Using simulation to improve communication skills among ICU staff

Project overview

St Luke’s Hospice’s education team were approached by a local NHS Trust, who had noticed that many of the nurses in the intensive care unit (ICU) lacked confidence in communicating with patients and their families around the end of life. The Trust recognised that hospice staff are skilled at having these discussions, and asked St Luke’s to provide some communication skills training for the ICU nurses.

The education team delivered two full-day workshops to 26 ICU nurses. The workshops began by teaching about communication models, followed by an afternoon of experiential learning.

The hospice used simulations to help nurses practice their communication skills in a safe environment. Participants were split into three groups, each with a facilitator from St Luke’s. Paid actors played the part of patients or family members in different scenarios.
Group members took it in turns to communicate with the actors, gaining feedback from facilitators and discussing any issues that arose with the group. The next group member then took a turn using the same scenario, learning from the feedback and discussion. This enabled the group to learn together and try out different communication methods.

Outcomes

The training was successful, with all participants rating it as being very helpful in improving their confidence and skills. The simulation was reported to be the most helpful part of the day.

Tackling the scenarios as a group allowed the nurses to learn with and from each other.

Key facilitators

The team reviewed the literature around training to improve communication skills, which showed that simulation has been tested and found successful. The scenarios they used for the training had already been tested by others.

The training took place over one full day, rather than spreading shorter workshops over several days. This made it easier for the nursing staff to be released for training.

The facilitators each used the same feedback model to ensure that all participants had a consistent learning experience.

Challenges

The majority of participants had not undertaken simulation based learning before therefore it was sometimes challenging to get people to volunteer to ‘go first’. People wanted to watch others and learn before taking their turn.

Some participants were nervous about taking part in a role play at all. The facilitators were able to discuss this with individuals and found that some were particularly anxious about their communication skills. By discussing this with the group, colleagues were able to support each other. Once they had been supported to take part in the simulation, all participants gave very positive feedback.

To help build a sense of security, the nurses stayed in the same groups with the same facilitator for the duration of the training.

Simulation training was new to all the nurses taking part. In planning the day, the team had support from a consultant in palliative medicine, who had previous experience of simulation.

The team would have liked to have spent more time teaching communication theory before moving on to the simulations, but they were limited by the nurses’ availability.

St Luke’s education team would like to deliver this training more widely to support other NHS trusts.

They are looking for training and development to ensure their facilitation skills are robust.