Acting to teach communication skills to nurses.

BACKGROUND: Interpersonal and communication skills are core competencies for nursing students. Empathetic, patient-centred communication improves patient outcomes and the care experience. Nursing trainees have reported a lack of preparation and confidence in communication and interpersonal skills with patients and members of the health care team. Acting-based hands-on training may provide a novel approach to develop communication in nursing students. APPROACH: The corresponding author worked as a professional actor before pursuing a medical career. He created an acting-based workshop, inspired by classic acting exercises taught in drama conservatories for decades, to develop core communication and interpersonal skills for health care professionals. The course creator and an instructor with no acting background each facilitated the workshops. The initiative was taught to over 200 preclinical baccalaureate freshmen and sophomore nursing students as part of their clinical skills courses at one institution. EVALUATION: Participants were asked to rate their self-efficacy for skills developed in the workshop using a 5-point Likert scale. A 4 or 5 rating was considered agreement. Most participants agreed the workshop developed their skills of self-awareness, observation, teamwork, flexibility, nonverbal and verbal communication, trust, mindfulness, body language awareness, active listening, and sensitivity to emotions expressed by others. IMPLICATIONS: An acting-based teaching intervention is efficacious in instilling core communication and interpersonal skills to preclinical nursing students based on participants' self-efficacy ratings. This innovative way to teaching communication provides students with an experiential environment conducive to learning. Similar ratings between sessions suggest that health professions educators with no formal acting training can successfully teach this course.

Screening for diabetic kidney disease in primary care: A quality improvement initiative.

Gaps in care currently exist between diabetic kidney disease (DKD) guidelines and diabetes management in primary care settings. Implementation of quality improvement (QI) initiatives often improves these gaps in care. This article outlines a QI initiative exploring whether a local Federally Qualified Health Center could improve rates of screening for microalbuminuria, diagnosis of DKD, and treatment of the disorder in patients with type 2 diabetes mellitus.

Self-care in older adults with heart failure: an integrative review.

PURPOSE: The aims of this integrative review were to examine the evidence specific to self-care in older adults, 65 years or older, with heart failure and to indicate best nursing practice interventions for use in this population. ASSESSMENT: Self-care is a complex set of activities involving self-care maintenance and self-care management. Age-related and psychosocial factors impact older patients' ability to engage effectively in self-care practices. Although self-care processes are the focus of the investigation, few studies provide implications specific for the older adult population. Limited research on heart failure self-care in the older adult meets the age criterion of 65 years or older. METHODS: A comprehensive search of the literature was performed using Medline, CINAHL, and the Cochrane Library, as well as an ancestry approach of reference lists of selected studies. Eligible studies were randomized controlled trial, qualitative, quantitative, and mixed-method design studies on older adults with heart failure related to self-care for the years 2002-2012. FINDINGS: Three themes of self-care were noted in the selected studies: patient-related factors, patient education, and telemonitoring. The patient-related factors identified were barriers to self-care such as age-related symptoms, cognitive factors, and social issues. The interventions promoting self-care were patient education (self-care knowledge) and telemonitoring (augmenting symptom recognition). Patient education tailored to older adults may be beneficial. Telemonitoring is an appropriate self-care enhancement tool for selected older adults. More emphasis needs to be placed on interventions to assist older adults with heart failure in symptom recognition and early notification of healthcare providers. CONCLUSIONS: As the population ages, a need for evidence-based care for older adults with heart failure is warranted. Heart failure self-care interventions do not address the special considerations of the older heart failure patient. To determine the best approaches for promoting effective self-care, older adults with heart failure need to be studied as a cohort. CLINICAL RELEVANCE: Older adults with heart failure face many challenges engaging in self-care practices. These older adults need individualized self-care instructions and home care follow-up. Identifying special needs of the patient, such as sensory or cognitive impairment, is necessary when providing instructions and follow-up care for the older adult.

Innovative approach to teaching communication skills to nursing students.

This study assessed the effectiveness of a learner-centered simulation intervention designed to improve the communication skills of preprofessional sophomore nursing students. An innovative teaching strategy in which communication skills are taught to nursing students by using trained actors who served as standardized family members in a clinical learning laboratory setting was evaluated using a two-group posttest design. In addition to current standard education, the intervention group received a formal training session presenting a framework for communication and a 60-minute practice session with the standardized family members. Four domains of communication-introduction, gathering of information, imparting information, and clarifying goals and expectations-were evaluated in the control and intervention groups in individual testing sessions with a standardized family member. The intervention group performed better than the control group in all four tested domains related to communication skills, and the difference was statistically significant in the domain of gathering information (p = 0.0257).