Therapeutic Communication In Nursing

Introduction

Effective communication skills are a vital ability for nursing students to master. Nurses will not be able to successfully establish strong patient relationships without this ability. It will also be harder for students to hold functional conversations with patients. In psychiatric nursing units, communication and understanding is a core quality to have. However, therapeutic communication teachings are not readily accessible for students. Limitations such as patient refusals, decreased length of stay, and the severity of mental illnesses decrease patient contact. Consequently, it is rare for nursing students to have direct interaction with patients, hindering the growth of their communication skills.

Current Methods of Teaching Therapeutic Communication

Currently, there is an insufficient amount of literature available for therapeutic communication. Therefore, it is common for faculty to pass down their knowledge from their own nursing education onto their students. Instructors utilize interpersonal

process recording, a written account of the interplay between a patient and nurse. Process recording allows the student to retrospectively analyze the client interaction in order to learn nonverbal cues and verbal feedback. However, this approach only allows students to identify communication techniques rather than physically practicing them. Process recording depends on memorization and recall, not on the nursing student’s ability to communicate. The documentation of environmental stimuli and patient behavior is not sufficient enough to teach therapeutic communication. As a result, it’s important to resort to other possible methods of teaching: standardized patients.

Standardized Patients: An Enhancement in Nursing Education
In nursing education, the usage of standardized patients is fairly new. Therefore, there is a limited amount of information regarding its effectiveness in nursing programs. However, the idea of implementing more lessons with standardized patients is useful in communication education. A standardized patient an individual who roleplays in a controlled, simulated environment. As a result, students are able to role play as a supplement for their didactic education. Overall, standardized patients allow psychiatric nursing educators to have the ability to recreate various medical scenarios. These events can be constructed to match specific lectures or a particular illness. The experience can be changed by altering the patient’s demographics, mental disorder, and complexity. Instructors are able to expose a range of mental illnesses to students, even in instances of uncertainty and potential hostility. In general, standardized patients are convenient because educators do not have to worry about patient confidentiality, unsafe situations, and a lack of patient consensus.

In addition to standardized patients, peer review is a critical learning strategy used in nursing education. After a clinical simulation, forming into groups can benefit all students. Through constructive criticism, students are able to discuss their strengths and weaknesses allowing them to better prepare for future patient interactions. This method of learning allows individuals to reinforce what they learn in class and execute these interpersonal tactics effectively. Overall, peer review encourages self-reflection, providing students a chance to revise any mistakes with their speech and enhances their authenticity. However, the benefits of standardized patients are not completely understood. Consequently, there must be an effort to evaluate its effectiveness so that this method of teaching can be frequently utilized.

The Standardized Patient Experience Study: Purpose and Methodology
Since the usage of standardized patients in nursing school is fairly new, it’s important to ensure that this method of teaching is efficient.

In order to achieve this, a study was done to determine how effective standardized patients were in a psychiatric clinical setting. A convenience sample was taken by collecting 89 senior nursing students that voluntarily participated ranging from ages 20 to 60. All of the participants were enrolled in the psychiatric nursing clinical course. The standardized patients were collected from theater majors at the university, a local acting group, and retired nurses. Nursing faculty with a minimum of 20 years of experience wrote the scripts for the standardized patients. The standardized patients rehearse and trained with the experienced nurses to simulate a patient with one of the following mental illnesses: depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, and post-traumatic stress

disorder.

To measure the effectiveness of this approach, nursing students were given two standardized patients in a semester. The nursing students in the study were not given prior information regarding the patient and were given access to the recorded session afterwards to review. The first standardized patient was used early in the semester as a benchmark to provide feedback and constructive criticism for students. Faculty members gave feedback according to 14 expectations that were provided before the meeting rated on a scale from 1 (strongly agree) to 5 (strongly disagree). The criteria included eye contact, posture, appropriate responses, and demonstrating therapeutic communication techniques. After the first standardized patient, students are able to reflect upon their mistakes, review the criteria, and practice their therapeutic communication skills before their next assessment. The second standardized patient was used at the end of the semester to grade the quality of the student’s communication skills.