A Content Analysis of the Basic Communication Skills of Beginning-Level Nursing Students
Adams, Kathleen S.
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The purpose of this study was to describe the communication patterns of beginning-level nursing students. The study was based on Watson's Model for Helping Relationships (1979) which gives direction to nurses as they respond to requests for either action, information, understanding and involvement or inappropriate requests. The Framework for Analysis, developed for this study, was derived from Watson's model and identified three major categories of therapeutic communication responses- -attending, listening and exploring. It also delineated specific communication barriers and provided parameters for evaluating students' overall communication patterns. Two major research questions were posed for the study with specific subquestions for each. The two research questions were: 1. Following classroom content regarding nurse-client relationships and therapeutic communication, how do beginning-level nursing students respond to requests for understanding and involvement? 2. Following classroom content regarding nurse-client relationships and therapeutic communication, how do beginning-level nursing students evaluate their own communication? The research questions were analyzed using a qualitative design that applied content analysis to the interpersonal process recordings (IPRs) written by 78 beginning-level associate degree and diploma nursing students. Students were asked to document interactions in which people had specifically requested understanding and involvement. Each student response on the IPRs was coded according to predetermined response categories delineated in the Framework for Analysis. The overall findings of this study suggest that beginning-level nursing students demonstrate an initial understanding of therapeutic communication. The majority (87.2%) of students recorded interactions in which the person to whom they were interacting clearly had a desire for understanding and involvement. Many of the responses that students used in responding to these requests were helpful and encouraged the persons with whom they were interacting to share their thoughts, feelings and ideas. The use of communication barriers, however, also was common. Of the 78 IPRs analyzed, 76 contained at least one communication barrier. Overall, at least 35% of the students' responses impeded the communication process. A significant number of students recorded few (23.1%) or no (15.4%) nonverbal behaviors. Students generally recognized their responses correctly as either therapeutic or communication barriers. The majority of students (61.5%), however, incorrectly identified at least one response. Self-understanding varied considerable among the beginning-level nursing students. This study has contributed to nursing theory development by giving specificity to one aspect of Watson's Model for Helping Relationships. The taxonomy proposed by the Framework for Analysis can facilitate needed communication research. The study also provides important baseline information about the communication patterns of beginning-level nursing students that can guide nurse educators as they design curricula and educational strategies to meet the communication learning needs of nursing students.