Patterns of communication in high-fidelity simulation

High-fidelity simulation is commonplace in nursing education. However, critical thinking, decision making, and psychomotor skills scenarios are emphasized. Scenarios involving communication occur in interprofessional or intraprofessional settings. The importance of effective nurse-patient communication is reflected in statements from the American Nurses Association and Quality and Safety Education for Nurses, and in the graduate outcomes of most nursing programs. This qualitative study examined the patterns of communication observed in video recordings of a medical-surgical scenario with 71 senior students in a baccalaureate program. Thematic analysis revealed patterns of (a) focusing on tasks, (b) communicating-in-action, and (c) being therapeutic. Additional categories under the patterns included missing opportunities, viewing the "small picture," relying on informing, speaking in "medical tongues," offering choices…okay?, feeling uncomfortable, and using therapeutic techniques. The findings suggest the importance of using high-fidelity simulation to develop expertise in communication. In addition, the findings reinforce the recommendation to prioritize communication aspects of scenarios and debriefing for all simulations.