The Sensitivity Training Clown Workshop: Enhancing Therapeutic Communication Skills in Nursing Students

By Leef, Betty L.; Hallas, Donna | Nursing Education Perspectives, July/August 2013 | Go to article overview

The Sensitivity Training Clown Workshop: Enhancing Therapeutic Communication Skills in Nursing Students


Leef, Betty L., Hallas, Donna, Nursing Education Perspectives


Abstract

Aim. The aim of this study was to examine the long-term effectiveness of the Sensitivity Training Clown Workshop (STCW) provided to 131 baccalaureate nursing students.

Background. The STCW was designed and implemented through a collaboration between the ar tistic director of the Big Apple Circus and nurse faculty to help students understand emotions, learn peripheral awareness skills, and become engaged with patients.

Method. For ty participants responded to an 18-month follow-up evaluation sur vey.

Results. The majority of participants reported applying lessons learned in the workshop in their current practice, regardless of their area of nursing employment.

Conclusion. The STCW is an effective method of educating nursing students for pediatric practice. The techniques used in the workshop are applicable to other practice settings.

Key Words. Clown Care - Nursing Education - Student Engagement - Teaching Methods - Sensitivity Training - Therapeutic Communication

Traditionally, nursing students learn therapeutic communication skills early in their baccalaureate education, but major focus is placed on adult/elder case scenarios. When placed in a pediatric setting, the authors observed, students describe feeling overwhelmed when confronted with the need to translate communication techniques to the pediatric population.

Efforts to increase student comfort level with children led to the inception of an innovative program for sensitivity training using professional clowns. This article discusses the design, implementation, and evaluations of the Sensitivity Training Clown Workshop (STCW) with implications for student education as well as continuing education for all health professionals.

Review of the Literature

Although clown care has been a part of the hospital experiences for children in some areas of the United States for 25 years (Adams, 2002), and more recently has been reported in international journals (Hart & Walton, 2010; Koller & Gryski, 2007; Spitzer, 2001; Tener, Lev-Wiesel, Franco, & Ofir, 2010; Tse et al., 2010), research studies on the effectiveness of clown care for the hospitalized patient are limited. The majority of the articles are anecdotal and attempt to link clown care to the value of humor and the expression of "love" for patients or anyone who is suffering (Adams, 2002). Adams reported leading clown trips since 1985, using ordinary people dressed in clown clothing to spread "love and fun" in adverse settings such as a Kosovo refugee camp in 1997. After the first day's experience in clowning, Adams reported, camp elders said that "it was the first time they saw children playing in the camp, or couples holding hands; love and humor breathed life back into these suffering people" (p. 448).

Hunt (1993) examined six studies in which humor was used as a nursing intervention. Hunt's analysis determined that these studies, while lacking research rigor, provided some evidence that humor is an effective nursing intervention. Beck conducted a phenomenological study on humor in nursing (1997). Twenty-one nurses provided written descriptions of an experience in which they used humor in nursing care. Five themes emerged from Beck's data. Of significance to our work on the effectiveness of clown therapy in educating nurses were two themes: humor was found to help nurses deal effectively with difficult situations and difficult patients, and humor created lasting effects beyond the immediate moment for nurses and patients. Bennett (2003) studied the effects of humor at the cellular level of the immune system and reported positive effects on physical and mental health and overall well-be- ing of individuals.

Vagnoli, Caprilli, Robiglio, and Messeri (2005) con- ducted a randomized controlled investigation on the ef- fects of the presence of clowns on a child's preoperative anxiety during anesthesia induction and on the parent who remained with the child. …

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