Elsevier

Nurse Education Today

Volume 94, November 2020, 104565
Nurse Education Today

Health care students' perceptions about learning of affective interpersonal communication competence in interprofessional simulations

https://doi.org/10.1016/j.nedt.2020.104565Get rights and content

Abstract

Background

Health professionals need interpersonal communication competence (ICC) in their work with patients and other professionals. Interprofessional simulation provides health care students with an opportunity to practice communication skills in a safe and authentic environment.

Objective

The purpose of this study was to describe the perceptions of health care students of interprofessional simulations in acquiring affective interpersonal communication competence (AICC).

Design

This study was conducted using the quantitative descriptive research method.

Settings

The data were collected from health care students participating in interprofessional simulations at a university of applied sciences in Finland using a questionnaire titled Student questionnaire on a multiprofessional simulation exercise. The health care students included nursing, physical therapy and practical nursing students.

Participants

This study was participated by 149 health care students with a response rate of 41.2%.

Methods

The quantitative data were analysed using the SPSS 24.0 for Windows statistical software. Frequencies, percentages, averages, and standard deviation were used to describe the data. Two mean sum variables were formed using factor analysis from the variables describing AICC.

Results

The students' perceptions of learning AICC (attitude, motivation, emotions) in interprofessional simulations were largely positive; for example, the simulations reduced prejudice against, and increased appreciation of, other occupational groups. Even though the interprofessional simulations were sometimes perceived as stressful, stress could also be a positive source of learning and effectively fostered personal understanding of others in a team.

Conclusion

Interprofessional simulations increased knowledge of the activities of other professional groups for students in different fields of education. This encourages them to work together after completing their education and entering the workforce. Knowledge of the simulation process and the creating a safe learning environment also promoted students' AICC.

Introduction

In health care, interactions and communications must run smoothly between patients and staff as well as within interprofessional teams. Health professionals need communication and listening skills to communicate professionally in a variety of situations involving teamwork, leadership, problem solving and guidance (INACSL, 2016; Reeves et al., 2016; Labrague et al., 2018a). When communication also involves individuals' feelings and attitudes, we talk about interpersonal communication competence (ICC), an ability to communicate and interact with other people (Spitzberg and Cupach, 2011).

ICC is a key area of health care education, as solving an increasingly complicated range of patients' situations requires the expertise and work input of a number of professional groups (Roberts and Goodhand, 2018). ICC consists of cognitive, psychomotor and affective competence. Cognitive interpersonal communication competence includes knowledge of communication and interaction as well as the content of effective and appropriate interactions. Cognitive interpersonal communication competence also includes an understanding of oneself as a communicator and one's personal strengths and needs for development in interpersonal communications. Psychomotor interpersonal communication competence refers to the regulation of effective interaction behaviours appropriate to each context and situation, including the constant anticipation and evaluation of one's own communication competence (Spitzberg and Cupach, 2011).

Affective interpersonal communication competence (AICC) describes an individual's motivation for interaction and includes emotions and a positive attitude towards interactions. Motivation guides an individual's activities in a social context and essentially involves a desire to communicate. Moreover, AICC also includes the negative qualities of interaction, such as anxiety, fear, and potential deficiencies in communicating smoothly and understandably (Spitzberg and Cupach, 2011). In real life contexts, distinguishing different areas of communication from one another is difficult; instead, these are intertwined to form the person's communication capacity as a whole. The skills that this capacity includes are learned by practicing interaction and communications in different social situations and contexts. Moreover, practising interpersonal communication further increases a person's interest in learning, therefore forming a positive personal learning cycle (Yoo and Chae, 2011; Yoo and Park, 2015).

Simulation-based training provides an opportunity for practising interaction in general and enhancing specific areas of ICC. This is possible because, as an authentic learning method, simulation mimics health communication situations and skills in a natural way (Labrague et al., 2018b). Interprofessional simulations provide a safe context for practicing real-life nursing situations, often mimicking complex and unpredictable collaboration in health care environments nearly identically to their real-life counterparts (Defenbaugh and Chikotas, 2016; Roberts and Goodhand, 2018). A positive atmosphere during the simulation exercise promotes the learning of ICC (Thomas et al., 2014) and fosters health care students' capabilities to communicate with patients and in teams with other health professionals (Koo et al., 2014).

Simulation-based training positively influences students' attitudes towards ICC (Murphy and Nimmagadda, 2015; Chambers et al., 2018) as it increases students' confidence (Liaw et al., 2014; Andrea and Kotowski, 2017) and reduces their anxiety (Reid Searl et al., 2014). A positive attitude towards, and personal interest in, co-operation also increases students' learning opportunities (Andrea and Kotowski, 2017) and facilitates practising challenging nursing situations (Defenbaugh and Chikotas, 2016). In particular, interprofessional simulation effectively promotes mutual appreciation between professional groups (Reising et al., 2011; Koo et al., 2014) and a positive attitude towards other professions (Bolesta and Chmil, 2014; Tofil et al., 2014). These, in turn, strengthen students' own professional roles (Bolesta and Chmil, 2014) and increase their confidence in collaborating with others (Koo et al., 2014).

However, some may find practicing ICC in simulations more stressful compared to traditional teaching as simulations strongly resemble real-life situations where decisions often have to be made and actions taken quickly (Reising et al., 2011). On the other hand, students have felt that the different feelings emerging during simulations increase their self-awareness and stress management. This, in turn, promotes their ability to work in challenging situations (Jakobsen et al., 2018) and fosters tolerance of work-related pressures (Selim et al., 2012; Goodwin et al., 2019).

This study involved health care students practising interactive learning in interprofessional simulations carried out at a Finnish university of applied sciences. It has been recognized that arranging facilities suitable for learning in a simulation, providing sufficient time and prior knowledge of the simulation, and designing a simulation-based learning situation are important factors in ensuring the success of simulation learning experience (Koo et al., 2014). Other factors include careful planning of briefing the students on the interprofessional simulation and a related learning discussion (Paige et al., 2019), feedback provided by the facilitator, and reflecting on what happened during the simulation with others in a debriefing session (Griffiths, 2018). The study examined the development of health care students' cognitive, psychomotor and affective interpersonal communication competence in interprofessional simulations. This article reports on the learning perceptions of health care students related to AICC acquired in a simulation.

Section snippets

Aims

The purpose of this study was to describe the perceptions of health care students of interprofessional simulations used for acquiring AICC. The research questions were as follows:

  • 1.

    How did health care students perceive the learning of AICC in interprofessional simulations?

  • 2.

    How did the background variables of health care students relate to the learning of AICC in interprofessional simulations?

Setting and data

The research material was collected from health care students, who participated in the interprofessional simulations in the period 2016–2017. These simulations were organised in collaboration by a Finnish university, a university of applied sciences and a vocational education and training provider (VET). The purpose was to enable the health care students in these institutions to practise their interprofessional co-operation competence, including ICC. Data were collected from the health care

Demographics

In total, 149 nursing, physical therapy and practical nursing students participated in the study with a response rate of 41.2%. The youngest respondent was 18 and the oldest 54 years old. The majority of the respondents (92.6%) were female. 78.5% of the respondents studied in a university of applied sciences and 21.5% in a vocational education and training institution. Around 90% of the respondents were third-year students, and 59% had previous experience of working in the social and health

Discussion

The health care students had primarily positive perceptions of learning AICC (attitude, motivation, emotions) in an interprofessional simulation. The simulations reduced prejudice against other professional groups and increased respect for other professional groups. A positive experience will also encourage people to keep working together after the training, which is also supported by previous studies (Reising et al., 2011; Bolesta and Chmil, 2014; Koo et al., 2014; Tofil et al., 2014).

However,

Conclusions

The following conclusions can be made based on the results:

  • 1.

    The health care students had primarily positive perceptions of learning AICC (attitude, motivation, emotions) in interprofessional simulations, which reduced the students' preconceptions and increased their respect for other professional groups.

  • 2.

    The interprofessional simulations raised awareness of the activities by other professional groups among students representing different fields of education, which encourages them to also continue

Funding

No external funding.

Declaration of competing interest

No conflict of interest.

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