The ability to communicate effectively with patients, their families and colleagues, is a mandatory core skill for all nurses (Nursing and Midwifery Council, 2015). Nursing students are challenged to demonstrate good communication skills from their first patient encounter. The student is expected to maintain effective communication in practice by interacting continually with their patient and his/her family, and staff. Building good communication skills is learned; it is an art and process that takes time to fine tune. In the last decade, patient simulation has been developed as a learning method to simulate real-life interpersonal interactions and relationships (Loth, Andersen, & Mitchell, 2015). Nursing students interact face to face in vivo with actors that mimic real patients, family and staff. In this way, students have a controlled learning environment where instruction is effective in a supporting environment. Students gain meaningful experience to help them perform and hone their communication skills (Arveklev et al., 2018). Another recent approach for patient simulation is to use actors to dramatize real-life situations for students to enhance their action-based learning. The direct impact on students of these simulated acted scenarios is impressive resulting in long-standing learning gains (Arveklev et al. 2015). Additionally, drama offers students an opportunity to try and explore different roles and perspectives (Burton, 2013). Indeed, such theatrical scenarios allow communication skills to be observed by students when they are not within the situation. In this way, they can learn from others on what are more effective methods of communication.
Dramatic performance can play a significant role in the ability of individuals to empathize, understand, identify and have compassion with others (Lightblau, 2014). It enables participants to reflect on their actions (Harman, Ahn, & Bogue, 2016). Critical performative pedagogy (CPP) is a novel multidimensional pedagogy to facilitate dialogue between teachers and students. CPP provides a rehearsal space that encourages active and extensive engagements of the students in the learning process. Such practice promotes students’ awareness of their actions. In this way, students enhance both their personal and academic development in a social environment (Chapell & Cahnmann-Taylor, 2013), which facilitates their comprehension of the power dynamics that shape social interactions (Harman & Zhang, 2015).
Methods:
The undergraduate nursing program at the University of Haifa applies CPP in communication skills practice within a patient simulation framework. For the last 4 years, a sequence of patient simulations (N-11) have been performed in students’ clinical studies. These simulations were designed to accompany clinical learning experience and intentionally, like an echo, to transmit this learning into "communication with a simulated patient". The reflective journals of the students demonstrate the uniqueness of the CPP in succeeding to obtain the desirable learning process - Social and emotional learning (SEL) (CASEL, 2017).
Results:
The outcome of learning demonstrates social and emotional learning (SEL) of the students. That enhances students’ intrapersonal, interpersonal, and cognitive competence in the context of communication skills:
- Self-awareness
- Self-management
- Social-awareness
- Relationship skills
- Responsible decision making
Conclusion:
Due to the positive findings, we will continue to work with the SEL. Our future projects will build on each of the communication skills by developing specific modules. Our plan is to test each module for reliability, and to assess change over time.