Academic journal article Nursing Education Perspectives

A Mixed-Methods, International, Multisite Study to Develop and Validate a Measure of Nurse-to-Physician Communication in Simulation

Academic journal article Nursing Education Perspectives

A Mixed-Methods, International, Multisite Study to Develop and Validate a Measure of Nurse-to-Physician Communication in Simulation

Article excerpt


AIM This study examined the reliability and validity of the ISBAR Interprofessional Communication Rubric (IICR).

BACKGROUND Improving education regarding communication in health care is a global priority. Communication is difficult to measure and no evaluation rubrics were located that uniquely focused on nurse- to-physician communication in simulation.

METHOD This study used a mixed-methods design and included five sites.

RESULTS The IICR was determined reliable among nurse educator raters ([r.sub.s] = 0.79). The scale was found valid as assessed by nurse and physician experts (content validity index = 0.92). When describing their experience of using the tool, nurse educator raters described three categories: overall acceptability of the tool, ease of use, and perceptions of the importance of communication skills for patient safety.

CONCLUSION Teaching and evaluating communication in simulation with a standardized rubric is a research area in need of further exploration and refinement.


Rubric--Instrument--Interprofessional Communication--Simulation Tool


According to the Joint Commission (Joint Commission, 2014), the second most frequently identified root cause of sentinel events in the United States is miscommunication. Indeed, improved health care provider communication is one of the commission's 2015 National Patient Safety Goals (Joint Commission, 2015). Simulation has been associated with improved communication skills of nursing students (Foronda, Gattamorta, Snowden, & Bauman, 2013), but there is a dearth of instruments to measure interprofessional communication (IPC). Faculty are faced with the challenge of how to measure and evaluate the rather nebulous concept of communication when using simulation as an educational strategy to prepare students with IPC skills.

The National Center for Interprofessional Practice and Education (2013) website provides instruments to measure various interprofessional outcomes such as collaboration and teamwork, but no instruments on the website are solely focused on measuring communication between nurses and physicians. Likewise, the World Health Organization (WHO, 2015) published various organizational tools for patient safety, but the existing tools lack a mechanism for scoring or measuring communication performance.

The literature suggests that physicians and nurses struggle in communicating with each other (Dixon, Larison, & Zabari, 2006; Foronda, MacWilliams, & McArthur (2015); Rodgers, 2007). Physicians have expressed frustration, stating that nurses are disorganized with information, lack preparedness to answer questions, provide irrelevant information, and delay in getting to the point (Dixon et al.). Nurses see physicians as inattentive and perceive that they feel a need to discuss lists of signs and symptoms rather than stating the problem (Dixon et ah). The power differential perceived by nurses and physicians may affect interprofessional communications (Dixon et ah; Foronda et ah (2015); Heinrichs, Bauman, & Dev, 2012). Nurses have lacked confidence, have indicated a fear of being incorrect or humiliated, and have lacked a structure for communicating with physicians (Foronda et al).

Leading organizations, including the Joint Commission (2013), WHO (2015), the Australian Commission on Safety and Quality in Health Care (2012), the Agency for Healthcare Research and Quality (2014a, 2014b), the Institute for Health Improvement (IHI, 2015), and Quality and Safety Education for Nurses Institute (QSEN, 2014), endorse Situation, Background, Assessment, and Recommendation (SBAR) as a recommended standardized format for communication in patient care settings. While the SBAR format has served as a guide for nurses to structure interprofessional communications, the essential criteria to communicate remain ambiguous. Many variations of the SBAR worksheet are noted in the literature (Boaro, Fancott, Baker, Velji, & Andreoli, 2010; Dixon et al. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.