Dissertation/Thesis Abstract

The Effectiveness of AAC Training Protocols for Acute Care Nurses: A Randomized Controlled Trial of an Instructional On-line Medium for Clinical Skills Teaching
by Downey, Debora Ann, Ph.D., The University of Iowa, 2014, 155; 3628382
Abstract (Summary)

Acutely ill patients, across the age continuum, often present with complex communication needs (CCN) due to motor, sensory, cognitive and linguistic barriers they may experience during their hospital encounter. While hospital administrators recognize the importance of improving communication among the healthcare team members to increase quality and safety measures, few have focused on improving the patient-provider communication process, especially for patients with CCN. Recent Joint Commission standards mandates hospitals and healthcare providers improve communication for patients with CCN across all points of the care continuum. The study investigated the effectiveness of AAC training protocols for acute care nurses and ancillary healthcare providers using an on-line instructional medium for clinical skills teaching. The study design allowed for the measurement of learning following exposure to the tutorial and the analysis of possible clinical skill application. The current study invited a total of 377 nurses and graduate students to participate. Eight-three participated in the study and were divided randomly into two groups. Seventeen (20.5%) were assigned to in the control group, and 66 (79.5%) participants were into the test group. Both groups were directed to complete a pre-test measure. This was followed by exposure to the tutorial for the test group. The groups then were instructed to complete a post-test measure. For all participants in the test condition, the mean difference score (post-pre) was 19.2. The average pre-test score was 60.8 with a standard deviation of 12.4 while the average post-test score was 80.1 with a standard deviation of 11.3. This difference was significant (p<.00001). This suggests the on-line tutorial as a mode of delivery for clinical skills teaching of AAC solutions for patients with CCN was effective. The study also involved the design of a set of scenarios to assess transfer of knowledge from the tutorial to clinical practice in a safe environment. The scenarios targeted three areas for participants to problem solve through: the development of a yes/no response, recognition of sensory issues displayed by patients with CCN; and, candidacy for AAC use in an acute care setting. The scenarios were presented to both groups after completion of the post-test measure. No significant difference across the groups was noted. However, findings suggested that the use of scenarios may be a viable method for assessing the application of clinical skills when the participant had to generate a narrative outlining clinical practice as opposed being scaffold by the selection of correct and incorrect clinical skill strategies presented. The study emphasizes the need to enhance the patient-provider communication experience for patients with CCN and outlines basic elements for nurse training modules.

Indexing (document details)
Advisor: Hurtig, Richard
Commitee: Harper, Dennis, Karnell, Michael, Montgomery, LouAnn, Tomblin, Bruce J.
School: The University of Iowa
Department: Speech and Hearing Science
School Location: United States -- Iowa
Source: DAI-B 75/11(E), Dissertation Abstracts International
Subjects: Speech therapy, Nursing
Keywords: Augmentative/alternative communication, Complex communication needs, Nursing tutorial
Publication Number: 3628382
ISBN: 978-1-321-04055-5
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