The impact of nonverbal communication has been a source of research for many years, beginning in 1872 with Charles Darwin's publication of The Expression of the Emotions in Man and Animals. The observational study is regarded by many as the first research conducted on nonverbal communication and behavior. The study includes observations of infants, children and adults’ nonverbal expressions and the ways such expressions vary across cultures. Darwin found that nonverbal cues account for a large percentage of communication and are more reliable than the spoken word.

Additional evidence indicates between 55 and 93 percent of all communication is nonverbal. Dr. Albert Mehrabian, author of Silent Messages, has conducted several studies on nonverbal communication. His research demonstrates the following:

• Seven percent of any message is conveyed through words,
• 38 percent of communication is conveyed through certain vocal elements and
• 55 percent is conveyed through nonverbal elements, e.g., facial expressions, gestures, posture, etc.
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  Why Certified Deaf Interpreters Are Essential to Healthcare

Nonverbal communication, especially body language, can send a strong message that may support or conflict with what is being said. This is important to keep in mind in healthcare, particularly with the limited English proficiency (LEP) patient population. The tone of voice, pitch, volume, quality, and speed of speech can also impact the meaning of communication. According to Edward G Wertheim’s work, The Importance of Effective Communication, nonverbal communication has five main functions:

1. Repetition: reinforces what is being said
2. Contradiction: conflicts with the verbal message
3. Substitution: replaces what is being said
4. Complement: adds to the verbal message. For example, a pat on the back while saying “Congratulations”.
5. Accent: emphasizes a certain part of the verbal message

When asked whether nonverbal communication is universal, David Matsumoto, a renowned expert in the field of nonverbal expression, explains that “facial expressions of emotion are universal in the sense that everybody around the world regardless of race, culture, nationality, sex, gender, etc., whatever the demographic variable is, we all show the same facial muscle expressions on our faces when we have the same emotions.” While facial expressions of emotion are universal across cultures, gestures, he explains, are very different. Matsumoto breaks gestures down into two categories:

1. Speech illustrators are gestures used to accompany a point. For example, someone points when giving directions.
2. Emblems are culture specific gestures that correspond with verbal phrases. For example, a thumbs up means “OK”.

Gestures and facial expressions carry significant meaning, making up a considerable percentage of the overall message. For effective communication to take place, it is important to observe the manner is which something is said in addition to what is being said.

The Importance of Nonverbal Communication in Healthcare

Qualified medical interpreters are trained to pick up on cultural nuances that impact patient provider communication, including any gestures or facial expressions that vary from one country to another. They are also dedicated to interpreting the original message in its entirety, to ensure accuracy. This includes the meaning of any nonverbal communication that may accompany the verbal message. Qualified medical interpreters may be accessed over video, phone or onsite. The visual component of video remote interpretation (VRI) and onsite interpretation services yields a significant advantage, as over-the-phone interpretation services do not allow for the interpretation of nonverbal cues. Learn more here about how VRI services can improve communication with your LEP patients.

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Additional Language Services Resources

• Bon Secours Language Services Case Study
• Language Services Path of Value
• Choosing the Right Certified Medical Interpreter
• Medical Interpreters Improve LEP Patient Care: A Study Review
• Promoting Health Equity Through Language Access