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5.8: Case Study

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Cultural Appropriation: High School Celebrates Graduating Seniors with “Senores/Senoritas” Dress-Up Day

In the United States, we have a cultural tradition of dressing up for Halloween. This tradition dates back to ancient Celtic beliefs. Basically, in order to protect themselves from evil spirits on New Year’s Even when the boundary between the living and the dead was most accessible, people hid behind animal skin costumes. Over the many hundreds of years, dressing up in costume has become less about hiding from spirits and more about the nonverbal expression of individuality. This case study looks at an extreme case of dress-up that went horribly wrong and showed cultural appropriation at its worst and most offensive. The importance of this case study shows that cultivating and improving cultural intelligence is a necessary communication skill in today’s global environment.

Back in 2012, an Orange County high school made headlines with a dress-up day titled “Senores and Senoritas Day,” which was supposed to be a play on the word seniors . Canyon High School is located in Anaheim, California, and this event was intended to be a spirit day celebrating graduating seniors and California’s Mexican heritage. This event dates to at least 2009. According to the US Census Bureau American Community Survey, Hispanics/Latinos made up 52.8% of this city’s population between 2008 and 2012. It made sense to celebrate Hispanic heritage by highlighting some of the nonverbal elements of culture such as clothing, food, communication, and body language. However, the school’s administration did not properly specify guidelines for this event and broadly announced for students to wear Hispanic-themed attire.

As a result, students showed up to school dressed as US Border Patrol agents, immigration agents, gardeners, a pregnant woman pushing a baby stroller, and gang members with bandanas and teardrop tattoos. While these may seem like extreme examples, could students have dressed up in anything that did not perpetuate stereotypes? Even with clear guidelines, how does one avoid reducing the Hispanic culture to stereotypes and caricatures? How did the administration not see that this event was the epitome of cultural appropriation?

A former student raised concerns during his senior year but was told by an unidentified administrator to “get a sense of humor” (Do & Rojas, 2012). Upon taking a Chicano Studies class in college, he was motivated to take his concerns to the district level and insist they investigate. After an internal investigation, which included interviews with students and staff, a review of emails, and social media postings, it was found that, “There was a lack of oversight/supervision and that the school administration should not have allowed this activity.” The report also stated: “Even if strict guidelines were provided the result would still lead to hurtful and demeaning messages about Mexican culture and to the students of Mexican, Hispanic, and Latino descent” (Orange Communication System, 2012a).

Arya (2021) points out that recognizing that there “is an asymmetry of power between two cultures that involves the majority/dominant culture taking from the marginalized culture”  vital to understanding cultural appropriation. She notes, “Cultural appropriation is important because it concerns the phenomenon of exploitation that has existed historically and continues to do so between cultures of unequal power” (Ayra, 2021). While Anaheim’s Hispanic population was near 53%, Canyon High School was in the more affluent area of Anaheim Hills. At that time, the Los Angeles Times California Schools Guide reported about 55% of the students at Canyon HS were White compared to 16% Latino. Additionally, only 8% of the faculty was Latino, while white faculty dominated at 87% (“Enough Is Enough, Student Said of Seniores, Senoritas Day,” 2012).

At the conclusion of the district’s investigative report, Leal and Langhorne (2012) reported in the Orange County Register that  the district required:

• The high school’s administrators to complete sensitivity training
• The principal to address the inappropriateness of the dress up event in parent communication
• The school to sponsor an “International Week” to acknowledge and appreciate cultural diversity
• The school to enact a thorough review process for all proposed activities to consider what might go wrong and who it may offend

You may watch a YouTube video on the event here:  High School Cancels Demeaning Costume Event .

While this problem may seem to have been resolved, upon further digging, it was discovered that Greg Bowden, the principal of this high school, had been involved in previous district controversies. Back in 1988, Bowden was the band director at another high school in the district when the Associated Student Body and members of the pep squad donned afros and blackface to perform as the Jackson Five (San Roman, 2012). In 2008, Bowden and Canyon High School were at the center of a shocking physical and verbal bullying incident where a student was being called “faggot” and received no support from the administration. The real question is, “How did this individual continue to move up in the district without any repercussions and continue to overlook blatant cultural insensitivities?” (Orange Communication System, 2012a)

Reflection Questions

• Define cultural appropriation . How does this case exemplify cultural appropriation?
• What role does nonverbal communication play in cultural appropriation?
• Cultural appreciation and celebrations are common on school campuses. What can be learned from this case to set “appropriate” tones for future celebrations?
• Examine the consequences levied upon the school as a result of the investigation. Are these meaningful consequences from which the school and community can learn?
• What other examples of cultural appropriation can you think of that we, as a society, need to rectify?

H umanising L anguage T eaching

August 2020 - year 22 - issue 4, issn 1755-9715.

• Various Articles - Teachers’ perspective

A Case Study on Nonverbal Communication in EFL Classes in the Indonesian Context

• Yazid Basthomi, Indonesia
• Rida Afrilyasanti, Indonesia

Rida Afrilyasanti teaches at Taruna Nala Senior High School. She has published two books entitled Digital Storytelling as an Alternative Learning Media for EFL Learners and Learn English with Merah Putih Emas.

Yazid Basthomi is a Professor of Applied Linguistics at the Department of English, Faculty of Letters, Universitas Negeri Malang. Having interests in genre analysis, intercultural education, and digital culture, he is currently coordinator of the publication division of TEFLIN.

In this study, the nonverbal communication used by five Indonesian EFL teachers with different ranges of teaching experiences was evaluated. The study later found out that nonverbal communication surely bring some positive impacts for the teachers as well as learners when both parties have the same interpretation of the nonverbal cues used.

Nonverbal communication is inseparable from verbal communication. How our body moves, how and where we stand or sit, how we speak, and what expression we make are all nonverbal messages that in some ways are far more convincing than spoken word (Feldman and Rime, 1991). In his study, Gallo (2007) has identified that people tend to communicate nonverbally: 7% of communication involves actual words and the other 93% is nonverbal. He further states that 38% is vocal nonverbal signals such as pitch, speed, and volume of one’s voice and 55% of the nonverbal is visual such as body language and eye contact (Gallo, 2007).

Nonverbal communication in teaching and learning, especially in a foreign language context is very demanding, because nonverbal communication contributes to the students’ comprehension and understanding of concepts. Nonverbal communication helps to reach the aim of teaching, and develop teaching quality and methods (Pan, 2014). By employing nonverbal communication, teachers can more easily win the students’ attention so that they can focus on the subject matter.

In employing nonverbal cues in teaching, however, not all the teachers’ nonverbal cues are completely understood by the students. This happens as much about body language is defined by culture. Some people greet with handshakes, some hugs, and others kisses. Some consider that it is fine to point others using their index finger but some do not. Reiman (2007) has explained that these cultural expressions are dictated by “display rules”, the specific expectations every group has about body language. Nonverbal communication also involves the possibility of misunderstanding when it is misused and/or misinterpreted (Elfatihi, 2005; Lustig & Koester, 2006).

This paper aims to provide a brief analysis of the nonverbal communication used by teachers within their interactions with the students. Specifically, it touches on the use of nonverbal communication in EFL classes in the Indonesian context.

As nonverbal communication is bondless and there is no dictionary of nonverbal communication like in verbal communication, there must be some limitations in order to easily analyze the phenomena. Therefore, in order to answer the research questions, Darn’s (2005) article on the aspects of nonverbal communication will be used as the platform in describing the varieties of nonverbal communication used in the Indonesian EFL classes. In Darn’s (2005) study, it is explained that less than ten percent interpersonal communication involves words there are also varieties of nonverbal types or devices such as kinesics (movement), proxemics (space/physical distance), haptics (touch), oculesics (eye-contact), chronemics (time) & silence, vocalics (vocal set and qualities), sound symbols, adornment, and posture, which either replace or accompany verbal communication.

The purpose of this study is to discuss the importance and use of nonverbal communication in EFL classes in the Indonesian context. It highlights and analyzes nonverbal communication in terms of its various types and functions. This qualitative study involved five Indonesian EFL teachers with different ranges of teaching experiences. The participants responded to qualitative interview questions.

In order to enrich the data, observations of nonverbal cues performed by the teachers were also done. The participants’ nonverbal cues were analyzed based on the following nonverbal aspects: kinesics, proxemics, haptics, oculesics, chronemics & silence, vocalics, sound symbols, adornment, and posture (refer to Darn, 2005). In order to provide detailed reflections of the participants’ responses, a constructivist grounded theory approach to research was implemented so that the findings display direct representations of the data produced by the participants.

A total of five EFL teachers from Indonesia participated in the study. Of the sample, three teachers were female and two were male. Those teachers ranged in age from 23 to over 50. Three of the sample had a bachelor’s degree and two had obtained a master’s degree. Of those with bachelor degrees, two had teaching certificates and one did not. Meanwhile, of those with master's degrees, one had teaching certificate and one did not.

The teachers had some teaching experiences. Their experiences ranged from novice teachers with only two years of experience, to experienced teachers with over 30 years of experience. All of those five teachers had been teaching in senior high schools in which the ages of the students ranged from 16 to 18 years.

Findings and discussion

This section presents the results of data analysis along with some discussions.

The Importance of nonverbal communication in EFL classes

The teachers involved in this study said that gestures would help them in presenting language items such as grammar and vocabulary. The teachers admitted that their gestures help their students understand language items better. Some of the responses regarding the use of gestures in emphasizing teachers’ explanation on the language items are presented as follows:

Teacher I: “I tend to act out to present new verbs for my students. It helps them understand the meaning of the words more quickly and easily.”

Teacher II: “When I teach descriptive text, I prefer to start with vocabulary games and I use a lot of gestures. I point out certain parts of my body, pictures or objects around the students… and I think that really works.”

Many previous studies such as Behjat et.al. (2014), Shi & Fan (2010), and Sukirlan (2014) have come up with the similar findings on the importance of nonverbal cues in classroom interaction. Those are to help the students with inadequate target linguistic resources to communicate their message, to avoid being artificial and boring, and to encourage students to take active participation, which consequently enhances the level of their retention and understanding.

The teachers observed demonstrated a wide variety of nonverbal communication either consciously or unconsciously. However, when the teachers were explaining about concept and meaning, most of them consciously used various nonverbal cues along with their verbal explanation. They admitted that their nonverbal cues really accommodate their intent to help the students get the concept and meaning.

As depicted in the results of the interviews as well as observations, it can be construed that nonverbal communication can help improve the teaching practice and the learning process. Furthermore, the use of gestures is a good solution to solve misunderstandings. One of the examples is the use of pictures, movements, and gestures to explain the concept of time signal in English sentences.

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4.1 Principles and Functions of Nonverbal Communication

Learning objectives.

• Define nonverbal communication.
• Compare and contrast verbal communication and nonverbal communication.
• Discuss the principles of nonverbal communication.
• Provide examples of the functions of nonverbal communication.

As you’ll recall from our introductory chapter, a channel is the sensory route on which a message travels. Oral communication only relies on one channel, because spoken language is transmitted through sound and picked up by our ears. Nonverbal communication, on the other hand, can be taken in by all five of our senses. Since most of our communication relies on visual and auditory channels, those will be the focus of this chapter. But we can also receive messages and generate meaning through touch, taste, and smell. Touch is an especially powerful form of nonverbal communication that we will discuss in this chapter, but we will not get into taste and smell, which have not received as much scholarly attention in relation to nonverbal communication as the other senses.

To further define nonverbal communication, we need to distinguish between vocal and verbal aspects of communication. Verbal and nonverbal communication include both vocal and nonvocal elements, and Table 4.1 “Vocal and Nonvocal Elements of Communication” shows the relationship among vocal, nonvocal, verbal, and nonverbal aspects of communication. A vocal element of verbal communication is spoken words—for example, “Come back here.” A vocal element of nonverbal communication is paralanguage , which is the vocalized but not verbal part of a spoken message, such as speaking rate, volume, and pitch. Nonvocal elements of verbal communication include the use of unspoken symbols to convey meaning. Writing and American Sign Language (ASL) are nonvocal examples of verbal communication and are not considered nonverbal communication. Nonvocal elements of nonverbal communication include body language such as gestures, facial expressions, and eye contact. Gestures are nonvocal and nonverbal since most of them do not refer to a specific word like a written or signed symbol does.

Table 4.1 Vocal and Nonvocal Elements of Communication

Source: Adapted from Owen Hargie, Skilled Interpersonal Interaction: Research, Theory, and Practice (London: Routledge, 2011), 45.

Principles of Nonverbal Communication

Nonverbal communication has a distinct history and serves separate evolutionary functions from verbal communication. For example, nonverbal communication is primarily biologically based while verbal communication is primarily culturally based. This is evidenced by the fact that some nonverbal communication has the same meaning across cultures while no verbal communication systems share that same universal recognizability (Andersen, 1999). Nonverbal communication also evolved earlier than verbal communication and served an early and important survival function that helped humans later develop verbal communication. While some of our nonverbal communication abilities, like our sense of smell, lost strength as our verbal capacities increased, other abilities like paralanguage and movement have grown alongside verbal complexity. The fact that nonverbal communication is processed by an older part of our brain makes it more instinctual and involuntary than verbal communication.

Nonverbal Communication Conveys Important Interpersonal and Emotional Messages

You’ve probably heard that more meaning is generated from nonverbal communication than from verbal. Some studies have claimed that 90 percent of our meaning is derived from nonverbal signals, but more recent and reliable findings claim that it is closer to 65 percent (Guerrero & Floyd, 2006). We may rely more on nonverbal signals in situations where verbal and nonverbal messages conflict and in situations where emotional or relational communication is taking place (Hargie, 2011). For example, when someone asks a question and we’re not sure about the “angle” they are taking, we may hone in on nonverbal cues to fill in the meaning. For example, the question “What are you doing tonight?” could mean any number of things, but we could rely on posture, tone of voice, and eye contact to see if the person is just curious, suspicious, or hinting that they would like company for the evening. We also put more weight on nonverbal communication when determining a person’s credibility. For example, if a classmate delivers a speech in class and her verbal content seems well-researched and unbiased, but her nonverbal communication is poor (her voice is monotone, she avoids eye contact, she fidgets), she will likely not be viewed as credible. Conversely, in some situations, verbal communication might carry more meaning than nonverbal. In interactions where information exchange is the focus, at a briefing at work, for example, verbal communication likely accounts for much more of the meaning generated. Despite this exception, a key principle of nonverbal communication is that it often takes on more meaning in interpersonal and/or emotional exchanges.

About 65 percent of the meaning we derive during interactions comes from nonverbal communication.

Gideon – In Perfect Congruence – CC BY 2.0.

Nonverbal Communication Is More Involuntary than Verbal

There are some instances in which we verbally communicate involuntarily. These types of exclamations are often verbal responses to a surprising stimulus. For example, we say “owww!” when we stub our toe or scream “stop!” when we see someone heading toward danger. Involuntary nonverbal signals are much more common, and although most nonverbal communication isn’t completely involuntary, it is more below our consciousness than verbal communication and therefore more difficult to control.

The involuntary nature of much nonverbal communication makes it more difficult to control or “fake.” For example, although you can consciously smile a little and shake hands with someone when you first see them, it’s difficult to fake that you’re “happy” to meet someone. Nonverbal communication leaks out in ways that expose our underlying thoughts or feelings. Spokespeople, lawyers, or other public representatives who are the “face” of a politician, celebrity, corporation, or organization must learn to control their facial expressions and other nonverbal communication so they can effectively convey the message of their employer or client without having their personal thoughts and feelings leak through. Poker players, therapists, police officers, doctors, teachers, and actors are also in professions that often require them to have more awareness of and control over their nonverbal communication.

Have you ever tried to conceal your surprise, suppress your anger, or act joyful even when you weren’t? Most people whose careers don’t involve conscious manipulation of nonverbal signals find it difficult to control or suppress them. While we can consciously decide to stop sending verbal messages, our nonverbal communication always has the potential of generating meaning for another person. The teenager who decides to shut out his dad and not communicate with him still sends a message with his “blank” stare (still a facial expression) and lack of movement (still a gesture). In this sense, nonverbal communication is “irrepressible” (Andersen, 1999).

Nonverbal Communication Is More Ambiguous

In Chapter 3 “Verbal Communication” , we learn that the symbolic and abstract nature of language can lead to misunderstandings, but nonverbal communication is even more ambiguous. As with verbal communication, most of our nonverbal signals can be linked to multiple meanings, but unlike words, many nonverbal signals do not have any one specific meaning. If you’ve ever had someone wink at you and didn’t know why, you’ve probably experienced this uncertainty. Did they wink to express their affection for you, their pleasure with something you just did, or because you share some inside knowledge or joke?

Just as we look at context clues in a sentence or paragraph to derive meaning from a particular word, we can look for context clues in various sources of information like the physical environment, other nonverbal signals, or verbal communication to make sense of a particular nonverbal cue. Unlike verbal communication, however, nonverbal communication doesn’t have explicit rules of grammar that bring structure, order, and agreed-on patterns of usage. Instead, we implicitly learn norms of nonverbal communication, which leads to greater variance. In general, we exhibit more idiosyncrasies in our usage of nonverbal communication than we do with verbal communication, which also increases the ambiguity of nonverbal communication.

Nonverbal Communication Is More Credible

Although we can rely on verbal communication to fill in the blanks sometimes left by nonverbal expressions, we often put more trust into what people do over what they say. This is especially true in times of stress or danger when our behaviors become more instinctual and we rely on older systems of thinking and acting that evolved before our ability to speak and write (Andersen, 1999). This innateness creates intuitive feelings about the genuineness of nonverbal communication, and this genuineness relates back to our earlier discussion about the sometimes involuntary and often subconscious nature of nonverbal communication. An example of the innateness of nonverbal signals can be found in children who have been blind since birth but still exhibit the same facial expressions as other children. In short, the involuntary or subconscious nature of nonverbal communication makes it less easy to fake, which makes it seem more honest and credible. We will learn more about the role that nonverbal communication plays in deception later in this chapter.

Functions of Nonverbal Communication

A primary function of nonverbal communication is to convey meaning by reinforcing, substituting for, or contradicting verbal communication. Nonverbal communication is also used to influence others and regulate conversational flow. Perhaps even more important are the ways in which nonverbal communication functions as a central part of relational communication and identity expression.

Nonverbal Communication Conveys Meaning

Nonverbal communication conveys meaning by reinforcing, substituting for, or contradicting verbal communication. As we’ve already learned, verbal and nonverbal communication are two parts of the same system that often work side by side, helping us generate meaning. In terms of reinforcing verbal communication, gestures can help describe a space or shape that another person is unfamiliar with in ways that words alone cannot. Gestures also reinforce basic meaning—for example, pointing to the door when you tell someone to leave. Facial expressions reinforce the emotional states we convey through verbal communication. For example, smiling while telling a funny story better conveys your emotions (Hargie, 2011). Vocal variation can help us emphasize a particular part of a message, which helps reinforce a word or sentence’s meaning. For example, saying “How was your weekend?” conveys a different meaning than “How was your weekend ?”

Nonverbal communication can substitute for verbal communication in a variety of ways. Nonverbal communication can convey much meaning when verbal communication isn’t effective because of language barriers. Language barriers are present when a person hasn’t yet learned to speak or loses the ability to speak. For example, babies who have not yet developed language skills make facial expressions, at a few months old, that are similar to those of adults and therefore can generate meaning (Oster, Hegley, & Nagel, 1992). People who have developed language skills but can’t use them because they have temporarily or permanently lost them or because they are using incompatible language codes, like in some cross-cultural encounters, can still communicate nonverbally. Although it’s always a good idea to learn some of the local language when you travel, gestures such as pointing or demonstrating the size or shape of something may suffice in basic interactions.

Nonverbal communication is also useful in a quiet situation where verbal communication would be disturbing; for example, you may use a gesture to signal to a friend that you’re ready to leave the library. Crowded or loud places can also impede verbal communication and lead people to rely more on nonverbal messages. Getting a server or bartender’s attention with a hand gesture is definitely more polite than yelling, “Hey you!” Finally, there are just times when we know it’s better not to say something aloud. If you want to point out a person’s unusual outfit or signal to a friend that you think his or her date is a loser, you’re probably more likely to do that nonverbally.

Last, nonverbal communication can convey meaning by contradicting verbal communication. As we learned earlier, we often perceive nonverbal communication to be more credible than verbal communication. This is especially true when we receive mixed messages , or messages in which verbal and nonverbal signals contradict each other. For example, a person may say, “You can’t do anything right!” in a mean tone but follow that up with a wink, which could indicate the person is teasing or joking. Mixed messages lead to uncertainty and confusion on the part of receivers, which leads us to look for more information to try to determine which message is more credible. If we are unable to resolve the discrepancy, we are likely to react negatively and potentially withdraw from the interaction (Hargie, 2011). Persistent mixed messages can lead to relational distress and hurt a person’s credibility in professional settings.

We send mixed messages when our verbal and nonverbal communication contradict each other. If this woman said she was excited about seeing you, would you believe her?

Helena Peixoto – bored – CC BY-NC 2.0.

Nonverbal Communication Influences Others

Nonverbal communication can be used to influence people in a variety of ways, but the most common way is through deception. Deception is typically thought of as the intentional act of altering information to influence another person, which means that it extends beyond lying to include concealing, omitting, or exaggerating information. While verbal communication is to blame for the content of the deception, nonverbal communication partners with the language through deceptive acts to be more convincing. Since most of us intuitively believe that nonverbal communication is more credible than verbal communication, we often intentionally try to control our nonverbal communication when we are engaging in deception. Likewise, we try to evaluate other people’s nonverbal communication to determine the veracity of their messages. Students initially seem surprised when we discuss the prevalence of deception, but their surprise diminishes once they realize that deception isn’t always malevolent, mean, or hurtful. Deception obviously has negative connotations, but people engage in deception for many reasons, including to excuse our own mistakes, to be polite to others, or to influence others’ behaviors or perceptions.

The fact that deception served an important evolutionary purpose helps explain its prevalence among humans today. Species that are capable of deception have a higher survival rate. Other animals engage in nonverbal deception that helps them attract mates, hide from predators, and trap prey (Andersen, 1999). To put it bluntly, the better at deception a creature is, the more likely it is to survive. So, over time, the humans that were better liars were the ones that got their genes passed on. But the fact that lying played a part in our survival as a species doesn’t give us a license to lie.

Aside from deception, we can use nonverbal communication to “take the edge off” a critical or unpleasant message in an attempt to influence the reaction of the other person. We can also use eye contact and proximity to get someone to move or leave an area. For example, hungry diners waiting to snag a first-come-first-serve table in a crowded restaurant send messages to the people who have already eaten and paid that it’s time to go. People on competition reality television shows like Survivor and Big Brother play what they’ve come to term a “social game.” The social aspects of the game involve the manipulation of verbal and nonverbal cues to send strategic messages about oneself in an attempt to influence others. Nonverbal cues such as length of conversational turn, volume, posture, touch, eye contact, and choices of clothing and accessories can become part of a player’s social game strategy. Although reality television isn’t a reflection of real life, people still engage in competition and strategically change their communication to influence others, making it important to be aware of how we nonverbally influence others and how they may try to influence us.

Nonverbal Communication Regulates Conversational Flow

Conversational interaction has been likened to a dance, where each person has to make moves and take turns without stepping on the other’s toes. Nonverbal communication helps us regulate our conversations so we don’t end up constantly interrupting each other or waiting in awkward silences between speaker turns. Pitch, which is a part of vocalics, helps us cue others into our conversational intentions. A rising pitch typically indicates a question and a falling pitch indicates the end of a thought or the end of a conversational turn. We can also use a falling pitch to indicate closure, which can be very useful at the end of a speech to signal to the audience that you are finished, which cues the applause and prevents an awkward silence that the speaker ends up filling with “That’s it” or “Thank you.” We also signal our turn is coming to an end by stopping hand gestures and shifting our eye contact to the person who we think will speak next (Hargie, 2011). Conversely, we can “hold the floor” with nonverbal signals even when we’re not exactly sure what we’re going to say next. Repeating a hand gesture or using one or more verbal fillers can extend our turn even though we are not verbally communicating at the moment.

Nonverbal Communication Affects Relationships

To successfully relate to other people, we must possess some skill at encoding and decoding nonverbal communication. The nonverbal messages we send and receive influence our relationships in positive and negative ways and can work to bring people together or push them apart. Nonverbal communication in the form of tie signs, immediacy behaviors, and expressions of emotion are just three of many examples that illustrate how nonverbal communication affects our relationships.

Tie signs are nonverbal cues that communicate intimacy and signal the connection between two people. These relational indicators can be objects such as wedding rings or tattoos that are symbolic of another person or the relationship, actions such as sharing the same drinking glass, or touch behaviors such as hand-holding (Afifi & Johnson, 2005). Touch behaviors are the most frequently studied tie signs and can communicate much about a relationship based on the area being touched, the length of time, and the intensity of the touch. Kisses and hugs, for example, are considered tie signs, but a kiss on the cheek is different from a kiss on the mouth and a full embrace is different from a half embrace. If you consider yourself a “people watcher,” take note of the various tie signs you see people use and what they might say about the relationship.

Immediacy behaviors play a central role in bringing people together and have been identified by some scholars as the most important function of nonverbal communication (Andersen & Andersen, 2005). Immediacy behaviors are verbal and nonverbal behaviors that lessen real or perceived physical and psychological distance between communicators and include things like smiling, nodding, making eye contact, and occasionally engaging in social, polite, or professional touch (Comadena, Hunt, & Simonds, 2007). Immediacy behaviors are a good way of creating rapport, or a friendly and positive connection between people. Skilled nonverbal communicators are more likely to be able to create rapport with others due to attention-getting expressiveness, warm initial greetings, and an ability to get “in tune” with others, which conveys empathy (Riggio, 1992). These skills are important to help initiate and maintain relationships.

While verbal communication is our primary tool for solving problems and providing detailed instructions, nonverbal communication is our primary tool for communicating emotions. This makes sense when we remember that nonverbal communication emerged before verbal communication and was the channel through which we expressed anger, fear, and love for thousands of years of human history (Andersen, 1999). Touch and facial expressions are two primary ways we express emotions nonverbally. Love is a primary emotion that we express nonverbally and that forms the basis of our close relationships. Although no single facial expression for love has been identified, it is expressed through prolonged eye contact, close interpersonal distances, increased touch, and increased time spent together, among other things. Given many people’s limited emotional vocabulary, nonverbal expressions of emotion are central to our relationships.

“Getting Real”

Teachers and Immediacy Behaviors

A considerable amount of research has been done on teachers’ use of immediacy behaviors, which points to the importance of this communication concept in teaching professions (Richmond, Lane, & McCroskey, 2006). Immediacy behaviors are verbal and nonverbal behaviors that lessen real or perceived physical and psychological distance between communicators (Comadena, Hunt, & Simonds, 2007). Specific nonverbal behaviors have been found to increase or decrease perceived levels of immediacy, and such behaviors impact student learning, teacher’s evaluations, and the teacher-student relationship (Richmond, Lane, & McCroskey, 2006). Even those who do not plan on going into teaching as a career can benefit from learning about immediacy behaviors, as they can also be used productively in other interpersonal contexts such as between a manager and employee, a salesperson and a client, or a politician and constituent. Much of this research in teaching contexts has focused on the relationship between immediacy behaviors and student learning, and research consistently shows that effective use of immediacy behaviors increases learning in various contexts and at various levels. Aside from enhancing student learning, the effective use of immediacy behaviors also leads to better evaluations by students, which can have a direct impact on a teacher’s career. While student evaluations of teachers take various factors into consideration, judgments of personality may be formed, as we learned in Chapter 2 “Communication and Perception” , after only brief initial impressions. Research shows that students make character assumptions about teachers after only brief exposure to their nonverbal behaviors. Based on nonverbal cues such as frowning, head nodding, pointing, sitting, smiling, standing, strong gestures, weak gestures, and walking, students may or may not evaluate a teacher as open, attentive, confident, dominant, honest, likable, anxious, professional, supportive, or enthusiastic. The following are examples of immediacy behaviors that can be effectively used by teachers:

• Moving around the classroom during class activities, lectures, and discussions (reduces physical distance)
• Keeping the line of sight open between the teacher’s body and the students by avoiding or only briefly standing behind lecterns / computer tables or sitting behind a desk while directly interacting with students (reduces physical distance)
• Being expressive and animated with facial expressions, gestures, and voice (demonstrates enthusiasm)
• Smiling (creates a positive and open climate)
• Making frequent eye contact with students (communicates attentiveness and interest)
• Calling students by name (reduces perceived psychological distance)
• Making appropriate self-disclosures to students about personal thoughts, feelings, or experiences (reduces perceived psychological distance, creates open climate)

Teachers who are judged as less immediate are more likely to sit, touch their heads, shake instead of nod their heads, use sarcasm, avoid eye contact, and use less expressive nonverbal behaviors. Finally, immediacy behaviors affect the teacher-student relationship. Immediacy behaviors help establish rapport, which is a personal connection that increases students’ investment in the class and material, increases motivation, increases communication between teacher and student, increases liking, creates a sense of mutual respect, reduces challenging behavior by students, and reduces anxiety.

• Recall a teacher you have had that exhibited effective immediacy behaviors. Recall a teacher you have had that didn’t exhibit immediacy behaviors. Make a column for each teacher and note examples of specific behaviors of each. Discuss your list with a classmate and compare and contrast your lists.
• Think about the teachers that you listed in the previous question. Discuss how their behaviors affected your learning and your relationship.
• How much should immediacy behaviors, relative to other characteristics such as professionalism, experience, training, and content knowledge, factor into the evaluation of teachers by their students, peers, and supervisors? What, if anything, should schools do to enhance teachers’ knowledge of immediacy behaviors?

Nonverbal Communication Expresses Our Identities

Nonverbal communication expresses who we are. Our identities (the groups to which we belong, our cultures, our hobbies and interests, etc.) are conveyed nonverbally through the way we set up our living and working spaces, the clothes we wear, the way we carry ourselves, and the accents and tones of our voices. Our physical bodies give others impressions about who we are, and some of these features are more under our control than others. Height, for example, has been shown to influence how people are treated and perceived in various contexts. Our level of attractiveness also influences our identities and how people perceive us. Although we can temporarily alter our height or looks—for example, with different shoes or different color contact lenses—we can only permanently alter these features using more invasive and costly measures such as cosmetic surgery. We have more control over some other aspects of nonverbal communication in terms of how we communicate our identities. For example, the way we carry and present ourselves through posture, eye contact, and tone of voice can be altered to present ourselves as warm or distant depending on the context.

Aside from our physical body, artifacts , which are the objects and possessions that surround us, also communicate our identities. Examples of artifacts include our clothes, jewelry, and space decorations. In all the previous examples, implicit norms or explicit rules can affect how we nonverbally present ourselves. For example, in a particular workplace it may be a norm (implicit) for people in management positions to dress casually, or it may be a rule (explicit) that different levels of employees wear different uniforms or follow particular dress codes. We can also use nonverbal communication to express identity characteristics that do not match up with who we actually think we are. Through changes to nonverbal signals, a capable person can try to appear helpless, a guilty person can try to appear innocent, or an uninformed person can try to appear credible.

Key Takeaways

• Nonverbal communication is a process of generating meaning using behavior other than words. Nonverbal communication includes vocal elements, which is referred to as paralanguage and includes pitch, volume, and rate, and nonvocal elements, which are usually referred to as body language and includes gestures, facial expressions, and eye contact, among other things.
• Although verbal communication and nonverbal communication work side by side as part of a larger language system, there are some important differences between the two. They are processed by different hemispheres of the brain, nonverbal communication conveys more emotional and affective meaning than does verbal communication, nonverbal communication isn’t governed by an explicit system of rules in the same way that grammar guides verbal communication, and while verbal communication is a uniquely human ability, many creatures including plants, birds, and mammals communicate nonverbally.
• Nonverbal communication operates on the following principles: nonverbal communication typically conveys more meaning than verbal communication, nonverbal communication is more involuntary than verbal communication, nonverbal communication is often more ambiguous than verbal communication, and nonverbal communication is often more credible than verbal communication.
• Nonverbal communication serves several functions.
• Nonverbal communication affects verbal communication in that it can complement, reinforce, substitute, or contradict verbal messages.
• Nonverbal communication influences others, as it is a key component of deception and can be used to assert dominance or to engage in compliance gaining.
• Nonverbal communication regulates conversational flow, as it provides important cues that signal the beginning and end of conversational turns and facilitates the beginning and end of an interaction.
• Nonverbal communication affects relationships, as it is a primary means through which we communicate emotions, establish social bonds, and engage in relational maintenance.
• Nonverbal communication expresses our identities, as who we are is conveyed through the way we set up our living and working spaces, the clothes we wear, our personal presentation, and the tones in our voices.
• Getting integrated: To better understand nonverbal communication, try to think of an example to illustrate each of the four principles discussed in the chapter. Be integrative in your approach by including at least one example from an academic, professional, civic, and personal context.
• When someone sends you a mixed message in which the verbal and nonverbal messages contradict each other, which one do you place more meaning on? Why?
• Our personal presentation, style of dress, and surroundings such as a dorm room, apartment, car, or office send nonverbal messages about our identities. Analyze some of the nonverbal signals that your personal presentation or environment send. What do they say about who you are? Do they create the impression that you desire?

Afifi, W. A. and Michelle L. Johnson, “The Nature and Function of Tie-Signs,” in The Sourcebook of Nonverbal Measures: Going beyond Words , ed. Valerie Manusov (Mahwah, NJ: Lawrence Erlbaum, 2005): 190.

Andersen, P. A., Nonverbal Communication: Forms and Functions (Mountain View, CA: Mayfield, 1999), 17.

Andersen, P. A. and Janis F. Andersen, “Measures of Perceived Nonverbal Immediacy,” in The Sourcebook of Nonverbal Measures: Going beyond Words , ed. Valerie Manusov (Mahwah, NJ: Lawrence Erlbaum, 2005): 113–26.

Comadena, M. E., Stephen K. Hunt, and Cheri J. Simonds, “The Effects of Teacher Clarity, Nonverbal Immediacy, and Caring on Student Motivation, Affective and Cognitive Learning,” Communication Research Reports 24, no. 3 (2007): 241.

Hargie, O., Skilled Interpersonal Interaction: Research, Theory, and Practice , 5th ed. (London: Routledge, 2011), 47.

Guerrero, L. K. and Kory Floyd, Nonverbal Communication in Close Relationships (Mahwah, NJ: Lawrence Erlbaum, 2006): 2.

Oster, H., Douglas Hegley, and Linda Nagel, “Adult Judgments and Fine-Grained Analysis of Infant Facial Expressions: Testing the Validity of A Priori Coding Formulas,” Developmental Psychology 28, no. 6 (1992): 1115–31.

Richmond, V. P., Derek R. Lane, and James C. McCroskey, “Teacher Immediacy and the Teacher-Student Relationship,” in Handbook of Instructional Communication: Rhetorical and Relational Perspectives , eds. Timothy P. Mottet, Virginia P. Richmond, and James C. McCroskey (Boston, MA: Pearson, 2006), 168.

Riggio, R. E., “Social Interaction Skills and Nonverbal Behavior,” in Applications of Nonverbal Behavior Theories and Research , ed. Robert S. Feldman (Hillsdale, NJ: Lawrence Erlbaum, 1992), 12.

Communication in the Real World Copyright © 2016 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Nonverbal Communication Skills: 19 Theories & Findings

In it, he introduces the concept of dramaturgy, which compares everyday social interactions to actors’ portrayals of characters, suggesting that one’s social interactions are analogous to a string of varying performances (Ritzer, 2021).

Goffman’s work also included the concept of impression management. The key to impression management includes appearance; your manner of interacting; and the attitudes conveyed through gestures, facial expressions, and nonverbal skills (Ritzer, 2021).

William Shakespeare said, “All the world’s a stage.”

I’m not a trained actor, but teaching public speaking courses has made me aware that audiences seem to prefer speakers who use a variety of hand gestures. These gestures signify the speaker as “warm, agreeable, and energetic” (Goman, 2021).

Just that nugget of information has taught me to incorporate hand gestures to develop my public speaking skills.

What other nonverbal communication skills enhance daily interactions?

Before you continue, we thought you might like to download our three Positive Communication Exercises (PDF) for free . These science-based tools will help you and those you work with build better social skills and better connect with others.

This Article Contains:

What is nonverbal communication, 9 types of nonverbal communication skills, is nonverbal communication important, 2 psychology theories and models, 8 fascinating research findings, importance in counseling and healthcare, resources from positivepsychology.com, a take-home message.

Nonverbal communication is a way to convey information “achieved through facial expressions, gestures, touching (haptics), physical movements (kinesics), posture, body adornment (clothes, jewelry, hairstyle, tattoos, etc.), and even the tone, timbre, and volume of an individual’s voice (rather than spoken content)” (Navarro & Karlins, 2008, p. 2–4).

In this YouTube video, Joe Navarro explains several nonverbal communication cues, exposes some myths, and discusses his work with nonverbal communication in law enforcement.

Marco Iacoboni (2008, p. 81), author of Mirroring People , takes it a step further, stating that “gestures accompanying speech have a dual role of helping the speakers to express their thoughts and helping the listeners/viewers understand what is being said.”

To competently read body language, Navarro and Karlins (2008) provide suggestions such as rigorous observation and a familiarity with the person’s baseline behaviors. They also recommend watching for changes, or ‘tells.’

Navarro and Karlins (2008) advise becoming familiar with universal behaviors and contextualizing nonverbal cues. However, cultural norms could inhibit rigorous observation.

Characteristics of nonverbal communication

The United States is considered a low-context communication culture (MacLachlan, 2010). This means that much of the information in a message comes directly from words rather than through implication or body language.

This style of communication involves lots of verbal detail so as not to confuse listeners. Low-context cultures rely less on nonverbal communication, which can obscure or censor portions of the message.

Nonverbal communication is culturally determined, and it is largely unconscious. It indicates the speaker’s emotional state. When nonverbal cues conflict with the verbal message, it may convey confusion or deception (Navarro & Karlins, 2008).

Finally, nonverbal communication varies by gender and displays power differentials, information effective leaders can use to influence others (Hybels & Weaver, 2015; Henley, 1977).

Nonverbal communication of successful leaders

It’s essential for leaders to read body language, also known as decoding. Deciphering between engagement (e.g., nodding, tilting the head, open body postures) and disengagement (e.g., body tilting away, crossed arms and legs) can be the difference between success and failure (Goman, 2021).

Successful actors could be considered professional first-impression artists. Like actors, leaders often find themselves center stage; they must learn the art of creating first impressions.

Subjective awareness and the ability to express yourself nonverbally are known as encoding – crucial for positive first impressions. Advice from professional actors includes a maintaining a pleasant facial expression, good posture, pausing, breathing, relaxing, and avoiding hiding your hands (Shellenbarger, 2018).

This video , 8 Things Successful People Do to Look Confident , provides quick tips for confident body language even if you’re not feeling confident.

First impressions are said to be formed in less than seven seconds (Goman, 2021). In this short time, others formulate labels such as “powerful,” “submissive,” or “trustworthy.” Evolved leaders incorporate mindfulness to help.

Naz Beheshti (2018) states, “Evolved leaders… use nonverbal tools mindfully and deliberately to reinforce their message.” She goes on to say, “this lifts the value of your communication and your value as a leader” (Beheshti, 2018).

Awareness of self, others, and the situation (mindfulness) allows us to ensure that our gestures and body language align with our spoken words. This creates congruence and generates trustworthiness (Beheshti, 2018; Newberg & Waldman, 2013).

This means we are analyzing several, simultaneous nonverbal cues. A frustrated person may tap their foot, cross their arms, and tightly squeeze their biceps (Jones, 2013). These clusters may cross over and include a variety of nonverbal categories, summarized below.

1. Kinesics

Kinesics is the study of how we move our body, specifically the head, hands, body, and arms (Jones, 2013). This includes sending messages through facial expressions, gestures, eye contact, and posture.

Haptics is the study of touch or coming into physical contact with another person (Hybels & Weaver, 2015). Throughout history, touch has been surrounded by mystery and taboo. We are perplexed by healing touch and riveted by stories of infants who perished due to lack of touch. Touch can denote relationship, status, power, and personality (Henley, 1977).

Cultural norms dictate guidelines regarding touch. Mindfulness regarding social and environmental settings is prudent. We greet a friend at an informal party differently than we would greet a boss or coworker in a professional setting.

3. Proxemics

The study of space and distance is called proxemics, and it analyzes how people use the space around them (Hybels & Weaver, 2015).

This YouTube video is a fun demonstration of students completing a school project on personal space and the discomfort felt by both humans and animals when social norms are violated.

4. Territory

Territory is often used to display power or reveal a lack thereof.

“'[P]osture expansiveness,’ positioning oneself in a way that opens up the body and takes up space, activated a sense of power that produced behavioral changes in a subject independent of their actual rank or role in an organization” (Goman, 2021).

Expansiveness conveys power.

5. Environment

Environment includes objects we use to adorn ourselves and the artifacts we surround ourselves with in order to create an impression. These objects provide nonverbal cues that help others form impressions (Jones, 2013).

6. Paralinguistics

Paralinguistics, also known as vocalics, is the study of how we speak and involves pitch, volume, rate of speech, tone, quality, tempo, resonance, rhythm, and articulation to help determine the context of the message (Jones, 2013).

7. Chronemics

Chronemics is the study of time, including how it is used. Nancy Henley (1977, p. 43), author of Body Politics: Power, Sex & Nonverbal Communication , asserts “Time is far from a neutral philosophical/physical concept in our society: it is a political weapon.”

Henley (1977, p. 47) describes the concept of “ritual waiting,” stating, “The more important the person, the longer we will ungrudgingly wait for the service or honor of attention.”

8. Attractiveness

The power of drawing attention to oneself doesn’t rely on physical appeal alone. Although facial symmetry and fashion of adornment are important (Jones, 2013), people who master good eye contact, have a lively face, offer encouragement, and use open gestures are also considered attractive (Kuhnke, 2012).

9. Olfactics

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Nonverbal communication is very important, as you could reveal unintentional information, as well as cause your communication to be misinterpreted.

Leakage: Unintentional messages

Teaching social–emotional skills to incarcerated people provided me with a powerful lesson about the nuances of nonverbal communication. On a particularly challenging day, I thought it wise to meditate and center myself prior to entering the jail. However, upon seeing me, the people inside began inquiring what was going on with me. What did they detect?

Nonverbal leakage can be shown through micro-expressions, which are “very fast facial movements lasting 1/25 to 1/5 of a second” and indicate a person’s real feelings (Ekman, 2003, p. 214).

This YouTube video is the opening scene of the series Lie to Me , based on the work of Paul Ekman regarding micro-expressions.

Varying statistics on the value of nonverbal communication may cause concern for those less practiced, but which statistics are accurate?

Crossed messages

The original research from Mehrabian and Ferris (1967) regarding nonverbal communication is widely interpreted. Elizabeth Kuhnke (2012, p. 10), author of Body Language for Dummies , interprets the study, saying, “55% of the emotional message in face-to-face communication results from body language.”

A nonverbal communication formula often cited is 7–38–55, which indicates 7% of the message comes from words, 38% vocal, and 55% facial. However, Lapakko (2007) believes this formula is reckless, faulty, and misleading. Sometimes the nonverbal elements of a message, such as gestures with directions, are incredibly important, and at other times incidental.

In addition, what something “means” in communication is connected to such variables as culture, history of the relationship, people’s intentions, personal experiences, time of day and specific words used. It would be naive to suggest all these nuances could be neatly quantified, and therefore attributing a precise formula to nonverbal communication is flawed in many ways.

So regardless of statistics and formulas, we know that nonverbal communication is essential and that people skilled at both reading and interpreting body language tend to enjoy greater success in life than those not skilled (Goleman, 1997).

Basic emotion theory

Basic emotion theory (BET) posits that emotions are a “grammar of social living” that situate us in the social and moral order of society (Keltner, Sauter, Tracy, & Cowen, 2019, p. 133). In addition, emotions structure interactions, particularly in relationships that matter. BET is integral to emotional expression.

Foundational to BET is the assumption that emotional expressions coordinate social interactions in three ways:

• Through rapid conveyance of important information to aid in decision making
• To evoke specific responses
• To serve as incentives for others’ actions

This is accomplished through reward systems such as parents smiling and caressing a child who exhibits specific behaviors (Keltner et al., 2019).

BET initially focused on six basic emotions. Literature reveals there are over 20 emotions with distinct, multimodal expressions, providing a deeper structure and highlighting the advancing nature of emotional expression (Keltner et al., 2019).

Neural resonance

Two people who like each other will mirror each other’s facial expressions, gestures, postures, vocalics, and movements. This is known as neural resonance, and it aids the accurate transfer of information from one person to another (Newberg & Waldman, 2013).

To fully understand what another is saying, “you have to listen to and observe the other person as deeply and fully as possible” (Newberg & Waldman, 2013, p. 81). Neural resonance uses mirror neurons to create cooperation, empathy, and trust.

Studying nonverbal communication is revealing and intriguing. Most experts will include aspects such as eyes, facial expressions, and hands, but digging deeper reveals less-acknowledged nonverbal nuggets.

1. The benefits of yawning

Yawning is one of the fastest and simplest ways to lower mental stress and anxiety (Waldman & Manning, 2017). Social norms dictate that we refrain from yawning in specific settings, but yawning has many benefits. Did you know that snipers are taught to yawn before pulling the trigger (Waldman & Manning, 2017)?

According to Waldman and Manning (2017), yawning stimulates alertness and concentration; optimizes brain activity and metabolism; improves cognitive functioning; increases recall, consciousness, and introspection; decreases stress and relaxes the upper body; recalibrates a sense of timing; enhances social awareness and empathy; and increases sensuality and pleasure.

2. Feet don’t lie

According to Navarro and Karlins (2008), the most honest part of our body is our feet, as demonstrated by small children who dance with happiness or stomp in frustration. Many people look to the face for truth; Navarro and Karlins take the opposite approach:

“When it comes to honesty, truthfulness decreases as we move from the feet to the head” (Navarro & Karlins, 2008, p. 56), reasoning that emotions are suppressed through fabricated facial expression.

3. Gestures that help

Gestures improve memory and comprehension skills. Gestures may convey information that can influence how listeners respond, depending on the hand being used. “We tend to express positive ideas with our dominant hand and negative ideas with the other hand” (Newberg & Waldman, 2013, p. 44).

4. The eyes have it

“Social network circuits are stimulated through face-to-face eye contact, decreasing cortisol, and increasing oxytocin. The result is increased empathy, social cooperation, and positive communication” (Newberg & Waldman, 2013, p. 135).

Eyes reveal a lot about us. When we are aroused, troubled, concerned, or nervous, our blink rate increases. Once we relax, our blink rate returns to normal (Navarro & Karlins, 2008).

5. Power posing for success

Body language affects how others see us and how we view ourselves. In this YouTube video, Amy Cuddy discusses her research on power posing and how it affects success.

Amy Cuddy’s book is also discussed in our article listing books on imposter syndrome .

6. Fingers crossed

One explanation of the origin of crossing fingers for good luck comes from early beliefs in the power of the cross. The intersection of the digits, epitomizing the cross, was thought to denote a concentration of good spirits and served to anchor a wish until it came true (Keyser, 2014).

7. Fake positivity is harmful

Positivity that doesn’t register in your body or heart can be harmful. According to Barbara Fredrickson (2009, p. 180), “fake smiles, just like sneers of anger, predict heart wall collapse.” To truly benefit from a smile, touch, or embrace, you need to slow down and make it heartfelt.

8. Stand up straight

Poor posture can reduce oxygen intake by 30%, resulting in less energy (Gordon, 2003). Stooping over can make us look and feel old and out of touch. By straightening up, we can make significant differences in how we think and feel. The effect is bi-directional; attitude influences posture, just as posture influences attitude.

Good rapport between clients and practitioners stems from mirroring and synchronicity associated with neural resonance (Finset & Piccolo, 2011; Newberg & Waldman, 2013).

Carl Rogers’s Client-Centered Therapy is based on an empathetic understanding of clients. Nonverbal communication provides valuable information for both the client and the therapist. Showing you like and accept a client may be the most important information a therapist can convey (Finset & Piccolo, 2011).

Nonverbal patterns in therapy evolve over time. Specific behaviors that further the therapeutic process include “a moderate amount of head nodding and smiling; frequent, but not staring, eye contact; active, but not extreme, facial responsiveness; and a warm, relaxed, interested vocal tone” (Finset & Piccolo, 2011, p. 122).

Conscious awareness of nonverbal cues can aid in rapport building. Leaning toward the other signals comfort, whereas leaning away or crossing your arms signals discomfort (Navarro & Karlins, 2008).

Torsos and shoulder blades seem innocuous; however, blading away (turning slightly) from another person shows discomfort, while blading toward or facing another squarely shows a level of comfort (Navarro & Karlins, 2008).

Open palms are an ancient sign of trustworthiness that help establish rapport and are considered nonthreatening (Kuhnke, 2012). Hidden hands (placed in pockets or behind backs) signal disconnection and reluctance to engage. To display respect, keep an open posture with your muscles relaxed and weight evenly distributed.

Mirroring and matching go a long way to show synchronicity. Be careful to avoid mimicry, which signals disrespect (Kuhnke, 2012). Too much of a good thing can jeopardize credibility. An extended, fixed gaze into another’s eyes or effortful smiling can seem awkward, or worse.

This short YouTube video explains the dynamics of fluctuating facial expressions, based on the work of Charles Darwin and Paul Ekman.

This Silent Connections worksheet is an exercise for groups that combines mindfulness and nonverbal communication to build connections.

Someone who lacks the ability to make eye contact during conversation can be easily misinterpreted. To overcome this nonverbal communication issue, our Strategies for Maintaining Eye Contact can be very useful.

Our blog post 49 Communication Activities, Exercises, and Games includes six nonverbal communication activities for adults and three nonverbal exercises that work for families and children.

The blog post What Is Assertive Communication? 10 Real-Life Examples includes nonverbal qualities that complement and enhance assertive statements. Hints for eye contact, facial expressions, and posture can be found throughout.

In the blog post Cultivating Social Intelligence : 3 Ways to Understand Others , we discuss characteristics of social intelligence, including body language.

If you’re looking for more science-based ways to help others communicate better, this collection contains 17 validated positive communication tools for practitioners. Use them to help others improve their communication skills and form deeper and more positive relationships.

17 Exercises To Develop Positive Communication

17 Positive Communication Exercises [PDF] to develop help others develop communication skills for successful social interactions and positive, fulfilling relationships.

Created by Experts. 100% Science-based.

Nonverbal communication is an essential communication skill. Nonverbal expertise aids in delivering clear messages and forming positive impressions. It doesn’t have to be a big gesture to make a difference. Gently stroking the hand of a grieving friend speaks volumes.

Viewing life as a series of dramatic performances, as implied by both Shakespeare and Goffman, can add a sense of intrigue and adventure to enhancing nonverbal communication. These essential skills will help us achieve goals.

Just as the highly motivated thespian will study and polish their craft, anyone wanting to succeed in their career or interpersonal relationships can study and practice the nuances of nonverbal communication.

Actors and public speakers often practice their craft in front of a mirror or videotape themselves to reflect on strengths and weaknesses.

This article includes a myriad of resources to help improve nonverbal communication skills with many additional resources available.

By starting with something as simple as posture, we exit stage right, headed toward the competency of center stage. Break a leg!

We hope you enjoyed reading this article. Don’t forget to download our three Positive Communication Exercises (PDF) for free .

• Beheshti, N. (2018, September 20). The power of mindful nonverbal communication. Forbes . Retrieved April 26, 2021, from https://www.forbes.com/sites/nazbeheshti/2018/09/20/beyond-language-the-power-of-mindful-nonverbal-communication/?sh=6f40b3d71501
• Ekman, P. (2003). Emotions revealed: Recognizing faces and feelings to improve communication and emotional life . Holt Paperbacks.
• Finset, A., & Piccolo, L. D. (2011). Nonverbal communication in clinical contexts. In M. Rimondini (Ed.), Communication in cognitive-behavioral therapy (pp. 107–128).  Springer Science + Business Media.
• Fredrickson, B. L. (2009). Positivity . Crown Publishing Group.
• Goffman, E. (1956). The presentation of self in everyday life . University of Edinburgh.
• Goleman, D. (1997). Emotional intelligence . Bantam Trade Paperback.
• Goman, C. K. (2018, August 26). 5 Ways body language impacts leadership results. Forbes. Retrieved May 1, 2021, from https://www.forbes.com/sites/carolkinseygoman/2018/08/26/5-ways-body-language-impacts-leadership-results/?sh=5c1b235c536a
• Gordon, J. (2003). Energy addict: 101 Physical, mental, & spiritual ways to energize your life . Berkley Publishing Group.
• Henley, N. M. (1977). Body politics: Power, sex and nonverbal communication . Simon & Schuster.
• Hybels, S., & Weaver, R. L. (2015). Communicating effectively . McGraw-Hill Education.
• Iacoboni, M. (2008). Mirroring people: The new science of how we connect with others . Farrar, Straus and Giroux.
• Jones, R. (2013). Communication in the real world: An introduction to communication studies . University of Minnesota Libraries.
• Keltner, D., Sauter, D., Tracy, J., & Cowen, A. (2019). Emotional expression: Advances in basic emotion theory. Journal of Nonverbal Behavior , 43 (3), 133–160.
• Keyser, H. (2014, March 21). Why do we cross our fingers for good luck? Mental Floss . Retrieved May 27, 2021, from https://www.mentalfloss.com/article/55702/why-do-we-cross-our-fingers-good-luck
• Kuhnke, E. (2012). Body language for dummies . John Wiley & Sons.
• Lapakko, D. (2007). Communication is 93% nonverbal: An urban legend proliferates. Communication and Theater Association of Minnesota Journal , 34 (2), 7–19.
• MacLachlan, M. (2010, February 12). Cross-cultural communication styles: High and low context. Communicaid. Retrieved May 10, 2021, from https://www.communicaid.com/cross-cultural-training/blog/high-and-low-context/
• Mehrabian, A., & Ferris, S. R. (1967). Inference of attitudes from nonverbal communication in two channels.  Journal of Consulting Psychology, 31 (3), 248–252.
• Navarro, J., & Karlins, M. P. (2008). What every body is saying . Harper-Collins.
• Newberg, A. M., & Waldman, M. R. (2013). Words can change your brain . Avery.
• Ritzer, G. (2021). Essentials of sociology (4th ed.). SAGE.
• Shellenbarger, S. (2018, January 30). The mistakes you make in a meeting’s first milliseconds. Wall Street Journal . Retrieved May 22, 2021, from https://www.wsj.com/articles/the-mistakes-you-make-in-a-meetings-first-milliseconds-1517322312
• Waldman, M. R., & Manning, C. P. (2017). NeuroWisdom: The new brain science of money, happiness, and success . Diversion Books.

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This case distills the practical implications of current research on nonverbal communication. The first section sketches different kinds of nonverbal behavior: facial expressions, eye movements, physical gestures, paraverbal cues, posture, and "personal space." The next section looks more deeply at the interactive nature of nonverbal communication--specifically, how one person's behavior both influences and reflects what others do. The final section suggests how negotiators can make better use of nonverbal communication. Five themes run throughout the case: 1) we communicate far more information to other people than is conveyed by our words alone, 2) our nonverbal signals sometimes contradict the words we use, 3) much of this communication is less than fully conscious, 4) reading nonverbal communication is an art, not a science, and 5) nonverbal communication must be understood in the context of the broader set of interactions among all parties.

This case is accompanied by a Video Short that can be shown in class or included in a digital coursepack (available only to registered educators). Instructors should consider the timing of making the video available to students, as it may reveal key case details.

Learning Objectives

To learn about current research on nonverbal communication, particularly its practical application to negotiation, communication, and leadership. Provides a conceptual framework for students to assess their own performance in exercises and simulations and to help them develop keener insight into the behavior of others.

Feb 11, 2003 (Revised: Sep 14, 2009)

Discipline:

Negotiation

Harvard Business School

903081-PDF-ENG

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Case Study on NonVerbal Communication

Non-verbal communication case study:.

Nonverbal communication is usually understood as the process of communication through sending and receiving wordless (mostly visual) cues between people.

Messages can be communicated through gestures and touch, by body language or posture, by facial expression and eye contact, which are all considered types of nonverbal communication. Speech contains nonverbal elements known as paralanguage, including voice quality, rate, pitch, volume, and speaking style, as well prosodic features such as rhythm, intonation, and stress. Non-verbal communication is very important when one wants to produce positive first impression. When one appears in the new place with a new circle of people, his clothes, posture, expression, gestures, will say much about his character and occupation. Non verbal communication across cultures is very different, so when you travel abroad to a certain exotic country, always remember that your gestures may be treated there in different way.

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In order not to be understood wrongly one should avoid intensive usage of gestures or read about the traditions and customs, prejudices of the country you are travelling to.Much have be researched and written about nonverbal communication, but still many moments stay undiscovered. Students who study psychology, tourism are sure to prepare case studies on non verbal communication, because they have to be aware of such things, if they want to become professionals in their field. A well-organized case study on non verbal communication should be informative, interesting and contain reliable information on the topic. The case should be researched scrupulously and one should present the peculiarities of the non verbal communication in the case site and analyze the cause and effect of the problem, which occurred after it.

Case study writing is a big problem for inexperienced students who are not aware of professional paper writing. in order to complete a good case study and analyze the problem of the case, one should research the site carefully and in detail. It is possible to read various periodicals or encyclopedias dedicated to the topic and collect data from that sources. Moreover, one should read free example case studies on non verbal communication peculiarities in the Internet.One can find a lot of models for writing in the web and improve his knowledge in paper writing.

Every free sample case study on non verbal communication in different countries is useful for every student to understand the manner of writing, formatting and composition of the paper. On the other hand one should be careful choosing an example, because some of them are prepared by the poorly-trained amateur writers. It is obvious that help of this kind will only make harm to you. So, select only high-quality samples for help, if you want to complete an original informative case study on your own.

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A Model for Effective Nonverbal Communication between Nurses and Older Patients: A Grounded Theory Inquiry

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Nonverbal communication is an inevitable art to be effectively mastered by nurses. Nurse nonverbal communication has many benefits when it is effective. For instance, nonverbal communication is important to convey affective and emotional information, and demonstrate respect for and build therapeutic relationships with older patients. As the older population is growing fast worldwide, effective nonverbal communication with older patients is an essential skill for nurses and will improve patients’ satisfaction and the quality of care. Therefore, this article presents a model to guide effective nonverbal communication between nurses and older patients. A Grounded Theory approach guided the study. Data were collected between July 2018 and January 2020 through overt participant observations and individual interviews. Purposive and theoretical sampling were used to select 13 clinically experienced nurses, 4 nursing students, and 8 older adults. Data analysis encompassed open coding, axial coding, and selective coding. The results showed that effective nonverbal communication emerged as the co-phenomenon hinged within context and/or environment and is influenced by certain factors. This model, which is in support of person-centered communication and care, advocates for effective nonverbal communication between nurses and older patients.

1. Introduction

Worldwide, older adults account for 1.05 billion people, with 74.4 million in African countries with the expectation to reach 235.1 million by 2050 [ 1 ]. In sub-Saharan Africa, the burden of geriatric diseases is growing, with more older adults requiring geriatric healthcare services and frequent hospitalization with longer stays [ 2 , 3 ]. This is especially the case in sub-Saharan Africa where there are few long-term care settings [ 4 ]. With hearing deficits, changes in attention and coding of information, and restrictions in interaction, participation, and effective verbal communication [ 5 ], nurses’ effective communication with older adults emerges as an essential skill in geriatric care [ 6 ].

Communication, which is important to understand older adults’ needs and support their health and well-being [ 7 ], is defined as the process of sending and receiving messages to share knowledge, attitudes, and skills [ 8 ]. It includes both verbal and nonverbal components, since it is not just the mere transmission of information [ 9 ]. While verbal communication denotes the transmission of messages through spoken words [ 8 ], nonverbal communication describes the reaction of the face, body, or voice, including what is expressed between each other [ 10 , 11 ]. Nonverbal communication is important to convey affective and emotional information, demonstrate respect for patients, and build therapeutic relationships with patients [ 12 , 13 ]. This makes nonverbal communication unique and more important for effective communication between nurses and older patients. When nurses enhance their communication skills, it improves patients’ satisfaction as well as the quality of care [ 14 , 15 ].

Communication, as one of the important aspects of caring for patients that affects all other aspects of care, should be given special attention [ 16 ]. To date, there are few nonverbal communication models identified to help nurses to communicate effectively with patients let alone older adults. The first model is SOLER (Square, Open, Lean, Eye contact, Relax) developed in 1975 by Eagan to describe effective body language employed to make others feel listened to. It only includes proxemics (use of space) and kinesics (movements of the body), and mostly focuses on interactions during a consultation, not during hospitalization [ 17 ]. The second model is SURETY (Sit at an angle, Uncross legs and arms, Relax, Eye contact, Touch, Your intuition), which criticizes and advances the SOLER model by including the use of touch, emphasizing the importance of individual intuition, and encouraging the inclusion of therapeutic space [ 18 ]. Although it includes proxemics, kinesics, and haptics (use of touch), it has been developed to encourage the inclusion of therapeutic space and intuition in verbal communication skills’ content. None of these models were intended for nurses’ effective nonverbal communication with older patients or were derived from the participants’ views on nonverbal communication between patients and nurses. Moreover, a model with consideration of nurses’ views is more likely to be appropriate and acceptable by nurses [ 19 ], because healthcare workers’ perspectives are important in determining effective strategies [ 20 ].

As of 2018 in Cameroon, the growing older population is translating to increased healthcare demand [ 2 ]. Unlike other African countries such as Mauritius, Seychelles, and South Africa, there is no national effort to develop long-term care settings in Cameroon [ 4 ]. As a result, older adults solely utilize hospital settings when requiring medical assistance [ 21 , 22 ] where nurses communicate more often with them. Additionally, Cameroon is one of the most linguistically fragmented countries in sub-Saharan Africa, with approximately 250 indigenous languages, apart from English and French which are both considered official languages [ 23 ]. As a result, it is less likely that a nurse speaks the same vernacular as an older patient who does not speak French or English. Although communication skills training and models do not necessarily ascertain that nurses will be skilled communicators [ 24 ], they might be helpful in assisting nurses to improve their nonverbal communication with the older adult population. As some of these older adults mostly rely on nonverbal communication because of their functional impairments [ 25 ], nurses need to be equipped, more than ever, with tools to improve their communication skills. Therefore, this paper aims to present a model for effective nonverbal communication between nurses and older patients.

2. Materials and Methods

2.1. design.

The purpose of this study was to develop a model for effective nonverbal communication between nurses and older patients during hospitalization. It was for this reason that a qualitative Grounded Theory (GT) approach was followed [ 26 ]. GT was chosen because “it is a useful methodology for the study of interpersonal activities between nurses and patients and others because a social interaction is at the heart of the caring process in nursing” [ 27 ] (p. 16).

2.2. Study Settings and Context

The study took place in two public hospitals in the east and central regions of Cameroon, a low-and-middle-income country at the heart of the Gulf of Guinea in Central Africa [ 28 ]. Both hospitals are in the central level of the three-level pyramidal Cameroonian healthcare system. The first hospital was chosen because it is the only one with a geriatric unit in Cameroon. Similarly, the second was selected because it is a referral regional hospital. In both hospitals, older adults are admitted to adult wards with younger adults but are categorized according to their illness. In addition, both hospitals employ qualified nurses and nurse assistants, irrespective of registration status given that registration was not mandatory in Cameroon before 2022.

2.3. Study Participants and Sampling Methods

In keeping with GT, which aims to recruit participants with rich information on the phenomenon under investigation, purposive and later theoretical sampling were used. Firstly, 10 clinically experienced nurses who were involved in the day-to-day care of older adults admitted to the hospital, could articulate in English or French, and were willing to participate in the study were purposively sampled. Furthermore, 8 older adults who were not critically ill, could articulate in English or French, and expressed a willingness to participate in the study were also purposively sampled. Theoretical sampling included the recruitment of additional participants who cared for older patients. These were 2 middle unit managers, 4 undergraduate student nurses allocated for clinical placement in the selected hospitals, and 1 nurse assistant. We collected and analyzed data simultaneously as recommended in Grounded Theory; thereafter, we stopped recruiting and including participants when no additional information emerged from the analysis. All up, 17 nurses and 8 older patients were included in the study. Their characteristics are described in Table 1 .

Sociodemographic characteristics of the participants.

2.4. Data Collection

Data were collected between July 2018 and January 2020 through overt participant observations and individual interviews. The principal investigator commenced with a month-long observation of how nurses communicated nonverbally with older patients during different types of interactions. Such interactions were, but are not limited to, day-to-day nursing care-related tasks, social interactions, and health education interactions. The observations were recorded as field notes because no ethics permission was granted for video recording. Data from the observations guided the development of the initial interview guide which was used to conduct individual in-depth interviews with participants.

Only the nurses who were observed met the criteria to be interviewed. Therefore, the principal investigator approached them in the nursing station when they seemed free, verbally provided information about the study, and issued each with an information letter with the intention to obtain consent to be interviewed. Following this, those nurses who showed interest in participating in the study were booked for individual in-depth interview at times most convenient for them. The initial interviews captured the meaning and channels of nonverbal communication from the nurses’ perspectives. One open-ended question was asked: “How can you define nonverbal communication with older patients”? This was followed by probing questions that allowed the researcher to elicit more information, obtain more clarity, and confirm data captured during observations. Due to the constant comparative methods for data collection and analysis, interviews informed each other. Each individual interview, conducted in the participant’s preferred language, lasted between 50 min and 60 min. Subsequently, field notes were recorded during and after the interviews. Data saturation was achieved at interview 17 when no additional information emerged.

The same principles were followed to recruit and include older adults for interviews. A total of 47 older adults were referred to the study, but 13 did not meet the eligibility criteria. The remaining 34 older patients who met the inclusion criteria were individually approached at their bedside when they seemed free with no visitors nor care activities happening. The principal investigator introduced herself, explained the purpose of the study, and sought consent for participation in the study. Consent to be observed was provided by 29 older patients, of whom 8 were interviewed thereafter. Older adults who consented to participate in the study either agreed to be interviewed on the spot or preferred to make an appointment for a different time. The initial interviews with older adults captured their interpretation and understanding of nurse nonverbal communication. One open-ended question was asked: “How do you understand when a nurse communicates without saying a word?” This was also followed by probing questions for more clarity and to obtain additional information. The interviews with older adults also informed each other. Field notes were also taken during and after interviews. Data saturation was achieved at interview 8 when no additional information emerged.

2.5. Data Analysis

Data were analyzed by three researchers, who were all female and comprised a principal investigator and two academics with PhDs who have supervised graduate students following qualitative research methodology. None of the researchers worked or was working at the data collection site; therefore, they had no relationship with the participants. Data analysis encompassed open coding, axial coding, and selective coding, which seemed intertwined as the researchers moved back and forth between data collection and data analysis. The process is referred to as a constant comparative method by Strauss and Corbin [ 29 ]. This allowed the generation of increasingly focused questions, thus providing direction for subsequent interviews [ 30 ]. In addition, constant comparison was used throughout the study. The software NVIVO version 12 [ 31 ] was used to import transcripts, write memos, code conceptual categories, properties, and dimensions from the data, conduct data analysis, and refine the model.

Data were initially coded sentence-by-sentence during open coding to summarize and define emerging categories, paying special attention to the processes linking them. This was followed by axial coding, where data were reassembled and codes refined and categorized into categories and subcategories [ 32 ]. This allowed for a better understanding of the categories, with similar ones merged into higher-order categories. After creating concepts and categories from data in the open coding phase, the researchers continued to group categories and subcategories in the axial coding phase. The researchers then developed a category by specific conditions, context, and actions or interactions by which it was managed [ 33 ]. The researchers further refined a list of categories by carefully trying to merge or delete some of them after making possible connections. Categories were linked depending on their properties and dimensions. Some categories were named in words and phrased by the participants, while others were renamed by the researchers’ academic and professional knowledge and readings. These concepts are referred to as “literature-driven concepts” [ 29 ]. The researchers continued to code new data, re-examining and comparing the data until saturation was reached. Selective coding followed axial coding, which involved the process of selecting the core category “ effective nonverbal communication ”, systematically relating it to other categories, validating those relationships, and completing categories that needed further refinement and development; by following the process of reduction and comparison. The iterative nature of the data analysis process allowed the researchers to repeatedly ask questions while studying the data, in addition to using the “ waving a red flag ” technique , which allowed them to look beyond the obvious in the data [ 26 ]. The researchers were convinced that the model began to emerge as soon as the diverse properties began to integrate.

2.6. Ethical Considerations

Ethical approval (reference number HSS/2008/017D) to commence the research study was obtained from the University of KwaZulu-Natal Humanities and Social Sciences Research Ethics Committee. Permission was further obtained from the two participating hospitals. Following ethical approval requirements, before data collection, an information letter explaining the purpose and nature of the study was given to each participant. The participants were allowed to ask any questions before the voluntary signing to participate in the study, be observed, and be audio-recorded. The participants were informed that they may withdraw from the study at any time with no due penalty or repercussions. Furthermore, all participants were assured that no information provided by them would be shared with another person without their authorization. To maintain confidentiality, pseudonyms were used. Participants did not receive monetary benefits for participating in the study.

To ensure trustworthiness, the researchers used the criteria of credibility, transferability, dependability, and confirmability [ 34 ]. The credibility of the study was promoted by the researchers’ prior engagement with participants. Prolonged engagement was ensured by the establishment of relationships with participants during the study. Data analysis was audited by taking observational field notes regarding the context of the interviews, with peer debriefing conducted to confirm emerging categories and themes. Confirmability was ensured by triangulating data sources and validating audiotaped and transcribed transcripts against emerging categories and themes through constant comparison. Further, nine interviews were returned to participants who did not add much to what they originally said. Dependability was ensured by data quality checks with an expert in Grounded Theory, peer review of coding, and consultation with qualitative researchers to validate the codes and categories that emerged from the analysis. Finally, transferability was established by rich descriptions of the study context, informants, research procedures, and the provision of extracts from the interviews to enrich the findings.

3. Results and Discussion

The model was developed based on the findings from open coding, selective coding, and axial coding. Table 2 , Table 3 and Table 4 summarize the extracts from the participants and the observations, which served as a starting point to develop the model.

Extracts of the contextual conditions forming the basis for developing the model.

Extracts of the core phenomenon forming the basis for developing the model.

Extracts of the outcomes forming the basis for developing the model.

Additionally, Figure 1 indicates the elements of the model in line with Strauss and Corbin’s paradigm, which include the antecedents, the contextual conditions, the core phenomenon, the actions and interaction strategies, the intervening conditions, and the outcomes.

Summary of findings in line with Strauss and Corbin’s paradigm.

These elements ( Figure 1 ) were used as the foundation for the development of this model. Some of these elements were extensively described in other papers by the same lead author [ 35 , 36 ]. Hence, this paper focuses on the emerged model, to enhance nonverbal communication between nurses and hospitalized older adults.

We followed the components for developing a model, which include the purposes of the model, the concepts and their definitions, the structure of the model, and the assumptions of the model, as described by Chinn and Kramer [ 37 ].

3.1. Purpose of the Model

According to Chinn and Kramer [ 37 ], the purpose of the model justifies the context and situation in which the model applies. Although communication is bidirectional, nurses are responsible for its proper conduct [ 38 ]. Therefore, this model of effective nonverbal communication between nurses and older patients, in the context of this study, provides a framework that guides nurses to effectively communicate nonverbally with older adults in hospital settings. Furthermore, in-service training for nurses who were not part of this study can be developed based on the elements provided by this model. This model can be used by curriculum developers and policymakers as a guide for nursing schools in the teaching and learning of nonverbal communication to both undergraduate and postgraduate students. Furthermore, this model answers the United Nations’ [ 39 ] call for more data on older adults from developing countries, thus contributing to the limited body of knowledge in the area of nonverbal communication in geriatric care in hospital settings [ 40 ], as compared to nonverbal communication in long-term care settings.

3.2. Basic Assumptions of the Model

The assumptions that formed the basis of effective nonverbal communication between nurses and older patients in this model are outlined below:

Effective nonverbal communication is present in every healthcare encounter between nurses and older patients because it is impossible not to communicate nonverbally [ 10 ]. In other words, whenever there is an interaction between a nurse and an older patient, nonverbal communication is inevitable even when there is no verbal content. Scholars have estimated the amount of nonverbal content in communication, in comparison to verbal content. They described that nonverbal communication accounts for 60% to 90% of total communication [ 13 ]. Thus, nonverbal communication is unavoidable. Therefore, nurses should be aware that their nonverbal communication might send conflicting messages to older patients if they do not match the verbal content. In addition, the awareness of nonverbal messages sent to others is essential, as it often provides an explanation as to why people respond to us in the way they do [ 41 ]. Hence, nonverbal communication emerges as an intentional concept, which nurses should be aware of, as it may have negative consequences to the level of care rendered.

Effective nonverbal communication with older patients is person-centered . It is worth noting that older patients are not a homogenous group, as they have different experiences [ 42 ] coupled with different nonverbal communication needs. Person-centered care assumes that healthcare workers should communicate and interact with patients in a person-centered way while paying attention to patients’ different expectations and needs through verbal and nonverbal communication [ 43 ]. Hence, an added assumption in this model is that nonverbal communication is individualized and needs-oriented. Nurses are encouraged to take into consideration older patients’ nonverbal communication needs. Despite this, authors acknowledge the beliefs of Chan et al. that initial interactions with older patients tend to be scripted and governed by established social norms [ 44 ]. In time, nurses should be able to easily bend or break these norms to align them with each older patient’s specific needs.

Effective nonverbal communication is unique, dependent on the context and the nurse rendering care . The model brings forth the assumption that clinical contexts are different, along with the types of interaction with patients and the types of illnesses. On the other hand, nurses bring to the table different backgrounds, training, and personalities. These lead to unique encounters with each one. The emphasis in this model is that unique does not mean chaotic but instead means distinct, that may or may not be automatically replicable to another encounter. Moreover, effective nonverbal communication cannot be reduced to a set of theoretical and linear principles to absolutely follow because there is no universal way to communicate. This allows room for the creativity, flexibility, intuition, and authenticity that are needed in effective communication [ 44 ]. Furthermore, as nurses grow in confidence and experience, the model assumes that they will embrace and master effective nonverbal communication in every encounter and obtain mastery over the external display of their emotions. Hence, nurses will become shapers of and accountable for effective nonverbal communication with older patients.

Effective nonverbal communication is a subjective and interactive process which may be misinterpreted or misunderstood. Indeed, there is a risk of miscommunication or misunderstanding that cannot be eliminated when using nonverbal communication [ 45 ]. In this model, we posit that nurses interpret situations based on filters and frames. Filters refer to what influences the way nurses attempt to communicate nonverbally with older patients. Such filters are, but are not limited to, nurses beliefs, past experiences, and personality traits [ 36 ]. On the other hand, frames can be defined as a nurse’s own interpretation of a situation. As an example, one participant reported that some older patients practice witchcraft in the hospital, therefore preventing nurses from getting closer to them or spending more time with them. According to the participant, this may have negative consequences on the effectiveness of nonverbal communication between nurses and older adults. As nonverbal communication is an interactive process, nurses may misunderstand and misinterpret nonverbal messages sent by older patients. Like nurses, older patients can misunderstand or misinterpret the nonverbal messages sent to them, resulting in ineffective nonverbal communication. The mismatch in the interpretation and understanding of nonverbal communication may be due to past negative experiences with nurses, critical conditions, or different cultures or religions between nurses and older adults [ 36 ]. To minimize misinterpretations and misunderstanding, the model suggests that nurses be encouraged to obtain feedback that ascertains that the older patients have understood, or not, the nonverbal messages sent by nurses. Similarly, nurses should ascertain that they have correctly captured messages sent to them by older patients for the success of nonverbal communication. This is called reaching an area of communicative communality [ 46 ].

Effective nonverbal communication is reliant on cultural and religious beliefs complicated by the multilingual nature of the context. Hence, the assumption in this model is that within effective nonverbal communication are the components of religion and culture. As an example, in some cultures or religions, eye contact with an older adult is considered rude; conversely, it can express empathy in other contexts. Another example is affective touch, which can be considered invasive in some contexts. Hence, the model posits that effective nonverbal communication is reliant on one’s culture and religion. Within the context of this study, nurses and older patients are often from religious and culturally diverse regions with language differences. Cameroon is known for being multilingual with more than 250 indigenous languages [ 23 ] in a population of more than 26 million people. Although there may be instances where both nurses and patients share the same cultural and religious beliefs, the assumption in this model is that different social circumstances, orientations, and languages may influence nonverbal communication. Nurse prudence is therefore essential when initiating nonverbal modalities that can be considered ambiguous.

3.3. Concepts and Definitions

Effective nonverbal communication is the core concept from which other concepts evolve. It is a dynamic and evolving process that takes place as the relationship with an older patient develops. The emerging concepts in this study and those described in this paper are effective nonverbal communication, context and environment, action and interaction strategies, pillars, and outcomes.

3.3.1. Core Concept

The core concept in this study is effective nonverbal communication between nurses and older patients. It refers to a variety of communicative behaviors that do not carry linguistic content, but are unique, religiously and culturally sensitive, and person-centered. In the literature, common attributes of effective communication include a significant tool in planning and implementing person-centered care, a foundation for interpersonal relationships, and a determinant of promoting respect and dignity [ 47 , 48 , 49 ]. On the other hand, inaccurate or ineffective nonverbal communication behavior will not enable older patients to understand and interpret nurse messages. Therefore, it should be accurate to avoid distortion of messages. In this model, effective nonverbal communication entails the channels and the purposes of nonverbal communication in the context of the study. However, the core concept has been extensively discussed in another manuscript [ 50 ]. Therefore, the following is a summary of the core concept.

The Channels of Effective Nonverbal Communication

The channels of effective nonverbal communication mostly include haptics, proxemics, kinesics, and vocalics. Few participants mentioned active listening, physical appearance, and artefacts.

Haptics refer to the use of touch or physical contact, which in this study includes handshake, kiss, hug, pat, and stroke.

Proxemics , the use of space and distance, are the physical proximity and distance with older patients. In this model, physical proximity refers to sitting close to older patients, including sitting on their beds. Physical proximity includes standing at the door to talk to them, sitting far from them, and having their back towards them.

Kinesics are the movements of any part of the body, such as smiling, frowning, leaning forward, and waving hands.

Vocalics are the aspects of the voice used when communicating with older patients. In this study, speaking too loudly, too fast, or even too slow were reported by participants.

Artefacts refer to the use of objects during communication. In this study, some participants reported that they show a bottle or the medication to some older patients who did not understand French to express the time to drink medication. It was followed by a change of position by the older patient, showing that he has understood the message and was ready to swallow his tablets.

Physical appearance refers to how nurses dress when they come to work. As described by one participant in this study, a nurse with a uniform can still look like a drug addict. Another one said that a nurse with a see-through uniform could sexually provoke older male patients.

The Purposes of Effective Nonverbal Communication

The purposes of effective nonverbal communication: the ultimate purpose of nonverbal communication is to help patients with their coping and recovery during hospitalization [ 51 ]. In this study, nurses reported that nonverbal communication assisted them in building relationships with older patients, winning their trust, creating a positive atmosphere, supporting verbal communication, reassuring, and conveying empathy to older patients.

To build relationships : Effective nurse–patient communication has been proven to be fundamental to building a positive relationship between nurses and patients [ 52 ]. Hence, this model advocates for nurses to use one or more channels of nonverbal communication to express their willingness to build relationships with older patients.

To win patients’ trust : Kourkouta and Papathanisou recommend that for nurses to develop relationships with their patients, they must be mindful of their first encounter with those patients because first impressions last forever [ 35 ]. Therefore, we encourage nurses to be aware of their body language on their first encounter with older adults.

To support verbal communication : Communication has two components, namely, verbal and nonverbal. The differences in the native languages of nurses and patients creates communication barriers [ 53 ]. Moreover, verbal communication and nonverbal communication can conflict with each other in one interaction [ 10 ] and patients believe the nonverbal when verbal communication is incongruent with nonverbal communication [ 54 ]. Therefore, this model encourages nurses to ensure the congruency of both verbal and nonverbal communication.

To create a positive atmosphere : The hospital environment is stressful to older patients. The noise of machines, the unfamiliar healthcare workers and environment, the pain, the discomfort, and the uncertainty of death lead to patients’ emotional fluctuations [ 55 ] in an atmosphere of fear and anxiety. Therefore, nurses are encouraged to use nonverbal communication to create a positive atmosphere or to change a negative atmosphere into a positive one.

To convey empathy : Empathy is the ability to understand and share another person’s emotions [ 56 ]. Nurses are encouraged to communicate to older patients that they are compassionate, interested, and concerned about their situations. Knowing the changes that older adults undergo concerning their physical, psychological, social, and environmental health will help nurses better understand older patients [ 57 ].

3.3.2. Context and Environment

Anderson and Risor [ 58 ] have argued about the importance of contextualization and how it relates to the notion of causality for eventual understanding and insight. In this study, the context refers to the types of encounters between nurses and older patients. These range from encounters around health communication, nursing tasks, activities of daily living, and normal social life, as described by Barker et al. [ 59 ]. The context also encompasses the nursing shortages, excessive workload, and poor communication skills that have been identified by Kwame and Petrucka as some barriers to effective communication with patients [ 60 ]. Wards in Cameroon have limited resources and there are out-of-pocket payments for every healthcare service. For example, if patients cannot afford to pay for cotton wool or syringes, they will not receive their prescribed injections. Ward staffing is often limited to one staff member per shift, which limits the interaction of the nurse with the older adult due to lack of time versus accomplishment of the routine.

The environment , within this model, is the ward and the persons involved in the communicative encounter, namely, the nurses, the older patient, and/or the relatives. The ward is mostly a medical ward because there are very few geriatric units in acute settings in Cameroon. Similar to Cameroon, in Ghana [ 57 ], older adults are mostly nursed in general wards together with young and middle-aged adults after diagnosis has been classified as a medical or surgical case. In the wards, at least one relative is requested to stay with the older patient 24/7. During their stay, the relatives participate to care (personal hygiene, medicine intake, temperature checking, etc.) when nursing teams are short-staffed and/or alert the nurses when problems arise, such as in Malawi [ 61 ]. Moreover, the presence of relatives in the ward has been reported as a nuisance to care [ 62 , 63 ]. All employed nurses are certified but not necessarily registered with the Nursing Council, as registration was not compulsory for practice before 2022. Some older adults are often seen as witches by the community and the healthcare population, similar to Ghana [ 57 ] and Uganda [ 64 ]. On the other hand, some are also seen as babies or as intelligent people. All the above-mentioned constitute the context and the environment for effective nonverbal communication between nurses and older patients.

3.3.3. The Action and Interaction Strategies

To achieve effective nonverbal communication with older patients, participants reported on a series of strategies that needed to be put in place, referred to as action and interaction strategies according to the GT language. These were, but are not limited to, being aware of one’s nonverbal communication, being “angels”, putting yourself in the shoes of older patients, and reducing negative attitudes towards older patients. Additionally, creating long-term care facilities, improving acute healthcare structures, enhancing communication skills through education and training, and recruiting more gerontologist nurses were mentioned as strategies for effective nonverbal communication with older adults. However, they will not be discussed in this paper.

Awareness of nonverbal communication : Nonverbal messages are often subconsciously transmitted; thus, nurses tend to be neither aware nor mindful of the value of nonverbal communication when communicating with older patients. In this study, some nurses reported that they had never used nonverbal communication with older patients. This means that they were not aware that they have been using nonverbal communication. Moreover, awareness of one’s nonverbal messages leads to a greater understanding of the messages exchanged [ 65 ]. Nurses should be on constant guard of their NVC to ensure maximum satisfaction of patients [ 66 ], especially their kinesics and proxemics [ 67 ]. After all, awareness of nonverbal communication explains why people respond to us the way they do, and influences how the other person communicates with us [ 41 ]. This means that if older patients respond to nurses in a certain way, it is because of nurses’ nonverbal communication.

Being “angels”: Participants described that to achieve effective nonverbal communication with older patients, nurses should be “angels”. Angels are commonly described as spiritual beings who do good. In this study, being an angel entailed showing concern and interest in older adults, being kind and close to older adults, and conveying empathy. Furthermore, the angelic being of nurses is further evident in their soft voice tones versus commanding tones and positive facial expressions.

Putting yourself in the shoes of older patients : Ageing is an inevitable event, and it will happen to everyone in the absence of premature death. Nurses reported that they do imagine themselves as older adults. Therefore, they attempt to render imaginary care and nonverbal communication that they would want to receive if they themselves were hospitalized. This particular study finding concurs with that of Van Der Cingel, who reported that nurses who cared for older people with a chronic disease put themselves in the patients’ shoes [ 68 ].

Reducing negative attitudes toward older patients : Ageist attitudes, which comprise discrimination, prejudice, and stereotypes toward a person based on their age, have been recognized as a factor influencing older adults [ 69 , 70 ]. Ageist attitudes can lead to age-based disparities in diagnostic procedures, decision-making, and types of treatment offered. As previously indicated, in this current study, some nurses avoided older patients because of alleged witchcraft. Additionally, some nurses shouted at older patients because they saw them as children. Moreover, ageist attitudes are reflected in interpersonal interactions that are patronizing or involve elder speak [ 71 ]. Ageism in healthcare limits older adults’ access to appropriate and respectful care, and results in adverse clinical outcomes [ 72 ]. Ageist attitudes are easy to deal with because although they are social constructs historically and culturally situated, they are individually interpreted [ 73 ]. Therefore, this model advocates for nonverbal communication free of age-related bias, which is essential to high-quality, patient-centered care.

3.3.4. The Pillars to Sustain Effective Nonverbal Communication between Nurses and Older Patients

For this model, pillars refer to factors that influence effective nonverbal communication between nurses and older patients. In this paper, we only list the pillars because they have been extensively discussed in Keutchafo and Kerr [ 35 ] and Keutchafo et al. [ 36 ]. The factors that influence effective nonverbal communication in this model are summarized as nurse-related and older-patient-related factors. The nurse-related factors are awareness of nonverbal communication, personality traits, previous experience with older adults, beliefs system, love for the job and for older patients, and views on older adults. The older-patient-related factors include moods, financial situation, interpretation of nurses’ nonverbal communication, and medical condition.

3.3.5. The Outcomes of the Model

This study evidenced that when nonverbal communication between nurses and older patients is effective, it yields positive outcomes. For this model, the outcomes are categorized as nurse-related, older-patient-related, and operational.

Individual-Related Outcomes

In this paper, we only describe the most cited outcomes by participants. They include better relationships between nurses and older patients, compliance with care and treatment, discovery of the unsaid, and older patient satisfaction.

Communication encompasses the verbal, the nonverbal, and any form of interaction in which messages are created and meanings are derived to influence the nurse–patient relationship [ 60 ]. Likewise, in this model, it emerges that the outcome of effective nonverbal communication is better relationships between nurses and older patients . Although nurses and older patients are strangers at the beginning of the relationship, they are expected to improve their relationship through positive nonverbal communication. Participants in this study reported that they avoided nurses who were always shouting. Consequently, older patients will become closer to nurses who display positive nonverbal communication; this will lead to the betterment of their relationships.

Sumijati et al. have argued that the essence of communication is relationships that can lead to changes in attitudes and behaviors [ 74 ], which in this model is referred to as compliance with care and treatment . One of the outcomes of effective nonverbal communication with older patients is compliance with care and treatment, as described in Figure 2 .

A model for effective nonverbal communication with older patients.

Nurses in this study reported that older patients did not want to take their medication nor accept certain care. Moreover, studies have shown that effective communication with patients leads to compliance to care and treatment [ 60 ]. As proposed in this model, older patients will be able to accept the care and treatment provided by nurses when nonverbal communication is effective.

The betterment of relationships is expected to lead to the discovery of what older patients do not express or have wrongly expressed. It has been shown that effective communication empowers patients to disclose their concerns and expectations [ 75 ], whereas patients would be less motivated to disclose their needs and feelings to nurses when they have past negative experiences in their interactions with nurses [ 76 ]. Moreover, patients need encouragement to talk about their psychological issues [ 77 ]. However, when communication is effective, older adults feel cared for, respected, and more able to describe their concerns [ 42 ]. This means that when relationships are better because of positive experiences in nonverbal communication with nurses, nurses would discover the unsaid . This is another important outcome in this model.

Older patient satisfaction is one of the outcomes of effective nonverbal communication. Evidence shows that nurse nonverbal positive behaviors lead to higher patient satisfaction [ 78 ]. To improve patient satisfaction, nurses are encouraged to enhance their communication skills [ 63 ]. In this model, and as confirmed by Junaid et al., to ensure maximum satisfaction of patients, nurses should be on constant lookout of their nonverbal communication [ 66 ]. Such a level of awareness will prevent nurses from sending conflicting messages to older adults through their nonverbal communication.

Operational Outcomes

Improved nursing care is one of the hospital-related outcomes. As confirmed by Tran et al., enhancing the effectiveness of verbal and nonverbal communication can improve the quality of care [ 14 ]. Effective nonverbal communication with older patients will make room for nurses to shift from task-oriented care to person-centered care. This will improve the quality of care rendered.

When nursing care is improved, older patients will have shorter lengths of stay in hospital . Participants mentioned the reduction of length of stay in hospital because they viewed older patients as people who not only want to stay at home, but who also want to return home after hospitalization [ 79 ]. Moreover, studies support both a shorter or longer length of stay associated with better quality of care [ 80 ]. As nurses do not decide on the discharge or otherwise of patients, they are encouraged to use effective nonverbal communication with older patients irrespective of the length of stay.

Improved quality of care and shorter stays in hospitals will lead to a positive reputation for these healthcare structures according to this study’s participants. In another study, hospital reputation was one of the factors influencing patients’ choice of hospital in Iran [ 81 ]. In Cameroon, people can often go to a tertiary hospital without previous referral from a secondary or a primary hospital. As healthcare services in public institutions are out-of-pocket payments, these “good” hospitals will see an increase in their financing. Effective nonverbal communication with older patients goes a long way. It not only benefits individuals but hospitals and society in general. Therefore, nurses should strive to sustain effective nonverbal communication with older patients.

3.4. Relationships between Concepts

In this model, all categories and subcategories are directly or indirectly interlinked. The category “ effective nonverbal communication ” is the core category in this model. It comprises the modalities of effective nonverbal communication and its purposes, which are directly linked. For instance, one or more modalities of nonverbal communication can be used to achieve one or more purposes of nonverbal communication in one interaction between a nurse and an older patient; an affective touch coupled with physical proximity can be used to win trust in older patients. The next category is the action and interaction strategies that need to be implemented to achieve effective nonverbal communication between nurses and older adults. This category is directly linked to the core category and intervening conditions. For instance, to support verbal communication, get messages across, and convey empathy or win older adults’ trust, nurses should be aware of their nonverbal behaviors, “being angels”, reduce negative stereotypes about older adults, and put yourself in the shoes of older patients. This shows the links between the purposes of effective nonverbal communication, the actions that should be taken by nurses, and the intervening conditions.

Figure 1 also shows that effective nonverbal communication between nurses and older patients rests on certain pillars that are interlinked and serve together as a solid structure. This means that effective nonverbal communication relies on nurses’ intrinsic factors, positive views of older adults, awareness of nonverbal communication, and nonverbal communication skills. Effective nonverbal communication also relies on older adults’ related factors such as their positive moods, their non-critical medical condition, and their financial situation. The diagram also shows that nurses’ effective nonverbal communication with older patients takes place within a specific context, which is the healthcare encounter. It also depends on the type of interaction between the nurse and the older patient. For instance, if the interaction is more task-related, affective nurses can use touch and sustained eye gaze to convey a positive emotion. The nonverbal communication that happens in a particular healthcare encounter and during a particular type of interaction is expected to yield positive results, such as older patients’ compliance with care and improved nursing care, thus leading to shorter stays in hospitals and the enhanced reputations of these hospitals.

4. Limitations

Although this model of effective nonverbal communication falls under transactional models of communication, it focuses more on the role of nurses; thus, one could argue that this model is linear. Moreover, the model acknowledges that older patients also have a role to play in effective nonverbal communication between them and nurses, but emphasizes nurses as shapers of the communication. A greater number of older patients could have enriched the study findings. However, as confirmed by Hall, Longhurst, and Higginson [ 82 ] and Lam et al. [ 83 ], it was difficult to conduct research with older adults because of the lack of trust in the researcher, lack of interest in the topic, the involvement of family members, and difficulties in obtaining consent. In addition, most of the older adults could speak neither French nor English. This can be seen as a limitation. Another limitation is that the observations were overt; therefore, the proposed model relies only on participants’ reports of what happened as well as interpretations of the observations made. Video recordings of interactions could have captured more details that might not have been captured by the researcher. The last limitation is that views from other healthcare workers, who also communicate nonverbally with older patients in the same settings, could have further strengthened the model.

5. Conclusions

This model adds to the body of knowledge on nonverbal communication between nurses and patients. It also answers the United Nations’ call on more data on older adults from low-and-middle-income countries. This model also provides a tool to help nurses communicate more effectively with older patients who mostly rely on nonverbal communication. The improved communication with older patients is expected to improve the quality of care rendered and the reputation of clinical settings. It is therefore recommended that the model is tested, evaluated, and refined for better outcomes.

Acknowledgments

The authors acknowledge all the participants of this study as well as the College of Health Sciences of the University of KwaZulu-Natal for its support.

Funding Statement

This research received no external funding.

Author Contributions

Conceptualization, E.L.W.K. and J.K.; methodology, E.L.W.K. and J.K.; data analysis, E.L.W.K. and O.B.B.; data collection, E.L.W.K.; writing—original draft preparation, E.L.W.K.; writing—review and editing, O.B.B. and J.K.; supervision, J.K. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki and was approved by the Humanities and Social Sciences Research Ethics Committee of the University of KwaZulu-Natal (Number HSS/2008/017D, 23 November 2017).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

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