Teaching self-concept and self-esteem in a clinical communications course

Living experiences of people living with HIV-AIDS from the client's perspective in nurse-client interaction in Indonesia: A qualitative study

BACKGROUND

Nurse-client interaction when providing nursing services is limited to optimizing treatment and self-care, with limited focus on the psychological problems of people living with HIV-AIDS. However, psychological problems manifest more often than the health risks of the disease itself. This study aimed to determine the emotional response of people living with HIV-AIDS who received limited attention from nurses from the perspective of nurse-client relationship.

PATIENTS AND METHODS

A phenomenological qualitative design was used through in-depth face-to-face interviews in a semi-structured manner, in an effort to obtain complete data. This research used purposive sampling with Participatory Interpretative Phenomenology analysis, involving 22 participants (14 males and 8 females).

RESULTS

This research produces several themes, with six subcategories: 1) Difficulty of social access, 2) Forcing to accept their situation and suppressing their will, 3) Wanting to be recognized like other people in general, 4) Social stigma and self-stigmatization affecting surroundings, 5) Lacking enthusiasm for life expectancy, 6) Always lingering under the shadow "when death picks up."

CONCLUSION

The results showed that mental stress was experienced more than physical problems by people living with HIV-AIDS, thus prompting new changes to nursing services for HIV-AIDS patients that emphasize psychosocial aspects, in addition to clinical features, facilitated by satisfying relationships between nurses and clients to provide quality services.

Perceived stress, academic self-concept, and coping mechanisms among pharmacy students following a curricular revision

INTRODUCTION

Pharmacy students experience high levels of perceived stress. Data regarding the impact of curricular revision on students' stress level are lacking. The primary objective of this study was to compare perceived stress, academic self-concept, and coping strategies between pharmacy students prior to and following a curricular revision. Secondary objectives included determining university resources used by students to deal with stress.

METHODS

Students in the first, second, and third years of the pharmacy curriculum were asked to complete a survey, including the 14-item Perceived Stress Scale (PSS-14), Brief COPE, and Academic Self-Concept Scale (ASCS), and questions regarding use of university resources. Responses to the PSS-14, Brief COPE, and ASCS were compared to a student cohort prior to the curricular revision.

RESULTS

Perceived stress was reduced to a small, statistically significant degree following a curricular revision. In both cohorts, increased stress was statistically significantly correlated with decreased academic self-concept. Students reported increased use of self-distraction, along with decreased use of active coping, substance abuse, and planning, as coping strategies when compared to the previous cohort. Approximately half of the student cohort reported no use of university resources. The most commonly used resources were financial aid and mental health services.

CONCLUSIONS

Perceived stress decreased following the revision of a Doctor of Pharmacy curriculum. The most common coping strategies were positive and comparable with strategies reported by students in the former curriculum. The impact of curricular changes on student stress and the use of university resources in health professions students warrant further study.

How can pharmacists develop patient-pharmacist communication skills? A realist synthesis

OBJECTIVE

To understand how pharmacists develop patient-pharmacist communication skills.

METHODS

A realist synthesis approach was used to understand how educational interventions work to improve patient-pharmacist communication. Initial programme theories were developed through a scoping search and stakeholder focus groups (faculty, students, patients and public). A systematic search was then conducted for evidence to test initial theories. Included papers were assessed for relevance and rigour. Extracted data was synthesised to refine the initial programme theories and develop modified programme theories.

RESULTS

Forty-seven papers were included in the final synthesis. Role-play with simulated patients and peers, video recording and lectures were the most widely reported interventions. Repeated practice, feedback, reflection and confidence were among the mechanisms by which interventions work. Modified programme theories relating to interactions of role-play, experiential learning, video recording, self-assessment and workshops were developed.

CONCLUSIONS

Outcomes of communication education interventions are influenced by the level of learner. Educational interventions that promote reflection are particularly useful.

PRACTICAL IMPLICATIONS

There are a wide range of theory-informed interventions, which should be used in a programmatic approach to communications education. A longitudinal programme of communication skills training, with intervention choice based on level of learning, is important.

Using forum theatre to teach communication skills within an undergraduate pharmacy curriculum: A qualitative evaluation of students' feedback

BACKGROUND AND PURPOSE

Pharmacists need to learn communication styles which adopt a more consultative model. The objectives of this paper are to describe the use of forum theatre facilitated by actors to teach communication skills to pharmacy students and to highlight perceptions of the workshops.

EDUCATIONAL ACTIVITY AND SETTING

During the actor-led forum theatre, students redirected scenes depicting pharmacist-patient consultations. Students also learned about their own communication styles and role-played consultations and interview situations with actors. Pharmacy undergraduate students enrolled in years 2, 3, and 4 answered open-ended questions online at the end of workshops. All responses were coded to identify themes.

FINDINGS

Five themes emerged from 752 comments: (1) workshops were useful in facilitating communication skills development, (2) workshops encouraged reflection, (3) appreciation of feedback provided, (4) the live, interactive nature of the workshop enhanced learning, and (5) suggestions for improvement. There were requests for more varied scenarios involving different patient groups and more opportunities to participate in the role-plays. Students also requested smaller groups, which would encourage participation from those who were reticent and allow more personal feedback.

SUMMARY

The use of forum theatre employing role-play, small group coaching on consultation and interview skills, and emphasizing feedback was perceived as an effective and engaging method to teach communication skills.

Developing pharmacy student communication skills through role-playing and active learning

OBJECTIVE

To evaluate the impact on pharmacy students of a communication course, which used role-playing to develop active-learning skills.

DESIGN

Students role-playing pharmacists in patient care scenarios were critiqued by students and pharmacist faculty members. Grading was performed using the rubric inspired by Bruce Berger's Communication Skills for Pharmacists. Written skills were evaluated using student written critique questionnaires. Students completed precourse and postcourse self-assessment surveys. Preceptor evaluations were analyzed for course impact.

ASSESSMENT

Students demonstrated improvement in oral skills based on role-play scores (45.87/50) after practice sessions. The average score based on the student questionnaire was 9.31/10. Gain was demonstrated in all defined course objectives. Impact on introductory pharmacy practice experience (IPPE) communication objectives was insignificant. Student evaluations for course and teaching strategy reflected a high average.

CONCLUSION

Study results demonstrated improvement in oral and written communication skills that may help improve interprofessional teamwork between pharmacists and other health care providers.

Best practices for implementing team-based learning in pharmacy education

Colleges and schools of pharmacy are incorporating more team-based learning (TBL) into their curriculum. Published resources are available to assist instructors with implementing TBL and describing it in the health professions literature. The 7 core elements include: team formation, readiness assurance, immediate feedback, sequencing of in-class problem solving, the 4 "S" structure for developing team application exercises (significant problem, same problem, specific answer choice, simultaneous reporting), incentive structure, and peer evaluation. This paper summarizes best practices related to implementation of TBL in pharmacy education, including courses taught using teaching teams.

Communications training in pharmacy education, 1995-2010

The role of the pharmacist as a "communicator" of information and advice between patients, other healthcare practitioners, and the community is recognized as a vital component of the responsibilities of a practicing pharmacist. Pharmacy education is changing to reflect this, although the difficulty is in designing a curriculum that is capable of equipping students with the necessary knowledge and skills, using activities that are effective in promoting communication competency. The objective of this review was to identify published, peer-reviewed articles concerning communication training in pharmacy education programs, and describe which communication skills the structured learning activities aimed to improve and how these learning activities were assessed. A systematic literature search was conducted and the articles found were analyzed and divided into categories based on specific communication skills taught and type of learning activity used. Oral interpersonal communication skills targeted at patients were the most common skill-type described, followed by clinical writing skills. Common teaching methods included simulated and standardized patient interactions and pharmacy practice experience courses. Most educational interventions were assessed by subjective measures. Many interventions were described as fragments, in isolation of other learning activities that took place in a course, which impedes complete analysis of study results. To succeed in communication training, integration between different learning activities and progression within pharmacy educations are important.

A virtual practice environment to develop communication skills in pharmacy students

OBJECTIVE

To develop communication skills in second-year pharmacy students using a virtual practice environment (VPE) and to assess students' and tutors' (instructors') experiences.

DESIGN

A VPE capable of displaying life-sized photographic and video images and representing a pharmacy setting was constructed. Students viewed prescriptions and practiced role-playing with each other and explored the use of nonverbal communication in patient-pharmacist interactions. The VPE experiences were complemented with lectures, reflective journaling, language and learning support, and objective structured clinical examinations (OSCEs).

ASSESSMENT

Most students believed the VPE was a useful teaching resource (87%) and agreed that the video component enabled them to contextualize patient problems (73%). While 45% of students questioned the usefulness of watching the role plays between students after they were video recorded, most (90%) identified improvement in their own communication as a result of participating in the tutorials. Most tutors felt comfortable using the technology. Focus group participants found the modified tutorials more engaging and aesthetically positive than in their previous experience.

CONCLUSION

The VPE provided an effective context for communication skills development classes.

A systems approach to scaffold communication skills development

OBJECTIVES

To implement a communication skills development (CSD) system and evaluate its effectiveness in a clinical communications course.

DESIGN

Students conducted baseline interviews and wrote SOAP notes, and based on faculty, patient, self- and peer assessments, set goals for improvement of their communication skills. Students participated in various activities to scaffold their learning, several of which took place in a web-based environment to enhance access and function for both students and faculty members. Quantitative and qualitative analyses were performed.

ASSESSMENT

Students' communication skills improved as evidenced by assessment scores. Student and faculty comments offered additional evidence of the effectiveness of standardized patient interviews, learning strategies, and assessment methods.

CONCLUSION

The CSD system effectively integrated various types of learning activities and feedback processes. The use of scaffolding strategies appeared to enhance the development of students' communication skills.