#53 Adjusting During Crucial Conversations Based on Personality and Psychological Safety with guests: Julie Byington, C-TAGME, Ashley Johnson, C-TAGME, and Samatha Ankireddy, MD and Laura Thompson, MD 

June 18, 2025 | By Era Kryzhanovskaya

Audio

Transcript available via YouTube

Come share insights from AIMW25 with Julie Byington C-TAGME, Ashley Johnson C-TAGME, Samatha Ankireddy MD, and Laura Thompson MD on effective communication and navigating difficult conversations. Understanding our own emotions and personality traits—while being attentive to others’ verbal and non-verbal cues—helps build emotional intelligence and promotes respectful, productive dialogue. Adapting communication styles to different personality types and approaching high-stakes conversations with preparation, psychological safety, and clear follow-up can transform potential conflicts into opportunities for breakthrough.

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Meet our Guests:

Ashley Johnson, C-TAGME is the program coordinator for the White River Health in Batesville, Arkansas, with five years of experience in the Internal Medicine Residency.

Julie Byington. C-TAGME is a GME professional with 12 years of experience in residency and fellowship administration at the Washington University in St. Louis Internal Medicine Residency. She also serves as the administrative lead for the Department of Medicine Vice Chair of Education.

Dr. Samatha Ankireddy is an Internal Medicine Chief Resident at Penn State Health Milton S. Hershey Medical Center. She graduated from the University of Missouri- Kansas City School of Medicine in 2021 and completed internal medicine residency at Penn State Health in 2024. She will soon start her fellowship in Hematology / Oncology at Cleveland Clinic.

Dr. Laura Thompson is an Internal Medicine Chief Resident at Penn State Health Milton S. Hershey Medical Center. She graduated from the Medical College of Georgia at Augusta University in 2021 and completed internal medicine residency at Penn State Health in 2024. She will soon start her fellowship in Pulmonary / Critical Care at Rutgers New Jersey Medical Center.

Show Segments

• Intro, disclaimer, guest bio
• Guest one-liner/ Reflections on AIMW25 conference
• Exploring the Crucial Conversation Framework
• Learning how to maintain psychological safety 
• Using tools like the Mint HR Smalley Trent Personality Test to gain personality awareness 
• Tailoring communication styles based on personality for more productive dialogue and reduced conflict
• Skill for being an active listener 
• Take home points
• Outro

Adjusting Communication for Crucial Conversations Pearls

1. Effective communication begins with self-awareness and preparation. Understanding your own communication style, emotional triggers, and biases is crucial before engaging in any difficult conversation. Preparation—including outlining goals, clarifying facts, and anticipating reactions—sets the foundation for a more productive and focused dialogue.

2.  Psychological safety is essential for honest and constructive conversations. Creating an environment where both parties feel safe to share without fear of judgment or retaliation is key. 

3. Personality awareness enhances interpersonal communication. Being attuned to the personality traits, communication styles, and nonverbal cues of others helps tailor your approach. 

4. Stick to the facts and shared goals to prevent misunderstandings. Avoid assumptions by distinguishing what you know from what you think you know.

5. Having a structured approach—including direct communication, specific examples, and follow-up—ensures feedback is both actionable and respectful. 

Adjusting Communication in Crucial Conversations Notes 

This conversation highlights two presentations given at the Alliance for Academic Internal Medicine’s Academic Internal Medicine Week 2025:

Navigating the Jungle of Personalities: Leveraging Personality Awareness for Enhanced Communication presented by Ashley Johnson, C-TAGME and Julie Byington, C-TAGME

And Crucial Conversations: The One Where the Chief Resident Mediates Conflict within a Hierarchy presented by Priya Ramachandrula, MD, Farid Zeineddine, MD, Laura Thompson, MD, and Samatha Ankireddy, MD 

Approaching Crucial Conversations:

Crucial conversations are those that may have high stakes, strong emotions, and opposing viewpoints. The presenters adapted frameworks from the book Crucial Conversations by Patterson et al.  In the role of health professions educator, crucial conversations are part of the job and do not resolve on their own. 

Three outcomes can come of crucial conversations:

• Avoidance: we fear the situation may become worse and avoid the confrontation by putting off having a direct conversation. This lag time in addressing the conversation can create resentment, mistrust, poor decisions, and missed opportunities for improvement. 
• Breakdown: we allow strong emotions and the uncomfortable, difficult conversation to impede successful communication by not focusing on facts or goals
• Breakthrough: the conversation goes well because we used effective and goal-oriented conversation to reach a productive conclusion

Set yourself up for success when entering a conversation that may be charged. Focus on what the tangible goal of the conversation is so that you’re prepared when emotions flare.  Be deliberate and direct, stick to the facts.  Keep an open dialogue and come back to your mutual purpose.

Pitfalls to avoid: discussing the wrong problem, not understanding your own thoughts and feelings, not addressing your own biases and assumptions before you start the conversation.

Steps to a Successful Crucial Conversation

There are multiple steps we can take to ensure that our crucial conversations go well. Specifically, ensuring that we prepare appropriately for the conversation, ensure psychological safety while having the conversation, and end with a game-plan and follow up, we can ensure we are doing everything possible to mediate conflict (Clark 2015). 

• The Pilot – Before the Conversation: Before the conversation occurs, analyze your own emotions, biases, and concerns. Come up with productive goals for the conversation and focus on facts. Try not to sugar coat issues or rely on biases.   
• The Act – During the Conversation: Start with an open mind, try to understand the other person’s perspective.  Find your mutual purpose.  It is important to create psychological safety as this allows for good dialogue. If the person you are talking to feels attacked, they may become withdrawn or even angry during the conversation, which prevents both sides from hearing each other. By focusing on the facts at hand, avoiding judgement, and encouraging others to share their thoughts, we help to create and maintain psychological safety during the conversation. Recognizing that people may feel unsafe when they feel personally attacked or if they misunderstand your good intent helps us pin-point how the conversation may have veered off-track and allows us to rebuild that feeling of safety (Johnson 2020).
• The Finale – Wrapping Up the Conversation: Create a game plan to put your goals from the conversation into action. By summarizing the conversation and following up afterwards, we show that we are on the same team and invested in a positive result.  

Using Personality Awareness to Improve Communication

When having a conversation with others, it’s important to have awareness of our own emotions and the emotions of others. By being attentive to the other person’s body language, we can pick up on how they are feeling throughout the conversation. Having this emotional intelligence allows us to ensure the conversation is on track and we are being respectful of the emotions of the person we are talking with (Dott 2022).  

A major part of ensuring we have a productive conversation is recognizing our own personality traits, preferences, strengths, limitations, and behaviors that we each bring to a conversation. We are each unique because of the different experiences we have had. It’s important to also recognize how these personality traits may interact and differ from the people we are talking to. 

Enhancing Conversation Awareness: Active Listening

To enhance our communication skills, we need to improve our listening habits and hone in on our active listening skills. Many times, we are not actually listening to what the other person is saying because we are so focused on what our next response will be.  Interrupting the other person so they cannot finish their thoughts and hearing what we think the other person is saying instead of what they are actually trying to convey limits our ability to communicate well. By paying attention to the other person while they are speaking (both verbally and non-verbally with body cues), asking questions to ensure appropriate understanding, and responding respectfully, we can significantly improve our communication skills (Tennant 2023). 

Tailoring Communication Styles to Personality Types

The MINT HR Smalley Trent Personality Test is an example of a tool we can use to assess and recognize our own strengths and limitations, as well as the person we are trying to communicate with, understanding that these are just frameworks and we may act in one way in one setting and another in a different setting. By knowing our personality and understanding the personality of the person we are communicating with, we can adapt our conversations so they are as productive as possible. 

Lion: A natural, confident leader that likes to solve problems and take charge.They focus on the now and hate wasting time. 

• Strengths: Goal oriented, achievement and result driven, takes charge, likes challenges, competitive, and driven to complete projects quickly
• Natural Limitations: Impatient, demanding, blunt, and may “run over” others who are slower to act or speak 
• Giving feedback: be direct and straightforward

Otter: Excitable, supportive, and fun seeking individuals who love to talk and socialize. They desire to be liked and motivate others. Very people oriented. 

• Strengths: Enthusiastic, optimistic, good communicators, personal, and fun loving
• Natural Limitations: Not detail oriented, can be disorganized, lead with feelings and not logic, and can be too talkative 
• Giving feedback: handle with care! Make sure conversations are friendly and not confrontational 

Beaver: Great at following rules and providing quality control with accuracy. They are very task oriented and have the desire to be right and maintain quality.  

• Strengths: Accurate, detail-oriented, thorough, high standards, and analytical
• Natural Limitations: Can be very critical on themselves and others, perfectionists, and overly cautious 
• Giving feedback: Provide explanations and praise them for their efforts and thoroughness 

Retriever: Loyal, great listener, and team player. Very people oriented and devote lots of time to strengthening relationships. 

• Strengths: Patient, easy-going, compassionate, loyal, and dependable 
• Natural Limitations: Over-accommodating, avoid confrontation, sacrifice themselves to achieve harmony within the group
• Giving feedback: Be loving and sensitive but firm

Take home points: 

• Know your own communication style, emotional triggers, and biases before difficult conversations 
• Foster a safe space where everyone feels heard and respected to support open and goal-oriented dialogue 
• Recognize and respond to different communication styles using active listening and nonverbal cues
• Avoid assumptions! Stay objective and focused on mutual purpose to prevent misunderstandings
• Deliver feedback with clarity, preparation, and follow-up. The more we do this, the better we become at communicating. 

Goal

Listeners will learn frameworks for success and contextualization strategies to apply during communication in crucial conversations.

Learning objectives

After listening to this episode listeners will be able to …

1. Review how personality awareness can affect communication strategies 
2. Develop approaches to having feedback conversations based on different personalities   
3. Describe the steps to success in mediating conflict as part of crucial conversations

Disclosures

Our guests, Julie Byington, C-TAGME, Ashley Johnson, C-TAGME, Samatha Ankireddy, MD and Laura Thompson, MD, report no relevant financial disclosures. The Curbsiders report no relevant financial disclosures. 

Citation

Kryzhanovskaya E, Heublein M, Ankireddy S, Thompson L, Byington J, Johnson A, Garber R.“#53 Adjusting During Crucial Conversations Based on Personality and Psychological Safety from AIMW25.” The Curbsiders Teach Podcast. https://thecurbsiders.com/teach.  June 18, 2025.