created by the BC Patient Safety & Quality Council
Activities for Transforming Teams
and Igniting Change
ATTIC is a collection of tools, games, and activities to inspire innovation, teamwork and engagement in health care settings.


When we communicate with others, we cannot know if they have heard us as intended unless they tell us what they have heard. Communication strategies like closed-loop communication can ensure the message was transferred as intended. Telephone is an easy way to experience the differences between one-way (open-loop) and two-way (closed-loop) communication.

Download Activity Worksheet

  • 15-30 minutes
  • Groups of 5-10
  • 2 pre-prepared messages (approximately 3 sentences long)

  • Source: Unknown

What to do

This is a familiar activity that requires virtually no set up and is easy to pull together quickly. Two rounds of telephone will be played with two different examples. In the first round, one-way communication will be used. The second round will involve closed-loop communication (two-way).

  1. Once in groups, identify who the first message sender will be for both rounds. Provide that person with a pre-prepared message that is about three sentences in length.
  2. In the first round, the message sender must whisper the message exactly as written to the person sitting next to them. They can only say it once (no repeating). The receiver listens to the message once and cannot ask questions or write anything down.
  3. The receiver then becomes the new sender and conveys the statement quietly to the next receiver in line.
  4. Continue through the entire group.
  5. The last receiver will share the message they heard aloud with the group. The rst sender then reads the original message aloud.
  6. Debrief with the group (see debriefing questions back of card).
  7. Now, repeat this activity a second time with a new message. This time, the message sender says the message once and the receiver listening to the message repeats what they heard back to the sender. They can also ask one clarifying question. The sender repeats the message or clarifies discrepancies. This can only happen once per pair.
  8. The receiver becomes the new sender and conveys the statement to the next receiver with the new rules.
  9. Continue through the entire group.
  10. The last receiver will share the message they heard with the group. See how this compares to the original message written down by the initial sender.
  11. Debrief with the group a second time.


  • In both rounds you were receiving and conveying a message.
  • What were the differences between Round 1 and Round 2?
  • What was the difference in the accuracy of the message conveyed?
  • Did you feel the ow of the message change depending on one-way verses two-way communication?
  • Was there a clarifying question that was helpful?
  • How can we embed closed-loop communication in our day-to-day work?
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