Helping patients get well takes more than technical know-how.
Nurses need to develop excellent communication skills to connect and empathize with patients. For educators, the challenge is providing students with a safe, yet realistic, environment to practice these skills, explains Asst. Prof. of Nursing Margie Laccetti.
“Developing therapeutic communication skills takes practice. We have the computerized mannequins to teach physiologic and disease-related problem solving. But we needed to give students a safe environment to learn techniques that will help them assess, document and develop interventions.”
Enter UMass Lowell theatre students.
Laccetti, along with Clinical Asst. Profs. Laurie Soroken and Sandy Mote, teamed up with Asst. Prof. of Theatre Arts Dale Young to coach theatre students to portray patients in specific situations. For the student actors, it was like getting an improvisation assignment.
For example, a theatre student’s assignment may have looked something like this: You’re a 65-year-old female patient who was admitted two days ago to a New Hampshire rehabilitation center after a total hip replacement. Your 25-year-old granddaughter is pregnant with her first child and has gone into labor four weeks early. You want to leave the rehab early to go and support your daughter and granddaughter.
Nursing students had three minutes to interact while the student actors improvised using the patient scenarios. Techniques such as listening, empathizing and restating patient concerns were practiced to create a meaningful exchange and gather information.
“We got to see how to de-escalate a situation when our patients may be combative and how to react properly when a patient is telling you personal information,” says senior nursing student Ernesto Maurissaint.
The discussions were recorded and then the theatre and nursing students watched the recordings together. Nursing faculty facilitated a discussion about how the student nurses felt during the scenarios, if they achieved their goals and what they would do differently. The student actors gave nursing students insightful feedback.
“Without these real-life scenarios and people giving us the unexpected, I do not feel that I would successfully be prepared for clinical and my future career,” says Maurissaint.
Melissa Kiessling, an English major in the theatre arts concentration who coordinated the actors and helped draft the scenarios, says that she learned how actor training is useful for giving feedback.
“Actors are trained to examine relationships between characters and with their scene partner, and this self-awareness helped student actors give clear, specific feedback to the nursing students,” she says.
The partnership between nursing and theatre arts allowed for mistakes to occur and new communications strategies to be tested without harm to a patient or nurse.
“Dale Young was great at directing students,” says Laccetti. “In one situation, he told an actor to flirt with the nurse. The students got a good dose of the real world.”
Training individuals to act as patients is used by medical schools and some graduate nursing programs. However, Laccetti says it is rarely used in undergraduate nursing programs due to the high cost of hiring these individuals, and the time and effort involved in training them.
“We try to give undergraduate nurses the opportunity to practice therapeutic communication by having them take turns portraying a patient, but that is never as successful as using a trained individual as patient,” says Laccetti who presented the results of the project to the Eastern Nursing Research Society annual conference.
Funded by a grant from the College of Health Sciences and an innovative education award from the university, the project team received an innovative teaching award from the Massachusetts Association of Colleges of Nursing.