An evaluation of a communication skills course for health visitor students

Differences in the perception of seven behaviour-modifying techniques in paediatric dentistry by undergraduate students using lecturing and video sequences for teaching

Whilst preparing undergraduate students for a clinical course in paediatric dentistry, four consecutive classes (n = 107) were divided into two groups. Seven behaviour-modifying techniques were introduced: systematic desensitization, operant conditioning, modelling, Tell, Show, Do-principle, substitution, change of roles and the active involvement of the patient. The behaviour-modifying techniques that had been taught to group one (n = 57) through lecturing were taught to group two (n = 50) through video sequences and vice versa in the following semester. Immediately after the presentations, students were asked by means of a questionnaire about their perceptions of ease of using the different techniques and their intention for clinical application of each technique. After completion of the clinical course, they were asked about which behaviour-modifying techniques they had actually used when dealing with patients. Concerning the perception of ease of using the different techniques, there were considerable differences for six of the seven techniques (P < 0.05). Whilst some techniques seemed more difficult to apply clinically after lecturing, others seemed more difficult after video-based teaching. Concerning the intention for clinical application and the actual clinical application, there were higher percentages for all techniques taught after video-based teaching. However, the differences were significant only for two techniques in each case (P < 0.05). It is concluded that the use of video based teaching enhances the intention for application and the actual clinical application only for a limited number of behaviour-modifying techniques.

Self-reported changes in clinical behaviour by undergraduate dental students after video-based teaching in paediatric dentistry

Four cohorts of undergraduate students (n = 113) were filmed on video tapes whilst performing paediatric treatments. Selected parts of these tapes were shown the day after. Thus, within one term each student was able to view his performance on a videotape as well as those of fellow students. After completion of the clinical course in paediatric dentistry students were asked by means of a questionnaire about behavioural changes in their clinical work regarding different topics. Considerable changes in behaviour were reported for various topics. Most of the students emphasised the viable role of the video for changing their behaviour. This was especially true for aspects of verbal and non-verbal communication where mainly female students benefited. Moreover, video was thought to have been useful for improving capacities to deal with patients in fear or pain and for ergonomics. About two-thirds of the students (64.6%) thought that watching the video had made it easier for them to put theoretical knowledge into action. Video does not seem to play an important role for confirmation and maintenance of behaviour patterns. In conclusion however, it can be stated that video has a high impact on the modification of behaviour patterns of undergraduate students for many aspects of clinical work. The use of video can thus attribute to dental education in an effective way.

A patient-centred approach to defining and assessing interviewing competency

The inclusion of communication skills as a core competency in health care curricula, has led to the need to define adequacy in this area. Developments in the field of interview analysis have meant that robust and objective ways of assessing interview behaviours are now available; however, these systems in themselves do not provide a model for assessing competency. As adequacy in interviewing is contextually driven, this paper discusses the potential of using patient centeredness to address the issue. It suggests two ways in which patient centeredness may be operationally defined, permitting data available from current rating systems, and from a new system shortly to be available, to be used to assess interviewing competency.

Nurses' communication skills: an evaluation of the impact of solution-focused communication training

AIMS

This paper describes the evaluation of a short training course in solution-focused brief therapy (SFBT) skills. This evaluation examined the relevance of SFBT skills to nursing and the extent to which a short training course affected nurses' communication skills.

BACKGROUND

Nurses' communication skills have been criticized for many years, as has the training in communication skills that nurses receive. The absence of a coherent theoretical or practical framework for communication skills training led us to consider the utility of SFBT as a framework for a short training course for qualified nurses, the majority of them are registered nurses working with adults.

DESIGN AND METHODS

Quantitative and qualitative data were collected: the former using pre- and post-training scales, the latter using a focus group conducted 6 months after the training. Data were analysed using the Wilcoxon signed-rank test and content analysis.

RESULTS AND FINDINGS

Quantitative data indicated positive changes in nurses' practice following the training on four dimensions, and changes in nurses' willingness to communicate with people who are troubled reached levels of significance. Qualitative data uncovered changes to practice, centred on the rejection of problem-orientated discourses and reduced feelings of inadequacy and emotional stress in the nurses.

CONCLUSIONS

There are indications that SFBT techniques may be relevant to nursing and a useful, cost-effective approach to the training of communication skills. Solution focused brief therapy provides a framework and easily understood tool-kit that are harmonious with nursing values.

"What should I say?": qualitative findings on dilemmas in palliative care nursing

The nursing literature suggests that talking and listening to patients about issues associated with death and dying, is both important and difficult, and may be improved with training. This discussion presents the results of recent nursing research to confirm, and elaborate on, this theme. In this research participants touched on many central issues in communicating with patients that included articulating a sense of discomfort and inadequacy about the whole process, detailing the innumerable blocks to open communication [e.g., interference, denial, unrealistic optimism, resistance, collusion and anger] and sharing their sense of success and failure. The insights of nurses who participated in this research testify to the ongoing need to prioritize the development of nursing skills and support in this challenging but important area.

Student nurses perceptions of their interpersonal skills: a re-examination of Burnard and Morrison's findings

Heron's six category intervention analysis is a component of many counselling courses and is used extensively by teachers of interpersonal skills within nursing curricula. The popularity of this framework has generated a number of studies which have attempted to offer empirical support for the theory. The aim of this study was to re-evaluate some of these findings. Utilising an earlier research instrument, a set of findings are offered and comparisons made with previous work. Our findings suggest that student nurses perceive themselves to be most skilled in the use of supportive, prescriptive and cathartic interventions and least skilled in the use of informative, catalytic and confronting interventions. A discussion of the new findings and their implications is offered.

The Impact of Counselling Skills Training on the Interpersonal Skills of Undergraduate Occupational Therapy Students

A considerable emphasis has been placed on the role of social and communication skills within the health care professions. As a result, many pre-registration education and training courses now include counselling skills modules, on the basis that these will ultimately enhance a range of interpersonal skills within clinical practice. In order to test this assumption, a study was carried out to assess whether completion of counselling skills assignments had an impact upon a range of interpersonal skills in occupational therapy.

Using 36 first-year undergraduate occupational therapy students, the study investigated two related hypotheses. The first hypothesis compared the interpersonal skills performance on placement between those students who had completed the counselling skins assignment and those students who had completed an alternative. An unrelated t-test produced a non-significant result (t = 1.386, df = 34, p>0.05), which suggested that undertaking a counselling skills assignment had no effect on social skills. The second hypothesis was concerned with the relationship between interpersonal performance and the grade obtained for the counselling assignment. A Pearson's product moment correlation was carried out which also produced a non-significant result (r = 0.008, df = 34, p>0.05). This suggested that no relationship existed between performance on the counselling skills module and interpersonal skills in the clinical domain.

These results challenge existing assumptions about the value of including counselling skills modules within pre-registration occupational therapy courses, and highlight the need to seek more effective alternatives for enhancing essential interpersonal skills.

Role of questioning skills in patient assessment

This article is a critical analysis of the literature on patient assessment, nurses' questioning skills and effective methods of teaching questioning skills. Current practice and rituals are highlighted and recommendations regarding the search for excellence are included.

A selective review of the literature on nurse-patient communication: has the patient's contribution been neglected?

The literature on nurse-patient communication is selectively reviewed. Previous research has been critical of the quality and quantity of nurse-patient communication, describing it as brief and superficial. Nurses are depicted as controlling and restricting the course and topics of conversations with patients. Communication skills training for nurses has been advocated as a solution for this apparent deficit. In this paper it is argued that research has over-emphasized nurses' roles in nurse-patient communication, particularly their communication skills. The patients' contribution to the content and organization skills. The patients' contribution to the content and organization of nurse-patient communication has been largely ignored. Assumptions have been made about nurses' and patients' intentions and motives during nurse-patient conversations, but the participants, particularly patients, are rarely asked for their views. There has been a tendency to view nurse-patient communication in terms of isolated excerpts of conversation. When environmental and organizational factors are included, it is their effect on nurses' communication capability, not the patients', that are the interest. It is suggested that future research consider both patients' and nurses' contributions to nurse-patient communication.

Interpersonal skills training in nurse education: some theoretical and curricular considerations

Interpersonal skills training continues to be an important, but ill-defined aspect of nurse education. The author explores some theoretical and curricular issues that need to be considered when designing interpersonal skills training. He argues that Beattie's fourfold curriculum can be used to integrate the often opposing theoretical and educational frameworks used. The need for concept clarification and development to underpin this training is highlighted, within the context of the complex political and organisational factors that influence its process and outcome.