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Strategy Submission

Building Student Confidence in Clinical Communication with SBAR and Conversation Scripts

Author:

Cari Granier

MSN, RN

Title:

Instructor of Nursing

Coauthors:

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Institution:

Nicholls State University

Email:

cari.granier@nicholls.edu

Competency Categories:

Patient-Centered Care, Safety, Teamwork and Collaboration

Learner Level(s):

Pre-Licensure BSN

Learner Setting(s):

Clinical Setting, Skills or Simulation Laboratories

Strategy Type:

General Strategy

Learning Objectives:

Patient-Centered Care: 1. The student will assess their own level of communication skills in encounters with patients, families, and healthcare staff. 2. The student will utilize the conversation script to apply principles of effective communication in the clinical setting. 3. The student will communicate care provided and needed at each transition in care using the SBAR method. 4. The student will identify ways to improve their own communication skills. Teamwork and Collaboration: 1. Students will verbalize risks associated with handoffs among providers and across transitions in care. 2. The student will use communication strategies to function competently within their own scope of practice as a member of the intra- and inter-professional team. 3. Students will adapt their own style of communication to meet the needs of the team and situation. 4. Students will utilize SBAR to minimize risks associated with handoffs among providers and across transitions in care. Safety: 1. Students will verbalize communication strategies that create a culture of safety. 2. Students will use SBAR to communicate observations or concerns related to hazards and errors to patients, families, and the health care team.

Strategy Overview:

During clinical rotations, nursing students communicate with patients, visitors, faculty, and members of the interdisciplinary health care team. While effective communication leads to better outcomes and quality of care, ineffective communication among care providers is a major factor in medication errors, delayed treatments, injury, and mortality. Because of this correlation, it is crucial that nursing students are trained to communicate effectively and feel confident in their communication abilities. Nursing faculty can help students strengthen communication skills by encouraging the use of the situation-background-assessment-recommendation (SBAR) technique and providing students with a communication script resource. Students were given a template to help guide their SBAR conversations for the beginning of shift and end of shift reports (see attached template). This template was designed to help students communicate the most important details of their assigned patient’s diagnosis along with any concerns to their peers, instructor, and assigned nurse. The conversation script includes questions geared towards initiating and maintaining conversations with patients and their families (see attached script). Students were then instructed to provide follow-up questions and/or comments that express an interest in the patient’s life, hobbies, or preferences with a goal of moving the conversation beyond patient care and medical needs to create meaningful bonds and build trust with patients and visitors. It is important for students to reflect on their current communication abilities and identify strengths and areas for improvement. The following four questions can be used to guide students through self-reflection about their own communication abilities prior to and after interventions. How often do you feel confident communicating with patients one-on-one? How often do you feel confident communicating with a patient when family is present? How often do you feel confident communicating with your assigned patient’s nurse? And, how often do you feel confident communicating with your clinical faculty? Students should answer using a Likert scale with the following response options: never confident, rarely confident, often confident, and always confident.

Additional Materials:

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Evaluation Description:

Prior to beginning their second clinical rotation, 17 baccalaureate clinical nursing students utilized the self-reflection resource questions (see attached reflection resource) to report their perceived confidence levels in their own clinical communication abilities. Afterwards, students reviewed the SBAR technique and conversation script with their clinical faculty and practiced in simulation labs. Students were encouraged to use these skills during their clinical rotation. At the end of the rotation, students once again reported their perceived confidence levels using the same self-reflection questions. Overall, students reported an increased confidence with clinical communication. When communicating with patients, there was a 29.4% increase in students reporting always feeling confident, a 29.4% increase with patient communication when family was present, a 41.2% increase when communicating with nurses, and a 17.7% increase with assigned course faculty. Faculty utilizing this resource reported easy implementation with observed improvement in student clinical communication.
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