Background
The development and improvement of communication skills along with professional knowledge and skills is an indispensable component of the preparation of a modern nurse. Successful mastering of these skills can significantly improve the quality of care and should consist of several stages, including a preparatory training program before entering the practice. In reality, many graduates and novice nurses do not have sufficient professional communication skills, which leads to decreased performance in clinical settings. This study aims to create a virtual learning platform for nursing students to enhance their communication skills by engaging in various medical scenarios. The main difference from the previously elaborated virtual environments is that this training program presupposes communication with real people instead of simulations. Thus, the extent to which the students will engage in learning promises to be higher and more productive.
The primary theoretical approach is transformational teaching which provides conceptual frameworks for studying and creating the learning process in terms of experiences, attention, and feedback. Another methodological tool used in this study is the SPIKES model, which includes several stages operationalizable for the training program creation. The key research question of the study is formulated as follows: “Will communication practice via a virtual platform developed using a specific real-time approach improve social skills for students in pre-licensure nursing education?”. Therefore, empirical research aims to create a sound theory of difficulties, obstacles, psychological and varied non-verbal barriers to learning, as well as benefits and positive experiences. In addition, the study also seeks to assess the participants’ experiences in the learning progress.
Thus, the study design is intended to provide an empirically valid theory for answering the research questions proposed. To achieve this, the study followed a mixed-method strategy. The qualitative method of grounded theory was applied for studying the participants’ feedback in terms of experiences and perceptions. A quantitative strategy was applied to measure objectively manifested non-verbal communication signals that are theoretically linked to the expression of various experiences, perceptions, and intentions.
The study contributes to the discussion of the ways to enhance the communication skills training for nurses. We anticipate that creating an empirically grounded theory tested via the original program will help develop a standardized program for teaching social and communication skills communication practice via virtual platforms.
Significance and Summary
Reforming the medical education system raises many questions. So, one of the key tasks is designing a new model of a graduate of a medical university from the standpoint of practice-oriented and humanistic approaches; a graduate model combining both general cultural and general professional and professional competencies. Formation of practical skills of the future nurse implies mastering not only clinical skills but also skills of interaction with the patient and/or his relatives, as well as colleagues. Namely, non-technical skills – a combination of cognitive and social skills (the ability to communicate, leadership, cooperation, the ability to work in a team, the ability to present ideas, solve open problems of a social plan, etc.) cause particular difficulty for students (Kim et al., 2018). Communication skills are a specific set of verbal and non-verbal ways of constructive communication of a nurse, necessary in a specific clinical situation: “nurse-patient”, “nurse-patient-relative”, “nurse-nurse”, “doctor-nurse”.
There is no doubt that the creation of a psychologically favorable environment is fundamentally essential for the patient. One of the primary skills used by nurses in daily clinical practice is communication skills. The communicative abilities of nurses are very different: if it is not difficult for some to find a common language and gain confidence in the patient, then for others, on the contrary, communication with patients can be a source of constant nervous stress, which, in turn, serves as a prerequisite for the development of a professional burnout syndrome and a significant decrease in professional motivation (Abdolrahimi et al., 2017). The effectiveness of the treatment and diagnostic process, the degree of satisfaction of the patient with the help provided to him, the patient’s assessment of the professionalism of the nurse, the economic efficiency of the healthcare system as a whole are largely determined by the ability to correctly build communication between the nurse and the patient (Bennett, 2017). The same is true for professional communication in the nurse-to-nurse and nurse-to-doctor scenarios. An adequately built communication process affects the success of teamwork and the coherence of patient care and also increases the satisfaction of the medical staff themselves from their work (Kim & Jang, 2019). In order to prepare students for actual practice, it is necessary to integrate a cross-cutting educational interdisciplinary module aimed at teaching communication skills. However, there is currently a debate as to how exactly is the best approach to the construction and implementation of such training programs so that they are both effective and evidence-based.
There has been an abundant stream of research dealing with virtual training implementation for nurses and the medical profession in general. Currently, in order to bridge the gap between students’ theoretical knowledge and their communication skills in a real clinical environment, a mounting amount of virtual simulators have been developed. Traditionally, the basis of training in a simulation center is a simulation (educational role-playing) game, where the role of the patient is played by mannequins, simulators, computerized simulators, and specially trained people – simulated patients (Kononowicz et al., 2015). Each of these particular training aids is appropriate for its own stage of preparation. Since communication with the patient is an integral aspect of the work of any doctor and nurse, it is crucial to emphasize its necessity in clinical education. The use of simulators in the educational process contributes to the mobilization of students’ knowledge through various means of working out practical professional skills, technical support, and emotional support, which contributes to the implementation of their attitude in future professional activities. Thus, virtual training in communication skills has proved fruitful and promising in nursing. Practical training is impossible without contact and communication with real patients, but patient safety and wellbeing are becoming a fundamental ethical issue (Lee et al., 2018). Thus, one way to achieve this training task is through simulation learning, allowing students to make mistakes in a safe environment (McConville & Lane, 2006). However, communication is a complex process that depends on many factors. For a future nurse, a detailed mastery of practical work skills is a necessary guarantee of further successful clinical practice.
The present study aims at developing a novel virtual learning platform that combines online education excellence, real-world practice, and internship opportunities from anywhere in the world. The ability to communicate is not just a personality trait; it is a set of skills that a nurse acquires in the learning process and improves in further clinical practice. Thus, this project aims to enhance nurses’ social skills before their entering into actual practice.
This study also addresses the critical gap in the current literature concerning nurses’ cognitive and socially determined communication development strategies. The latter can include racial and socio-economic variables and more subtle features like coping strategies, ways of a situation assessment, and others. In order to achieve this, the study follows a mixed-method strategy combining grounded theory with qualitative audio-visual analysis to develop an evidence-based empirically grounded theory. The qualitative stage of analysis also intends to ensure the validity of the study.
The virtual training program proposed includes simulations of various communicative situations with which nurses typically deal in their practice. With the help of simulations of such situations, the study will identify possible opportunities and limitations of teaching communication skills to nursing students and novices using online technologies. Therefore, empirical research aims to create a sound theory of difficulties, obstacles, psychological and varied non-verbal barriers to learning, as well as benefits and positive experiences. Creating such a theory in the future will help develop a standardized program for teaching social and communication skills communication practice via virtual platforms. In addition, the study also seeks to assess the participants’ experiences in the learning progress.
Thus, the implementation of the competence-based approach largely depends on the development of the communicative competence of future nurses, i.e., they have a complex of skills of verbal and kinetic communication, cooperation, and interaction, which allows them to assess and interpret educational and professional situations adequately, make and execute effective decisions, and constructively interact both in professional and interpersonal communication. In current conditions, teaching communication skills can occur through the adaptation of virtual technologies to the goals and objectives of professional training of nurses for real clinical practice.
The advantage of the offered training program is that it trains not only language skills but also non-verbal socio-cultural and other extralinguistic parameters. On the one hand, the study assesses the participants’ ability to transmit and perceive the information necessary for the successful implementation of the interaction in linguistic forms. On the other hand, the study also assesses the degree of influence of extralinguistic parameters on the result of communicative situations, for example, the degree of readability of non-verbal gestures and their impact on the perception of the success or failure of a communicative session. Communicative activity is understood not only as the use of the language system but primarily as a social phenomenon that functions along with other types of human activity.
Recommendations for Further Research
Since the study sample is limited to haphazard sampling, further testing and generalizations are needed. Thus, it is recommended to transfer the training program and the underlying methodology and theory to other settings, contexts, and groups. New settings and contexts would include various educational institutions as well as different geographical locations. For example, medical educators can apply research findings to their own assessment methods that demonstrate that role-based video recording of communication situations helps students prepare for real-life clinical practice. It would also benefit from generalizing the study to other linguistic communities (not only English-speaking ones) and testing the results on statistically significant socio-demographic characteristics such as age, gender, race, socio-economic status, and other variables. The latter step would include an extension of the qualitative assessment in the study’s methodology and design. Also, the generalization process can extend the coding stage of the grounded theory stage since new categories can appear and influence the results.
References
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Bennett, B. (2017). A culture of caring: How nurses promote emotional wellbeing and aid recovery following a stroke. British Journal of Neuroscience Nursing, 13(2), 8-17. Web.
Kim, Y., & Jang, S. J. (2019). Nurses’ organizational communication satisfaction, emotional labor, and prosocial service behavior: A cross-sectional study. Nursing & Health Sciences, 21(2), 223-230. Web.
Kim, Y. H., Min, J., Kim, S. H., & Shin, S. (2018). Effects of a work-based critical reflection program for novice nurses. BMC Medical Education, 18(1), 1-6. Web.
Kononowicz A.A., Zary N., Edelbring S., Corral J., & Hege I. (2015). Virtual patients – what are we talking about? A framework to classify the meanings of the term in healthcare education. BMC Medical Education, 15(1), 11-29. Web.
Lee, K. C., Yu, C. C., Hsieh, P. L., Li, C. C., & Chao, Y. F. C. (2018). Situated teaching improves empathy learning of the students in a BSN program: A quasi-experimental study. Nurse Education Today, 64, 138-143. Web.
McConville, S. & Lane, A., (2006). Using On-Line Video Clips to Enhance Self-Efficacy towards Dealing with Difficult Situations among Nursing Students. Nurse Education Today 26(3), pp. 200-208.