Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Communication PEARLS


When speaking with patients and colleagues, use a respectful tone and convey empathy. Clear communication is the basis for effective and trusting relationships with patients and coworkers.

Sensitive and thoughtful communication may be perceived as simply a “soft” skill that increases our institution’s HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores. However, poor communication is a significant patient safety issue and has been repeatedly identified as a major factor in negative health outcomes. Equally important is effective communication within the healthcare team.


A few years ago I took a train-the-trainer course on communication in healthcare, also known as the “PEARLS” course.  We learned how to use Partnership, Empathy, Acknowledgement, Respect, Legitimization, and Support (PEARLS) to improve communication. PEARLS emphasizes that clear communication is the basis for satisfying and effective relationships with patients and coworkers. The first step of excellent communication? Listening.


When was the last time you had a stressful communication with a colleague? It can color your whole day, leave you feeling drained, and even thinking about pursuing other careers. By the same token, respectful exchanges with others help our days go smoothly and allow us to go home feeling satisfied and knowing that our team has provided the very best care.


Learning and practicing words and phrases that express that we’re listening, have heard the other’s concerns, and are acting to address the concerns, helps us to move the conversation forward. Here are some phrases you can practice to show you’re listening:




“I know we both want what’s best. We may disagree on how to achieve it, but I know we’re in this together.”



“This has been a really tough day for you, I can see that.”



“I’m sorry things can’t be easier for us right now.”



“Your expertise is valuable in this situation, I know you spend more time at the bedside than I do.”



“Anyone would feel angry (disappointed, exhausted) in that situation.”



“We’re working to take care of this.”


Once we understand that we’re all working together to give excellent patient care, it’s easier to listen empathetically to our colleagues and respond productively. Effective communication is empathetic communication—it lays the groundwork for respectful and productive collegial relationships that are an important bulwark of patient safety.


Note: PEARLS copyright whit the The Academy on Communication in Healthcare (ACH)

This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.