Inclusive Communication Strategies in the Veterinary Setting

Many of us joke about choosing veterinary medicine because we prefer interaction with animals over interaction with humans. In actuality, most of our work is centered on communication with coworkers, teams, clients, the industry, and the public. Inclusive communication in the veterinary profession can increase client compliance and improve team retention and wellbeing.^1,2 Inclusive communication is paramount to the advancement of our profession, both for our teams and for the communities that we serve.

Using communication strategies that are inclusive enables us to communicate with people who differ in terms of culture, gender, socioeconomic background, age, lived experiences, and ways of thinking. Diverse organizations are more likely to outperform homogeneous ones.^3-6 Diversity alone, however, is not enough. The key is an inclusive culture, a culture in which everyone feels comfortable respectfully expressing their opinions and ideas.⁷ Inclusive teams are twice as likely to meet or exceed financial targets, 3 times as likely to be high performing, 6 times as likely to be innovative, and 8 times as likely to achieve better business outcomes than teams that are not inclusive.^8.9 Homogeneous teams can sometimes feel like an echo chamber, as individuals have similar views, leading to similar outcomes. In diverse teams, individuals may have different opinions and ideas—but if the team is not inclusive, individuals may not feel comfortable sharing their opinions and expressing their ideas. On the other hand, diverse and inclusive teams engage in radically candid, open, and honest discussion that acknowledges a variety of experiences. Differences in opinion promote conversation, creating just enough tension to promote innovative problem solving, ultimately generating outcomes that more closely align with the needs of the communities they serve.

Inclusive communication requires an understanding of verbal or nonverbal communication strategies, communication barriers, and contextual clues (FIGURE 1). Some communication strategies are straightforward, such as using proper grammar and spelling when sending emails as well as limiting distractions and interruptions during a conversation. Other communication strategies, such as giving and receiving feedback and resolving conflict, are more complex and require contextual cues (TABLE 1). As veterinary professionals, we often use contextual clues based on our audience and are aware of the potential repercussions of miscommunications. I always prided myself on using plain language when talking to clients, but I will never forget the time I asked a client, “What questions do you have?” while on the phone, and she said, “I think I got it. I just have to go Google what neoplasia means.”

Barriers to communication are traditionally divided into physical, emotional, and language (FIGURE 2). One of the most important barriers to communication, which is often missed, is accurate perception. Accurate perception is the ability to differentiate fact from feeling and is affected by cultural differences, assumptions, biases, stereotyping, and generalizing. For instance, making eye contact during conversations is often listed as an effective communication strategy because, in some cultures, making eye contact is a sign of care and respect. Yet in other cultures, eye contact is considered rude. In addition, direct eye contact can be extremely uncomfortable for some neurodivergent individuals, resulting in increased anxiety that actually hinders communication. Another example of accurate perception involves correctly interpreting body language.¹⁰ Body language interpretation helps decipher demeanor because gestures and posture can reflect someone’s emotional state. Crossed arms and legs are seen as a sign of closedness, anger, and frustration. However, crossed arms can be secondary to ambient temperature; and persons with hypermobility disorders often unconsciously cross their arms, legs, and ankles in an effort to stabilize their joints.¹¹

How, then, can we use contextual cues and accurate perception to expand our ability to effectively communicate with individuals from a variety of backgrounds? We can do so by building a growth mindset, identifying and diminishing our biases, understanding the art of giving and receiving feedback, and leveraging differences in conflict resolution. Inclusion does not mean that we are perfect at all times, but it does mean that we actively try to act in a way that is respectful of others.

Building a Growth Mindset

Dr. Carol Dweck identified a continuum of mindsets that differ in individuals and affect their response to challenges, obstacles, feedback, mistakes, and the success of others.¹² She coined the terms “growth mindset” and “fixed mindset.” Individuals with a growth mindset believe that qualities are things that you can cultivate with effort, whereas individuals with a fixed mindset believe that qualities are innate and you either have them or lack them. While developing a new skill and in the face of unexpected results and even failure, individuals with a growth mindset rebound more easily while those with a fixed mindset experience greater setbacks.

Having a growth mindset means believing that to grow, we must challenge ourselves. Those with a growth mindset are more open to a variety of perspectives and views. To foster a growth mindset, first identify your current mindset and then start identifying the challenges around you. As you do, work on seeing them as positive actions and opportunities for growth, rather than failures.

Overcoming Biases

Although the veterinary clientele is very diverse, veterinary medicine continues to be described as one of the least diverse professions in the United States. The literature shows that women and people from historically marginalized communities frequently experience microaggressions and other forms of discrimination in the workplace that are detrimental to their wellbeing.^13-17 Microaggressions often stem from unconscious biases.

We all have biases, which are inclinations for or against an idea, object, group, or individual. Our biases are affected by the religious, racial, socioeconomic, and political makeup of the community in which we were raised. Biases do not necessarily align with someone’s personal identity, but they can still creep into interactions and decision making, affecting how we treat others from a particular demographic or social group. In clinical practice, for example, biases can creep into the medical plans we propose to clients for the care of the patient. We may be presenting the same plan to every patient in the same situation, but our tone, word choices, and body language can still show our biases, affecting client receptivity.

Having a growth mindset and disrupting biases go hand in hand because they both require being open to change, stepping outside one’s comfort zone, and learning from surprises and failures.¹⁸ Interrupting biases and decreasing their influence require acknowledging that they exist, recognizing that we all have them, and using a growth mindset to address them (BOX 1). Are you ever surprised at how well someone speaks English? Or when a particular client moves forward with the estimate? When something surprises you, continuously ask yourself why.

Individuals with a growth mindset are more open to a variety of perspectives and views.¹⁹ Overcoming biases through a growth mindset requires patience, persistence, and work. Do not expect changes to happen overnight, and give yourself grace as you navigate this journey.

Giving and Receiving Feedback

Feedback is part of any healthy relationship, enabling the professional and personal growth of individuals and teams.^20,21 Giving and receiving feedback can be uncomfortable because doing so challenges our existing mental maps and connections. Feedback can be either positive or corrective. The goal of positive feedback is reinforcement, and the goal of constructive or corrective feedback is modification or improvement. Often we focus on constructive feedback, which can make individuals defensive and can be misinterpreted as criticism if not delivered correctly. Both positive and constructive feedback, however, should be given regularly, as part of a 2-way conversation with a neutral power dynamic.

Supporting an inclusive relationship and team starts with trust. After trust has been established, feedback becomes part of a mutual partnership. To maintain that trust, avoid making assumptions, psychoanalyzing individuals, and forgetting to focus on behavior while providing feedback. Be open to receiving feedback and communicate your preferences for receiving it. Ask others about their preference for receiving feedback. For instance, some individuals prefer written feedback and others prefer verbal feedback; some prefer formal meetings for discussing feedback and others do not mind being pulled aside.

Each person giving and receiving feedback has their own preferences; in inclusive teams, those differences can be adapted to create a stronger team. For example, if part of the team prefers feedback in written form, and part of the team prefers verbal feedback, the team can have a 2-step strategy in which feedback is given and received in person and is then followed up in written form.

Giving Feedback

Effective feedback is delivered regularly and in a timely, constructive, specific, and nonjudgmental manner (BOX 2). When giving feedback, carefully consider the giver, recipient, and environment in which the feedback is given. To be sure the recipient is in the right mind space to receive feedback, first ask for permission.

Receiving Feedback

Being open to receiving feedback is as important as giving feedback to others. Ensure that you communicate your preferences for receiving feedback. When receiving feedback, maintain an open growth mindset. As previously stated, individuals with a growth mindset see constructive feedback as an opportunity for learning and growth. Consider that not everyone knows how to give and receive feedback or what to do with feedback when they receive it. Listen to the feedback, express gratitude for it, and clarify any questions you may have.²¹ Reflect on the feedback received and consider how to best integrate it, if necessary.

Managing Conflict

Conflict refers to a struggle between 2 or more parties in which the parties perceive that their goals are incompatible. Conflict is a normal part of every relationship that at times can result in innovation and motivation but at other times can result in loss of productivity.²² The goal of conflict management is to address and resolve conflict. Conflict management skills are crucial for building resilience, working in teams, and thriving in challenging situations. Conflict should be approached with genuine curiosity, ensuring that all parties know that their opinions are heard and valued.

Conflict and discomfort are not inherently negative. Members of inclusive teams, for example, are comfortable challenging each other’s ideas and assumptions respectfully and directly. The team feels comfortable giving and receiving open and honest feedback, but disagreements still cause some tensions. Paired with a growth mindset, such friction in a team with a multitude of experiences actually leads to innovation. 

Not everyone approaches conflict similarly. Five conflict resolution styles are avoiding, competing, accommodating, compromising, and collaborating (TABLE 3).²³ Although some individuals can adapt to different styles, others often unconsciously gravitate toward a specific conflict management style.²² The type of conflict management style we use during conflict management can significantly affect the outcome. For example, during emotionally charged situations, using an avoiding conflict management style can be effective because it gives individuals time to evaluate their emotions, whereas using a competing conflict management style can lead to resentment and damage relationships in the long term.

Tools for managing conflict include exploring conflict management styles, cultivating our emotional intelligence, and developing active and reflective listening skills (BOX 3, TABLE 1).

Summary

The veterinary profession is one of the least diverse U.S. professions, yet we work with diverse clientele. Inclusive communication strategies require understanding and respecting the individual needs of all parties. Communicating in a way that respects the individual needs and preferences of all people with whom we interact every day can lead to personal and professional success. Inclusive communication is not a one-size-fits-all strategy and requires time, work, and persistence. Having a growth mindset enables us to challenge ourselves every day, see opportunities for growth, and create spaces in which everyone around us feels included.