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A novel nurse-inteRN mentorship program to improve nurse-physician communication and teamwork in the emergency
Amanda Doodlesack1, Nicole Dubosh2, Anne Grossestreuer2
1Dept. of Emergency Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center Harvard Affiliated Emergency Medicine Residency, One Deaconess Road, W/CC2, Boston, MA, 02215, USA. adoodles@bidmc.harvard.edu.
Background:
Communication between nurses and physicians is essential to providing patient care in the emergency department. The American College of Graduate Medical Education includes interpersonal and communication skills as one of six core competencies for residents. There is a known correlation between poor communication and negative patient outcomes. Yet, formalized training programs in doctor-nurse communication are lacking and literature reports that physicians may view collaboration as less important than nurses. To address this gap, we developed and implemented a novel, pilot "Nurse-InteRN Mentorship Program". The program aimed to improve trainees' communication with nurses and enhance emergency department collaboration. We then evaluated the impact of this program on participant perception of nurse-physician communication, efficacy and overall benefit.
Methods:
We used Kern's Six-step approach to develop and implement this program. We then evaluated the program's impact with a pre-program and post-program 12-question survey to evaluate participation, perceived benefit, and efficacy of the program using a 1-5 Likert scale. Nurse vs. intern responses were compared using Fisher's exact and Wilcoxon rank sum tests. Pre- and post- intervention responses were paired by respondent and compared using marginal homogeneity tests.
Results:
13 interns and 22 nurses participated in the program. All 13 interns and 19 of 22 nurses completed the pre-program survey. 10 of 13 interns and 11 of 22 nurse mentors completed the post-program survey. Nurses showed greater interest in providing feedback on communication skills than interns showed in receiving feedback (p < 0.001). Interns rated themselves higher in communication skills with patients than nurses rated them (p = 0.004). Perceived benefit among nurses and interns decreased after completion of the program.
Conclusion:
We were able to successfully implement a one-year nurse-intern mentorship program aiming to promote communication, collaboration and professional development. Our results show differing attitudes between nurses and interns around interns' communication skills. There was some perceived benefit, but unfortunately this decreased over the course of the program. Further studies are needed to determine how this program impacts communication, teamwork, and patient care. We hope that given the novelty of such a nurse-intern mentorship program, this study may serve as a pilot for future programs.
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