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American Journal of Critical Care. 2008;17: 364-372
Copyright © 2008 by the American Association of Critical-Care Nurses.
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Patient Communication Simulation Laboratory for Students in an Acute Care Nurse Practitioner Program

By Margaret Rosenzweig, PhD, APN-BC, AOCNP, Marilyn Hravnak, PhD, APN-BC, Kathy Magdic, MSN, APN-BC, Michael Beach, MSN, APN-BC, Maurice Clifton, MD, MSEd and Robert Arnold, MD. Margaret Rosenzweig is an assistant professor, Marilyn Hravnak is an associate professor, Kathy Magdic is an instructor and the director, and Michael Beach is an instructor in the Acute Care Nurse Practitioner Program, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania. Maurice Clifton is associate dean for admissions and student affairs with the Mercer University School of Medicine in Macon, Georgia. Robert Arnold is the Leo H. Criep Chair in Patient Care, a professor of medicine, and chief, Section of Palliative Care and Medical Ethics, at the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Corresponding author: Margaret Rosenzweig, PhD, APN-BC, AOCNP, University of Pittsburgh School of Nursing, Rm 329-A, Victoria Bldg, Pittsburgh, PA 15261 (e-mail: mros{at}pitt.edu).

Background Effective communication skills for clinical practice are essential for all advanced practice nurses. However, competence in these skills is not necessarily intuitive. Advanced communication skills should be taught in a way that is similar to the way other psychomotor skills in advanced nursing practice programs are taught.

Objectives To develop a patient communication simulation laboratory for the acute care nurse practitioner program at a major university and to evaluate students’ perceived confidence and communication effectiveness before and immediately as well as 4 months after completion of the laboratory.

Methods The communication simulation laboratory was developed in collaboration with faculty from the schools of nursing and medicine. Students participated in a didactic session and then completed a 2-hour communication simulation in the laboratory. Content and simulation concentrated on breaking "bad news," empathetic communication, motivational interviewing, and the "angry" patient. Students’ self-reported confidence and perceived skill in communication were measured via a Likert scale before, immediately after, and 4 months after completion of the laboratory simulation. Students also evaluated the experience by responding to open-ended questions.

Results Compared with baseline findings (before the lecture and simulation), students’ confidence in initiating difficult conversations increased significantly both immediately (P<.001) and 4 months after (P=.001) the laboratory simulation. Students’ self-ratings of overall ability to communicate were also significantly greater immediately (P<.001) and 4 months (P=.001) after the simulation. Overall, students rated the laboratory simulation experience highly beneficial.

Conclusions The content and methods used for the simulation improved students’ confidence and perceived skill in communication in potentially difficult acute care situations.


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Copyright © 2008 by the American Association of Critical-Care Nurses.