When teaching advanced communication skills, I have often heard the phrase, ‘well this is how I do it’ or ‘this is what I always say,’ in relation to giving difficult news to someone. My heart sinks a bit in these moments, because there isn’t one size fits all approach to communication. I can appreciate why this happens though. People feel safe having a trusted script to hand. They don’t have to think too much about what they are going to say or do. It is a personal protective barrier if you like and increasingly scripts are being created by AI as an alternative option.
Why am I writing about this? well I was doing a bit of research and it seems that there is an increase in people looking online to see if it is okay to use AI to help them script difficult conversations with patients. I guess it is tempting, when you know a hard conversation is coming, to ask an AI tool to draft the words for you. AI can help you get the phrasing right, or take some of the pressure off. I understand the appeal. Used well, AI can genuinely help you prepare; structuring your thoughts, flagging language what might be perceived as being too blunt or uncaring, or too jargonistic. Consequently, it can help you rehearse the conversation. That kind of preparation is no different, really, from writing notes before a hard conversation, or asking a colleague to sense-check what you are planning to say.
But there is a difference between preparing for a conversation and handing it over; letting AI words replace your own words and judgement in the moment.
The thing about a script, whether you have said it a 100 times, or one an AI wrote for you 5 minutes ago, is that it protects you from having to be fully present. This isn’t a good thing. Being present is where the real work of a difficult conversation happens. It is in the pause after you have said something hard; in the moment you notice someone’s face change and adjusting what you say next. It is in the silence you don’t rush to fill. No script can anticipate how this person, in this moment is going to respond. If part of your intention is on remembering your lines, less attention is placed on them.
I would also say though, that the discomfort of preparing for a hard or difficult conversation is doing something useful. Sitting with it beforehand, feeling a bit uneasy, turning over how this particular person might hear the news, is often how we access empathy in the moment itself. But if you skip straight to the script you can lose some of that attunement before you have even walked into the room.
Genuinely useful for:
Not a substitute for:
The best use for AI here isn’t to write your words for you. It is to help clear some space beforehand, so that when you are in the room you can be fully in it and present.
To help guide you further, you can use the SPIKES model by Robert Buckman to help you prepare further for difficult conversations.
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