Effective therapeutic communication is the foundation of a mutually beneficial nurse-patient relationship, because it minimises psychological difficulties during the care process and positively affects patient recovery. Many psychiatric nursing students are anxious about interacting with patients who struggle with mental disorders, and this anxiety can hinder open and empathetic communication. There are various ways to teach therapeutic communication skills to these students, so they feel comfortable, confident and prepared to enter the workforce.
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Hire and train consumer tutors to teach the curriculum in clinical classes. Consumer tutors are current psychiatric patients who have insight into the medical system and are motivated to share their experiences with students. Interacting with consumer tutors can improve attitudes towards patients and teach students to value good communication skills.
Use art to develop empathy and self-awareness, key therapeutic skills. Have students analyse and interpret paintings, poetry, short stories and dramatic skits that concern pain, cultural issues, patients, family members and doctors. Through personal reflections and small-group discussions, nursing students will better gain an understanding of others' perspectives, backgrounds and needs.
Simulate real-life patient scenarios by using mannequins, role-playing exercises, interactive games, or specialised software. Students acquire therapeutic communication skills by actively participating in the scenario, or by observing and discussing in groups. Through simulated activities, students overcome stigmas of mental disorders and increase their confidence in implementing learnt skills in a safe environment.
Introduce students to standardised patients. These patients are actors trained to realistically display psychiatric symptoms. Videotape the clinical interview, so the student can evaluate his or her therapeutic communication skills. If each nursing student conducts a clinical interview with the same standardised patient, the students can later benefit from comparing their experiences and sharing feedback in a group discussion.
Provide experiential learning opportunities by setting students up with real patients. Screen volunteers for patients who have relatively straightforward psychiatric issues. A supervising psychiatrist or psychiatric nurse should hold regular group meetings to address concerns, encourage self-reflection and cultivate learning through sharing between peers.
Instruct students to use social reminiscence during meetings with patients. Encouraging the patient to reminiscence on past experiences teaches students effective listening skills and establishes a connection with the patient, which are essential to therapeutic communication. As they listen to the patients' life stories, students feel more respect and empathy for the patient, become less anxious about patient interaction and better understand the impact of history on current mental states.
Invite students to write therapeutic letters to their patients. Students should compose encouraging, personalised letters to explain the care process, follow-up on patient goals and give reminders. The process of letter writing encourages nursing students to consider patients' perspectives, personalities and needs. This allows students to effectively build relationships that will support their patients' recovery.
Tips and warnings
- Training in therapeutic communication should start early in psychiatric nursing education.
- The SimMan is one of the latest human simulators that can respond to psychiatric scenarios as if he were a real patient.
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- "BioMed Central Medical Education"; Consumers as tutors -- Legitimate Teachers?; Cathy Owen, et al.; 2004
- Auburn University; Empathy and Empathic Communication: Nursing Student Perceptions ...; Libba Reed McMillan; 2007 (PDF)
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- "Psychiatric Nursing: Contemporary Practice"; Chapter 9: Communication and the Therapeutic Relationship; Cheryl Forchuk, et al.; 2008