A Study On Designing Systemtic Curricula To Improve Probationer Nurses' Clinical Communication Ability

Objectives:The purpose of this study was to design systematic curricula to improveprobationer nurses'clinical communication ability.Methods:1. We used a questionnaire designed by FangYu Yang to assess probationernurses'clinical communication ability after they practiced for 3-5 months (n=341).And a self-administered questionnaire was used among probationer nurses (n=341)and clinical nurse instructors (n=39) to analyse how probationer nurses'communicated with patients, what're the reasons of probationer nurses'clinicalcommunication problems, and how to resolve them.2. A questionnaire based on the tentative project of curricula was designed andused among college teachers (n=13), clinical nurse specialists (n=16), and clinicalnurse instructors (n=32). So, by Delphi method, we determined the curricula as"systemtic curricula based on clinical context to train probationer nurses'communication ability".4. By stratified random sampling, 83 probationer nurses were sampled randomlyfrom 445 probationer nurses, and were divided randomly into intervention group(n=40) and control group (n=43). Except traditional clinical instruction, theintervention group was trained by curricula to improve communication skills. Thequestionnaire of probationer nurses'clinical communication ability was used toevaluate two groups'communication skills pre and post curricula. A questionnaire ofprocesses of curricula was used among intervention group. ResultsResults:1. Probationer nurses'clinical communication ability was 3.45 (5 likert). Thedifferences of clinical communication ability among different educationalbackgrounds probationer nurses weren't significant(P＞0.05), the differences ofdifferent learning experiences were so too.2. Clinical nurse instructors thought there were 5 problems duiring probationernurses'communicating with patients, such as the lack of communication skills,diffidence, little professional knowledge and poor professional skills. The traditionalclinical instruction couldn't meet well the needs to improve probationer nurses'clinical communication ability. There were differences between clinical instruction'sreality and expectation (P＜0.05).The special training of probationer nurses'clinicalcommunication ability didn't fulfill its promise. We got 93 clinical communicationevents. 122 probationer nurses and 24 Clinical nurse instructors gave somesuggestions about how to train probationer nurses'communication ablity.3. Curricula were designed by Delphi method. Experts of this study hadsatisfying representativeness and authority. Experts had high opinions of the tentativeproject of curricula. Curricula got experts'high consistent evaluation, 20 experts gaveadvices on designing of curricula.4. The curricula based on clinical context could improve probationer nurses'communication skills. The differences of clinical communication ability betweenintervention and control groups weren't significant pre-training (P＞0.05). Theintervention group's communication skills were improved post-training (P＜0.01).The intervention group had more communication skills than the control group aftertraining(P＜0.01). There were positive correlations between attendances of classesand communication skills. The differences of clinical communication ability betweendifferent education backgrounds probationer nurses weren't significant (P＞0.05). Probationer nurses approved the processes of curricula; the processes got 3.60-4.51 (5likert). Probationer nurses also gave some advices on how to improve the curricula.Conclusions:1. Probationer nurses'clinical communication ability was unsatisfying.Probationer nurses with different educational backgrounds and different learningexperiences could be unified trained.2. There were some problems when probationer nurses communicated withpatients, such as the lack of communication skills, diffidence, little professionalknowledge and poor professional skills. The training of probationer nurses'clinicalcommunication ability should be reformed and enforced. The communication eventsand suggestions we collected helped us design the curricula.3. Experts had high opinions of the tentative project of curricula, 20 experts gaveadvices on designing of curricula. According to these results, we determined threeeprinciples to design the curricula, such as useful, problem directing, and systematic.Acoording to Constructism, the curricula would use Action Learning and ProblemBased Learning to train probationer nurses. We designed six curricula, such as: Howto communicate with just admitted patients, How to communicate with patients whendosing, How to communicate with patients when un-dose mursing, How tocommunicate with pre-and post-operation patients, How to communication withleaving patients, and How to communication with special patients.The content ofeach curriculum would consist of: Informations to communicate, Professionalknowledge, Communication skills, Coping communication barriers, and How toidentify and cope patients'mental states. Teaching steps would consist of: Games (5mins), Presitation (10 mins), Watching videos(15 mins), Group discussion(25 mins),Sharing group's summary with the class(15 mins), and Feedback of instructor(15mins). we determined the curricula as"systematic curricula based on clinical context totrain probationer nurses'clinical communication ability".4. The results of this study showed that curricula based on clinical context couldimprove probationer nurses'clinical communication ability. The processes ofcurricula got high acceptance of probationer nurses.5. The curricula also had some defects and should be improved.