Peer-to-Peer Teaching: Improving Communication Techniques for Students in an Accelerated Nursing Program

Abstract

For nurses, effective communication skills are essential components for the delivery of patient-centered care and the development of positive working relationships. Although communication is an essential skill in health care (McCabe, 2004; McGilton, Irwin-Robinson, Boscart, & Spanjevic, 2006), it has been suggested that schools of nursing do not properly address communication skills (Rosenzweig et al., 2008). Students require practice in therapeutic communication prior to entering the patient care setting (Zavermik, Huff, & Munro, 2010). Sprengel and Job (2004), acknowledging the anxiety of new nursing students, recommended peer mentoring as a way to help students socialize into the rigor of nursing school while developing skills and attitudes essential to nurses. In this accelerated baccalaureate program at an academic health center in the Southeast, therapeutic communication is taught to incoming juniors during the summer session, introducing a new language and a new set of skills. Despite weekly lab sessions designed to help students implement content taught in the classroom, faculty observed that junior students seemed overwhelmed as they transitioned into the nursing program and had difficulty organizing interviews and obtaining accurate health history information. A peer-to-peer communication exercise, led by more experienced senior students, was seen as a way to enhance learning and increase student confidence and perceived competence in interviewing and therapeutic communication. Senior-level students in the program begin their mental health nursing course during the summer semester. This course begins with a review of therapeutic communication techniques, providing an opportunity for a merged experience with juniors. McKenna and French (2011) indicated that students participating in a peer teaching project reported increased confidence in their knowledge and teaching abilities as well as greater perceived competence in interviewing and therapeutic communication skills. Bensfield, Solari-Twadell, and Sommer (2008) documented benefits for upper-level students, including increased confidence in the clinical nursing role and enhanced interpersonal skills. METHOD As part of their clinical requirement, 21 seniors in the mental health nursing course were assigned to participate with 109 juniors in three health assessment lab sessions on interviewing for a health history. The seniors were credited with four and one half clock hours for preparing and participating in the health history interview sessions. Their objectives were to: a) promote learning in a nonthreatening environment, b) foster peer-to-peer relationships to model professional behaviors, and c) enhance health history interview techniques of juniors, while developing confidence and perceived competence in communication techniques. The project was described in detail to the seniors, who met twice with the nursing laboratory director to review learning objectives for both levels and their own responsibilities. The senior-level nursing students prepared two demonstration health history interviews according to the stated guidelines, as well as questions to ask following the interviews. They were to use and identify open-ended, closed-ended, and directive questioning; communication enhancement and diminishment techniques; and strategies for managing awkward moments in an interview. They were to prompt junior students as needed and provide time management for the group process. Instructions for the project, as well as the assessment form to be used by the juniors for interviews, were placed on the e-learning course management system used by the school of nursing. Seniors began the lab sessions by presenting a role-play interview and explaining the techniques used throughout the interview. A large-group debriefing session, led by the faculty facilitators, allowed students to reflect on the interview process and what was learned. …