Using discourse analysis to teach communication and relational strategies in nurse education

Nurses require complex communication abilities to enable informed, culturally safe and person-centred care in challenging contexts. The way in which a clinician manages communication is consequential and can have a pivotal influence on clinical outcomes. Learning how to build relationships with patients and develop rapport or display empathy in difficult circumstances requires students to become more aware of their own as well as their patients' attitudes, emotions and needs however, such skills take time to develop and are difficult to teach. Communication is a key standard for practice, and the teaching of communication strategies across undergraduate nursing curricula is often incorporated in a range of topics and scenarios, using methods such as role play, simulation, and virtual reality. Despite this, students have reported reluctance to engage with patients, difficulty initiating conversations and anxiety engaging in complex conversations. In this paper, we propose a new approach to teaching communication, underpinned by Kolb's Experiential Learning Theory that uses discourse analysis to supplement and enhance other methods. Discourse analysis uncovers the strategic interactional work that builds relationships, highlighting the strategies and ways nurses achieve this with their patients. We use excerpts of transcripts from real-life nurse-patient interactions to demonstrate the communication and relational strategies that RNs use to build therapeutic relationships; how they build rapport with their patients and display empathy.