacy to address complex sustainability challenges. Ambio 52 , 30–44 (2023). https://doi.org/10.1007/s13280-022-01764-6

Download citation

Received : 11 July 2021

Revised : 11 January 2022

Accepted : 22 June 2022

Published : 09 August 2022

Issue Date : January 2023

DOI : https://doi.org/10.1007/s13280-022-01764-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

  • Collective action
  • Environmental literacy
  • Social movements
  • Sustainability
  • Find a journal
  • Publish with us
  • Track your research

Communication Sciences and Disorders

Sharice clough rejoins csd, this time as assistant professor.

Sharice Clough

The journey of Dr. Sharice Clough (MA-SLP, 2018) from a student to a professional in her field, and soon-to-be faculty member, speaks volumes about CSD’s bragging rights that they’re a department dedicated to cultivating leaders in the field of communication sciences and disorders.

“I’m excited and confident that Sharice will bring fresh perspectives, innovative ideas, and a deep commitment to excellence in her new role,” said Eric Hunter, Department Executive Officer and Harriet B. and Harold S. Brady Chair in Liberal Arts and Sciences.

After completing her master’s degree in Speech-Language Pathology at Iowa, Clough embarked on doctoral studies in Hearing and Speech Sciences at Vanderbilt University, followed by interdisciplinary post-doctoral training in the Multimodal Language Department at the Max Planck Institute for Psycholinguistics in Nijmegen, The Netherlands.

She will join us as an assistant professor in CSD at Iowa in Fall 2026. 

Clough investigates acquired neurogenic communication disorders, such as traumatic brain injury, aphasia, and dementia in adults. More specifically, she strives to know more about how people use and comprehend language in rich and dynamic contexts, like those we encounter in daily life. 

Real-world communication is interactive , involving a collaborative exchange between individuals. It is also multimodal , containing a variety of communicative cues like speech, gesture, facial expressions, and eye gaze. Her goal is to better understand how these flexible and social language abilities are disrupted by brain injury. 

For example, in a recent behavioral experiment, she examined how adults with and without traumatic brain injury adapted their speech, gesture, and eye gaze behavior when talking to groups of listeners with different levels of knowledge based on their prior interactions. These types of social skills underlie the ability to design our communication appropriately and efficiently for different audiences (e.g., talking to a friend versus a group of coworkers). 

"Although people with traumatic brain injury can have difficulty with social communication, we tend to assess language in very controlled and isolated contexts in both the clinic and lab," she said. “It’s critical that we incorporate these dynamic and rich properties of language into our practices to create assessments that sensitively detect communication difficulties and treatments that generalize beyond the clinic room into the real world.”

Clough uses a variety of methods to study the cognitive and neural systems that underlie neurogenic communication disorders, such as behavioral testing, eye-tracking, motion tracking, neuropsychological testing, and lesion mapping. In addition to advancing our understanding of the communication abilities of people with acquired brain injury, combining these methods allows her to learn more about the links between language and the brain.

“Iowa CSD is the perfect place to grow my research program and lab. My experiences as a master’s student in the department opened many doors for me and ignited a passion for science and discovery that I’m excited to pass on to future students. Iowa has all the right ingredients and an incredible community of scholars who I’m thrilled to be joining,” she said.

Hunter says he’s eager to see the research, academic, and leadership impacts Clough will undoubtedly have on the CSD program and its students. 

“ Iowa CSD leans into its mission to foster a culture of growth and discovery. Our graduates –such as Sharice -- go on to achieve great things, and it’s doubly-fulfilling when those individuals return to give back to the community that supported them,” he said.

NOTICE: The University of Iowa Center for Advancement is an operational name for the State University of Iowa Foundation, an independent, Iowa nonprofit corporation organized as a 501(c)(3) tax-exempt, publicly supported charitable entity working to advance the University of Iowa. Please review its full disclosure statement.


  1. Communication Skill Assessments

    communication skills research

  2. What Are Some Of The Ways To Improve Business Communication Skills

    communication skills research

  3. 7 Tips To Improve Your Communication Skills

    communication skills research

  4. How To Develop Excellent Communication Skills

    communication skills research

  5. Communication is A Skill We Must Learn!

    communication skills research

  6. 5 Qualities That Foster Communication Skills

    communication skills research


  1. Four Skills of Communication| Listening, Speaking, Reading & Writing| Process and Barrier to Avoid

  2. Effective Communication Skills

  3. Basic Communication Skills

  4. Motivation is essential for all round development of students, for details, @vipinkumartyagi5716

  5. Waiting for 10th & 12th exams results?? 🤔💭 || #viralshorts #prostarimmigration #ieltsprep #shorts

  6. Importance of Effective Communication Skills and Proposal Writing


  1. Performance-based assessment of students' communication skills

    Referred to as "performance-based" or "competence-oriented tests" within the field of competence research, such tests seek to represent holistically the individual's capabilities to act (Blömeke et al., 2015; Shavelson et al., 2018 ). Thus, even the designation of a "competence-oriented examination" of communication skills, for ...

  2. (PDF) Perceived importance of communication skills and ...

    Seven of eight communication skills identified in previous research (Burleson & Samter, 1990; Frymier & Houser, 2000) were perceived by students to be important in the teacher‐student relationship.

  3. The Teaching and Learning of Communication Skills in Social Work

    Purpose: This article presents a systematic review of research into the teaching and learning of communication skills in social work education.Methods: We conducted a systematic review, adhering to the Cochrane Handbook of Systematic Reviews for Interventions and PRISMA reporting guidelines for systematic reviews and meta-analyses.Results: Sixteen records reporting on fifteen studies met the ...

  4. Communication Skills among University Students

    There are many types of communication skills, but generally it. involves oral and written skills. Mohd Helmi (2005) proposes that there are essentially three types of. communication, which are ...

  5. Communication skills training for improving the communicative abilities

    For social work educators, our understanding of how communication skills and empathy are taught and learnt remain limited, due to a lack of empirical research and comprehensive discussion. Despite the limitations and variations in educational culture, the findings are still useful, and suggest that communication skills training is likely to be ...

  6. Tailoring Scientific Communications for Audience and Research Narrative

    Communication Skills for Success in Science. The National Academies of Sciences, Engineering, and Medicine recommend that Ph.D.-level scientists should be able to "communicate, both orally and in written form, the significance and impact of a study or body of work to all STEM professionals, other sectors that may utilize the results, and the public at large" (Leshner & Scherer, 2018, p. 107).

  7. Improving your communication skills

    At no stage in our careers should we stop developing and learning about communication. Research has shown that poor communication can contribute to burnout among consultants, dissatisfaction among patients, lack of compliance, and medicolegal problems. Improved communication skills could have a positive effect on all these.

  8. Global communication skills: contextual factors fostering their

    Previous research found low student engagement in online lectures (Mayende, Prinz, and Isabwe Citation 2017) and graduates lacking in online collaboration competencies, including communication skills (Kolm et al. Citation 2022). As universities gradually resume in-person teaching, graduates may still need to work remotely after transitioning ...

  9. Communication Skills

    The aim of this systematic review was to analyze the results of educational research on developing communication skills for learners (≤21 years) with ASD and comorbid ID. Approaches used, and aspects found to be important to develop learners' communication skills were identified. The review was guided by three research questions:

  10. Developing Effective Communication Skills

    The starting place for effective communication is effective listening. "Active listening is listening with all of one's senses," says physician communication expert Kenneth H. Cohn, MD, MBA, FACS. "It's listening with one's eyes as well as one's years. Only 8% of communication is related to content—the rest pertains to body language and ...

  11. (PDF) Communication Skills in Practice

    modifying or even changing in behaviour. Specifically, communication is held to. share feelings and thoughts for several purposes that aim to connect with others. such as: inspiring, motivati ng ...

  12. What Is Effective Communication? Skills for Work, School, and Life

    Effective communication is the process of exchanging ideas, thoughts, opinions, knowledge, and data so that the message is received and understood with clarity and purpose. When we communicate effectively, both the sender and receiver feel satisfied. Communication occurs in many forms, including verbal and non-verbal, written, visual, and ...

  13. Important Communication Skills and How to Improve Them

    Try incorporating their feedback into your next chat, brainstorming session, or video conference. 4. Prioritize interpersonal skills. Improving interpersonal skills —or your ability to work with others—will feed into the way you communicate with your colleagues, managers, and more.

  14. How Great Leaders Communicate

    Transformational leaders are exceptional communicators. In this piece, the author outlines four communication strategies to help motivate and inspire your team: 1) Use short words to talk about ...

  15. PDF An Assessment of Students' Performance in Communication Skills A Case

    Communication Skills course at the University of Education, Winneba. The research also has an aim of bringing out suggestions and recommendations on how to improve the teaching and learning of communication skills. 1.3 Research questions The following questions guided the research: 1.

  16. How to communicate your research more effectively

    Whether you're giving a conference talk, writing a grant, or explaining your work to a family member, the ability to effectively communicate about your research is an essential skill for an Early Career Researcher (ECR) to develop.Read on for our interview with science writer Stephen S. Hall to learn how he helps researchers improve their communication skills, and why that matters.

  17. Effective Communication Improving Your Interpersonal Skills

    Effective communication is about more than just exchanging information. It's about understanding the emotion and intentions behind the information. As well as being able to clearly convey a message, you need to also listen in a way that gains the full meaning of what's being said and makes the other person feel heard and understood.

  18. Novel approaches to communication skills development: The untapped

    Results. Three key themes characterizing the impact of qualitative research participation on aspiring clinicians' communication skills development and practice arose - the 3Cs: (1) Connection, therapeutic alliance, and accompaniment; (2) Clarity and prognostic communication; (3) Compassion, empathy, and understanding.Participants emphasized that qualitative research learning improved their ...

  19. Issues

    Issues | Human Communication Research | Oxford Academic. Browse issues. Decade. 2020 2010 2000 1990 1980 1970. Year. 2024 2023 2022 2021 2020. Issue. Volume 50, Issue 1, January 2024, Pages 1-142 Volume 50, Issue 2, April 2024, Pages 143-308. Browse by volume.

  20. The Importance of Communication in Research

    Let's read why communicating research is important. It helps boost awareness of your work: Communicating research findings to wider audiences can help bridge the gap between academic research and public understanding and goes a long way in boosting researcher credibility. When the public is informed about your research, it increases the ...

  21. (PDF) University Students' Communication Skills as a ...

    Present research was to study the effect of the communication skills on th e students' academic achievement (CGPAs) at university le ve l. Fo llowing procedures were adapted for this study .

  22. Implementation of research oriented collaborative inquiry learning

    This research was concerned with determining whether students with good critical thinking skills have better oral and written communication skills. This research was descriptive and quantitative, with a sample of 49 junior high school students in class IX. Observation sheets and student activity sheets became instruments in this study.

  23. Lack of effective intercultural communication is hobbling academia

    Bad intercultural communication is hobbling academia — fix it for research equity. By. Shoumit Dey &. Pooja Sharma. Across cultures and geographies, effective communication drives progress in ...

  24. Effective Communication, Productivity And Collaboration

    In 2012, a McKinsey study found that effective communication improves productivity by up to 25% when team members feel connected and aligned. Imagine the impact of this in your workplace: fewer ...

  25. Boost Market Research Career with Communication Skills

    Here's how you can boost your communication skills for a successful career in market research. Powered by AI and the LinkedIn community. 1. Listen Actively. Be the first to add your personal ...

  26. Effectively teaching cultural competence in a pre-professional

    There has been research documenting the rising numbers of racial and ethnic minority groups in the United States. With this rise, there is increasing concern over the health disparities that often affect these populations. Attention has turned to how clinicians can improve health outcomes and how the need exists to educate healthcare professionals on the practice of cultural competence.

  27. (PDF) Communication Skills for Workplace Success

    clarity and conciseness are important communication skills for workplace success. Friendliness - Friendliness is regarded to be of utmost significance in facilitating. effective communication ...

  28. Leveraging collective action and environmental literacy to address

    To support research and practice promoting collective action to address sustainability issues, we define the term "collective environmental literacy" by delineating four key potent aspects: scale, dynamic processes, shared resources, and synergy. ... such information, communication, and educational outreach efforts will shift attitudes and ...

  29. Sharice Clough rejoins CSD, this time as assistant professor

    These types of social skills underlie the ability to design our communication appropriately and efficiently for different audiences (e.g., talking to a friend versus a group of coworkers). "Although people with traumatic brain injury can have difficulty with social communication, we tend to assess language in very controlled and isolated ...