Learning Environment Project: Communication Skills within a New Nurse Workshop

1. Learning Environment Project:Communication Skills within a New Nurse Workshop Jimmy Hall University of West Georgia NURS 9003

2. Introduction • Effective communication is an essential element of patient-centered care and has a positive impact on patient satisfaction and compliance to treatment and management of disease. (Levinson, Lesser & Epstein, 2010). • Levinson et al. believed that through successful communication methods, the patient will take on a greater autonomy and responsibility in self-care and will build a greater trust with the healthcare team (2010). • Incorporating a communication skills learning environment into the New Nurse Workshop should facilitate the new nurses’ sense of autonomy and desire to meet patient needs.

3. Purpose • The focus of this learning environment project is to prepare new nurses who will be able to provide better patient care by effective communication with patients and the healthcare team.

4. Problems • Utilizing the most appropriate teaching methods is critical when planning educational activities to ensure that the learner truly learns the materials presented. • Nursing education courses traditionally depend on rote learning, the memorization of material, and nursing students did not participate in active learning tasks. • The use of research-based teaching methods, such as problem-based learning (PBL), in the communication learning module will enhance critical thinking skills as it involves discussions, answering questions, peer review and feedback (Magnussen, Ishida and Itano, 2000).

5. Communication Board • The facilities participating in the New Nurse Workshop have adopted the use of communication boards that will serve as an aid in teaching communication skills in this program. • By incorporating research-based activities into the learning environment, the learners should be able to actively learn by performing simulation activities, answering questions, and peer review and critical feedback (Magnussen, Ishida and Itano, 2000).

6. Learning Theory • The methods used in this learning environment project closely follow the assumptions set forth by Knowles (1990): • Need to know • Learner self-concept • Prior experience • Readiness to learn • Orientation to learning • Motivation to learn

7. Andragogy • The andragogical model plays a huge role in individual learning styles as it intertwines with every aspect of daily living. • The learner must be motivated and have a strong desire to learn in order for the teaching to be effective. • As identified by Knowles (1990), learners must understand why the information is important for them to know. This is shared with them in the didactic portion of the learning module. • The learners may not be able to perform the tasks assigned initially, but by learning the information and actively performing the task of communication, the learner should grow independent and be self-directed, completing the learner self-concept component.

8. Research-based Activity #1 • Didactic / Metacognition • A didactic component will present the key components of communication and how they are to be incorporated on the communication board. • The communication board will be displayed. • Participants will be informed of the importance of each component and given instructions for communicating utilizing the board.

9. Research-based Activity #2 • Role Play / Transfer of Learning • Competent individuals will demonstrate how to properly communicate using the board. • Demonstrations will include the use of the communication board to communicate with patients as well as their peers during hand-off communication.

10. Research-based Activity #3 • Role Play / Problem-based Learning • The students will practice what was shown to them by communicating to patients and peers within various scenarios in front of a faculty member. • Each student will be provided a different patient scenario and will be expected to • Communicate all components from the board, including medication actions and side effects, fall risk and others. • Communicate effectively to a peer as they hand-off report. • Embody each person – the nurse communicating, the patient, and the peer receiving the communication.

11. Research-based Activity #4 • Reflection / Metacognition • The final learning activity will include critical reflection and peer feedback to evaluate communication skills using the communication board. • The student will have an opportunity for revision and to repeat a scenario if found to be unsuccessful or if he or she felt additional practice was needed.

12. Metacognition • Metacognition encompasses many aspects, including goal setting and methods of learning, and, if utilized appropriately, can improve the transfer of knowledge (Ramocki, 2007). • Various studies have been conducted to validate the effectiveness of incorporating various teaching methods into educational offerings to meet the needs of most students (Cromley, 2000; Curry, 1990; Stahl, 2002). • Although attempting to cater to the needs of student learning preferences is a common practice, these studies found that adjusting teaching styles to accommodate various learning styles has shown little impact on increasing knowledge gained. • Attempting to meet the learning preferences of students can limit student adaptability and may have a negative impact on learning. • Cromley (2000) found that skills need to be taught in the way they will be used.

13. Transfer of Learning • According to Lauder, Reynolds, & Angus (1999), the transfer of knowledge is essential in nursing practice. • Braunack-Meyer (2001) found through a qualitative study that the use of reasoning, based on previous experiences, assisted in the decision-making practices of practitioners. • Those who were able to practice in the simulated scenario were better prepared to transfer their knowledge to real-life situations (Issenburg, Mcgaghie, Petrusa, Gordon, & Scalese, 2005).

14. Problem-Based Learning • Active learning methods, such as PBL, resulted in greater improvements on the critical thinking skills(Magnussen, Ishida, and Itano, 2000; Jones, 2008). • Magnussen et al. shared that the use of PBL learning increases knowledge and improves problems solving by using an “inquisitive style of learning rather than rote knowledge” (2000, p. 360). • In a study conducted by Jones (2008), it was found that in a sample size of 60 students in PBL learning environments increased critical thinking skills versus those in a control group.

15. Summary • Research-based strategies were implemented in the learning environment to ensure that newly hired nurses are competent in communicating effectively with patients and peers. • If newly hired nurses are not able to identify and communicate important information effectively, they will not be successful in the transition to the bedside role. • Incorporating various research-based teaching strategies, such as metacognition, transfer of learning, and problem-based learning, on communication in a Workshop for New Nurses, should enhance communication skills and should result in improved patient care and satisfaction.

16. References • Braunack-Mayer, A. (2001). What makes a problem an ethical problem? An empirical perspective on the nature of ethical problems in general practice. Journal of Medical Ethics, 27(2), 98. • Christmas. K. (2008). How work environment impacts retention. Nursing Economics, 26(5), 316-318. • Cromley, J. (2000). Learning to think: Learning to learn. Washington, DC: National Institute for Literacy • Curry, L. (1990). One critique of the research on learning styles. Educational Leadership, 48, 50-56. • Department of Health (2010) Preceptorship Framework for Newly Registered Nurses, Midwives and Allied Health Professionals. Retrieved on February 7, 2013 from https://www.goshgold.org/resources/forms/forms/Preceptorship%20framework%202010.pdf • Duchscher, J. (2001). Out in the real world: newly graduated nurses in acute-care speak out. Journal of Nursing Administration, 31(9), 426-439. • Hippeli, F. (2009) Nursing: Does it still eat its young, or have we progressed beyond this? Nursing Forum, 44(3), 186-188. • IOM (Institute of Medicine) (2010). A Summary of the October 2009 forum on the Future of Nursing: Acute Care. The National Academies Press, Washington, DC. • Issenberg, S., Mcgaghie, W. C., Petrusa, E. R., Gordon, D., & Scalese, R. J. (2005). Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Medical Teacher, 27(1), 10-28. • Jones, M. (2008). Developing clinically savvy nursing students: An evalua­tion of problem-based learning in an associate degree program. Nursing Education Perspectives, 29, 278-283. • Knowles, M. (1990). The adult learner. A neglected species, 4thEdition. Houston: Gulf Publishing. • Lauder, J., Reynolds, W., & Angus, N. (1999). Transfer of knowledge and skills: Some implications for nursing and nurse education. Nurse Education Today. 19, 480 – 487. • Levinson, W., Lesser, C., & Epstein, R. (2010). Developing physician communication skills for patient-centered care. Health Affairs, 29(7), 1310-1318. • Magnussen, L., Ishida, D., & Itano, J. (2000). The impact of the use of inquiry-based learning as a teaching methodology on the development of critical thinking. Journal Of Nursing Education, 39(8), 360-364. • Ramocki, S.P. (2007). Metacognition and transfer: Keys to improving marketing education. Journal of Marketing Education, 29(1), 18 – 24. • Rassool, G., & Rawaf, S. (2007). Learning style preferences of undergraduate nursing students. Nursing Standard, 21(32), 35-41. • Romyn, D., Linton, N., Giblin, C., Hendrickson, B., Limacher, L., Murray, C., & Zimmel, C. (2009). Successful transition of the new graduate nurse. International Journal of Nursing Education Scholarship, 6(1). • Stahl, S. A. (2002). Different strokes for different folks? In L. Abbedutto (Ed.), Taking sides: Clashing on controversial issues in educational psychology (pp. 98-107). Guilford, CT: McGraw-Hill. • Thorndike, E.L. & Woodworth, R.S. (1901). The influence of improvement in one mental function upon the efficiency of other function: (I). Psychological Review, 8, 247 – 261.