Undergraduate nursing students’ team communication skills within a simulated emergency setting : a grounded theory study
- Authors: Bourke, Sharon
- Date: 2022
- Type: Text , Thesis , PhD
- Full Text:
- Description: Recognising and managing clinical deterioration is considered a high priority in health care with ineffective communication being a significant contributing factor to poor clinical outcomes for patients. Nurses are in a unique position to make a difference in influencing improvements in team communication. In Australia, nurse education has become more complicated and demanding with nursing students focus on behaviour skills, such as communication, becoming more difficult in a saturated curriculum. Simulation-based education has provided an experiential way to learn these complex skills. Although there has been much work in the healthcare literature on clinical teamwork, including communication and its intersection with patient safety, there is still a gap in explaining how individuals within the team contribute to communication. The purpose of this study was to explore and explain how nursing students communicate in simulated emergency settings and how factors, such as culture, language, gender, age and power, affect nursing students’ team communication. This study investigated how transitioning nursing students are prepared with the necessary skills to achieve effective team communication at the point of transition to clinical practice as registered nurses. In order to address the aims of the study, a constructivist grounded theory methodology, informed by Kathy Charmaz (2006), was employed. Using purposive sampling, third year nursing students were recruited from one Australian university, to undertake a structured team simulation experience. Participants worked in teams of three or four to experience the team communication whilst working together to care for a deteriorating patient in the form of a mannequin. Simulations were video recorded after which individual, in-depth, semi-structured interviews were conducted with 21 participants. In line with a grounded theory approach, data collection and analysis were conducted concurrently until theoretical saturation was achieved. In response to the central problem of how nursing students communicate in simulated emergency settings, a core process was established that explained the factors that affect team communication. This problem is conceptualised as Navigating uncertainty: Explaining communication of nursing students within an emergency setting. This theoretical construct helps to explain nursing students’ actions and insights into factors that influence their communication within emergency teams. The core process is represented in three transitional stages of the theory comprising: Finding a place in the team, Understanding and working out differences and Looking to the future: Developing strategies to improve communication. This process was mediated by contextual conditions of the student, the simulation and the team. The phases are reinforced by the three main categories of Having a place in the team, Knowing yourself, and Transitioning from student to registered nurse. These categories represent the key activities that nursing students were engaged with that led to the development of the core category and process. The generated findings and theory offer valuable insights into factors that influence team communication skills within emergency settings. The theory raises awareness of social processes undertaken by nursing students during team communication, and highlights obstacles that can assist educators and academics to structure team communication education to better meet the needs of nursing students transitioning to practice settings.
- Description: Doctor of Philosophy
- Authors: Bourke, Sharon
- Date: 2022
- Type: Text , Thesis , PhD
- Full Text:
- Description: Recognising and managing clinical deterioration is considered a high priority in health care with ineffective communication being a significant contributing factor to poor clinical outcomes for patients. Nurses are in a unique position to make a difference in influencing improvements in team communication. In Australia, nurse education has become more complicated and demanding with nursing students focus on behaviour skills, such as communication, becoming more difficult in a saturated curriculum. Simulation-based education has provided an experiential way to learn these complex skills. Although there has been much work in the healthcare literature on clinical teamwork, including communication and its intersection with patient safety, there is still a gap in explaining how individuals within the team contribute to communication. The purpose of this study was to explore and explain how nursing students communicate in simulated emergency settings and how factors, such as culture, language, gender, age and power, affect nursing students’ team communication. This study investigated how transitioning nursing students are prepared with the necessary skills to achieve effective team communication at the point of transition to clinical practice as registered nurses. In order to address the aims of the study, a constructivist grounded theory methodology, informed by Kathy Charmaz (2006), was employed. Using purposive sampling, third year nursing students were recruited from one Australian university, to undertake a structured team simulation experience. Participants worked in teams of three or four to experience the team communication whilst working together to care for a deteriorating patient in the form of a mannequin. Simulations were video recorded after which individual, in-depth, semi-structured interviews were conducted with 21 participants. In line with a grounded theory approach, data collection and analysis were conducted concurrently until theoretical saturation was achieved. In response to the central problem of how nursing students communicate in simulated emergency settings, a core process was established that explained the factors that affect team communication. This problem is conceptualised as Navigating uncertainty: Explaining communication of nursing students within an emergency setting. This theoretical construct helps to explain nursing students’ actions and insights into factors that influence their communication within emergency teams. The core process is represented in three transitional stages of the theory comprising: Finding a place in the team, Understanding and working out differences and Looking to the future: Developing strategies to improve communication. This process was mediated by contextual conditions of the student, the simulation and the team. The phases are reinforced by the three main categories of Having a place in the team, Knowing yourself, and Transitioning from student to registered nurse. These categories represent the key activities that nursing students were engaged with that led to the development of the core category and process. The generated findings and theory offer valuable insights into factors that influence team communication skills within emergency settings. The theory raises awareness of social processes undertaken by nursing students during team communication, and highlights obstacles that can assist educators and academics to structure team communication education to better meet the needs of nursing students transitioning to practice settings.
- Description: Doctor of Philosophy
- Bourke, Sharon, Cooper, Simon, Lam, Louisa, McKenna, Lisa
- Authors: Bourke, Sharon , Cooper, Simon , Lam, Louisa , McKenna, Lisa
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Clinical Simulation in Nursing Vol. 60, no. (2021), p. 42-63
- Full Text: false
- Reviewed:
- Description: Team communication problems have been reported to be responsible for up to 80% of medical errors in healthcare settings. Although simulation is a recognized means to learn communication skills, little is known about students’ team communication in a simulated setting. This review sought to explore what is known about undergraduate health professionals team communication in simulated emergency settings. The Joanna Briggs Institute framework was used to identify studies through five databases. After titles and abstracts and full texts review, 22 studies were identified for analysis and synthesis using inductive thematic analysis. Three key themes emerged: the context of simulation, teamwork and communication, and student interpretations. Simulation is a successful tool to experience communication and teamwork for students. Non-technical skills enhanced students’ performance of clinical skills based on expert rating and in understanding shared values, collaboration, and respect for each other, and improving confidence. Simulation is a suitable approach to measure and enhance team communication and teamwork. Exploration of gender, age, and ethnicity and other factors to assess their impact on communication should be the focus of future research in this area. © 2021
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