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Interpersonal Communication: An Essential Skill for Nursing Students

Hopefully you've never encountered a nurse the likes of Nurse Ratched. She's the cold and cruel tyrant in "One Flew Over the Cuckoo's Nest," whose outrageous behavior is the antithesis of the caring nurse. And that's not without cause. Nurse educators work to develop appropriate interpersonal skills in nursing students, often from the first course in the Nursing program.

"In order to function in any capacity, nurses need to have strong communication skills," says Marilyn Klakovich, DNSc, RN, NEA-BC. "So much of what we do is communication-based. Patient teaching, being present during stressful times—it's the nurse who is there."

To facilitate a structured assessment of the interpersonal skills in nursing students, Dr. Klakovich and her colleague, Felicitas delaCruz, DNSc., RN, FAANP, developed The Interpersonal Communication Assessment Scale (ICAS). The ICAS is a 23-item instrument that can be completed by the nursing student or a clinical instructor to gauge the student's interpersonal skills along three major themes: advocacy, therapeutic use of self and validation.

According to Dr. Klakovich, advocacy refers to a nursing student's ability to help a patient deal with the health care system. Evaluating the effectiveness of such behaviors as: "Prepares patient/family for procedures by explaining the process and reasons before occurrence," "Explains to patient/family varied treatment options" and "Requests consultation when needed" assess this skill.

Therapeutic use of self is described by Dr. Klakovich, as "the nurse making use of her total being in relating to a patient." The ICAS evaluates this skill by rating: "Demonstrates behaviors (such as eye contact, touching) when communicating if appropriate to situation and acceptable to the cultural background" and "Detects inconsistency between verbal and non-verbal communication."

Validation, or letting a patient know that his or her feelings are legitimate, is gauged by: "Acknowledges concerns of patient and family members as important," "Spends time with patient and family members to listen to their concerns and problems" and "Initiates a conversation with patient/family member who is usually silent."

In programs where the ICAS is used, it is usually given during the first semester and again during the last semester of the student's Nursing program. Dr. Klakovich's experience shows that there is a significant improvement because interpersonal communication training is blended into the curriculum as well as practical experience in the clinical setting.

Traditionally, role playing has allowed nursing students to practice their interpersonal skills. Feedback from peers and clinical instructors can help hone a student's skills prior to interacting with actual patients. Recording interactions between Nursing students and patients is another tool for refining a student's skills. And now, advances in technology such as simulation and virtual hospitals can make it even easier to ensure students have the breadth of experience necessary to give them confidence.

The importance of developing appropriate interpersonal communication skills in Nursing students is a worldwide issue. In fact, the ICAS has been translated into Italian and is currently being translated into Portuguese.

According to Dr. Klakovich, all of this training not only translates into greater career satisfaction for nurses, but also improved patient outcomes and increased patient satisfaction. And after all, taking the best possible care of patients is the goal of any nurse.