April 2016 Vol 7, No 3


Learning Guide
Katie Bathje, MA, LPPC, HON-OPN-CG
Program Director, Kentucky Cancer Consortium, University of Kentucky, Lexington
Linda Fleisher, PhD, MPH
Academy of Oncology Nurse & Patient Navigators, Cranbury, NJ
Christi Sheffield
Manager of Supportive Care Services,
Bethlehem, PA

Patient navigators interact routinely with patients, their families, and other healthcare professionals, and need to be skilled communicators to effectively exchange information and collaborate.1 Effective communication includes expressing empathy, integrity, honesty, and compassion, especially in difficult conversations; building trusting relationships across a broad range of socioeconomic and cultural backgrounds; using active listening; solutions-oriented interactions with patients, families, and members of the healthcare team; and communicating effectively with navigator colleagues, healthcare professionals, and health-related agencies to promote patient navigation services and leverage community resources to assist patients.2

Another important element of communication is encouraging patients to become advocates for themselves.1 Patient navigators need to be able to assess patients’ capacities to self-advocate, help patients optimize time with their physicians and treatment team (eg, prioritize questions, clarify information), and encourage productive communication between patients, their families, and healthcare providers to optimize patient outcomes. In addition, as patient navigators address health disparities and our diverse populations of patients, they need to be culturally sensitive, and increase their competency by using the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care to advance health equity, improve quality of care, and reduce health disparities.

Case Study

Jean, aged 70 years, is a man and patient with cancer who has been referred to you because he is about to begin radiation treatment for his head and neck cancer. When you first meet Jean, he doesn’t seem to understand you, and you are also having difficulty understanding him. His daughter is with him, and often speaks for him in English. Jean seems to be very anxious and confused about what is happening and involved in his treatment.

Check Your Knowledge

1. It seems that English is not Jean’s first language. You:

a. Ask Jean’s daughter if she will interpret for you
b. Ask Jean what language he is most comfortable speaking, and find someone on staff who speaks that language
c. You know a staff member who speaks French, which seems to be the language used by Jean’s daughter when she is talking to him, and you ask the staff member to translate for you
d. You ask Jean what language he is most comfortable speaking, and order translation services

2. You ask Jean what he would like to know about the radiation treatments he will be receiving, and suggest that you come up with some questions together. He says he doesn’t want to bother the physician. You say to Jean, “It sounds like you aren’t sure you want to bother your physician with your questions. Is that right?” Your response is an example of:

a. Active listening
b. Open-ended questions
c. Being flexible
d. Taking nonverbal cues

3. As you talk with Jean through the translator and ask him more about what he has heard about radiation treatment, he shares that he is worried about side effects (eg, trouble swallowing and being tired), and is not sure that he wants to go through with the treatment. Which of the following communication strategies would be most appropriate for Jean to use with his physician, Dr Jones?

a. Actively listening to what his physician has to say
b. Being assertive by saying, “I defer to you, Dr Jones”
c. Expressing his feelings by saying, “I am worried about the side effects of this treatment”
d. Saying, “I do not feel radiation will benefit me”


1, D; 2, A; 3, C.


  1. Mazor KM, Beard RL, Alexander GL, et al. Patients’ and family members’ views on patient-centered communication during cancer care. Psychooncology. 2013;22:2487-2495.
  2. The Centre for Teaching Excellence; University of Waterloo. Effective communication: barriers and strategies. Accessed March 10, 2016.
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Last modified: August 10, 2023

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