Background: Nurses must be able to effectively communicate information to other members of the healthcare team. Between 33% and 72.6% of nurses experience bullying in their work environment (Berry, Gillespie, Gates, & Schafer, 2012; Laschinger, Grau, Finegan, & Wilk, 2010). Bullying and incivility can negatively impact a nurse’s ability to communicate vital information to other team members. The Joint Commission reports that a root cause of the majority of sentinel events involve communication (Joint Commission, 2015). There have been several initiatives aimed at improving communication between healthcare team members, but these programs are aimed at practitioners, not students. Nursing students have limited opportunities to practice communication with healthcare providers. Students are often exposed to incivility and bullying in clinical settings, but often do not report or seek help in dealing with these challenges (Anthony, Yastik, MacDonald, & Marshall, 2014). Schools of nursing teach students to report findings using Situation Background Assessment Recommendation (SBAR) and Concerned Uncomfortable Safety (CUS) from Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS™). However, these skills are not always reinforced in the clinical setting. Learned communication skills are more difficult to implement when confronted with incivility or bullying,
Researchers have reported that when people are faced with incivility or bullying the victims have increased anxiety levels (Einarsen, Hoel, Zapf, & Cooper, 2011). Nursing students are particularly vulnerable to increased levels of anxiety when faced with incivility or bullying. These negative behaviors can cause students to doubt their ability to function as a student nurse, decreasing their self-efficacy and damaging the learning environment.
Nursing students that have the opportunity to practice skills in simulation have decreased anxiety and increased self-efficacy in those skills (Megel et al., 2012). This suggests that a simulation scenario in which students can practice communication skills in dealing with incivility and bullying in the workplace could alleviate some anxiety and increase self-efficacy in their communication skills when exposed to these situations as a registered nurse.
Methods:
Participants will be recruited from undergraduate nursing students who are enrolled in a baccalaureate nursing program in the Southeastern United States. Institutional Review Board approval will be obtained from the University. Subjects will be given a pre-test survey that will include demographic information, the State Trait Anxiety Instrument (STAI), and the General Self Efficacy scale (GSE). All students will complete an online module on communicating with difficult people. All students will complete a simulated nursing scenario that includes bullying behavior, with debriefing. Research participants will repeat the STAI and the GSE after the simulation activity. Data will be analyzed using SPSS, using a t-test analysis to compare mean values between pre and post testing.
Purpose:
The purpose of this intervention study is to evaluate how an education session and simulation practice experience on difficult communication impacts students’ anxiety and self-efficacy. The hypothesis underpinning this study is that learning strategies to deal with difficult communication and practice of these skills will decrease student’s anxiety about communication and increase their self-efficacy when faced with incivility and bullying.