Reinforcing communication skills while registered nurses simultaneously learn course content: a response to learning needs

This article describes the implementation and evaluation of Integrated Skills Reinforcement (ISR) in a baccalaureate nursing course entitled "Principles of Health Assessment" for 15 registered nurse students. ISR is a comprehensive teaching-learning approach that simultaneously reinforces student writing, reading, speaking, and listening skills while they learn course content. The purpose of this study was to assess the influence of ISR on writing skills and student satisfaction. A learner's guide and teacher's guide, created in advance by the teacher, described specific language activities and assignments that were implemented throughout the ISR course. During each class, the teacher promoted discussion, collaboration, and co-inquiry among students, using course content as the vehicle of exchange. Writing was assessed at the beginning and end of the course. The influence of ISR on the content, organization, sentence structure, tone, and strength of position of student writing was analyzed. Writing samples were scored by an independent evaluator trained in methods of holistic scoring. Ninety-three per cent (14 of 15 students) achieved writing growth from .5 to 1.5 points on a scale of 6 points. Student response to both the ISR approach and specific ISR activities was assessed by teacher-created surveys administered at the middle-end of the course. One hundred per cent of the students at the end of this project agreed that the ISR activities, specifically the writing and reading activities, helped them better understand the course content. These responses differed from evaluations written by the same students at the middle of the course. The ISR approach fostered analysis and communication through active collaboration, behaviors cited as critical for effective participation of nurses in today's complex health care environment.