Indiana University of Pennsylvania Knowledge Repository @ IUP Teses and Dissertations (All) 2-2-2015 Nursing Students' Lived Experiences in Learning Communication Skills in a Teater Class Taught by Teater Faculty Pamela S. O'Harra Indiana University of Pennsylvania Follow this and additional works at: htp://knowledge.library.iup.edu/etd Recommended Citation O'Harra, Pamela S., "Nursing Students' Lived Experiences in Learning Communication Skills in a Teater Class Taught by Teater Faculty" (2015).Teses and Dissertations (All). 774. htp://knowledge.library.iup.edu/etd/774 Tis Dissertation is brought to you for free and open access by Knowledge Repository @ IUP. It has been accepted for inclusion in Teses and Dissertations (All) by an authorized administrator of Knowledge Repository @ IUP. For more information, please contact NURSING STUDENTS’ LIVED EXPERIENCES IN LEARNING COMMUNICATION SKILLS IN A THEATER CLASS TAUGHT BY THEATER FACULTY A Dissertation Submitted to the School of Graduate Studies and Research in Partial Fulfillment of the Requirements for the Degree Doctor of Education Pamela S. O’Harra Indiana University of Pennsylvania December 2014 © 2014 Pamela S. O’Harra All Rights Reserved ii Indiana University of Pennsylvania School of Graduate Studies and Research Department of Professional Studies in Education We hereby approve the dissertation of Pamela S. O’Harra Candidate for the degree of Doctor of Education ___________________ _________________________________________ Kelli R. Paquette, Ed.D. Professor of Professional Studies in Education, Advisor ___________________ _________________________________________ Theresa Gropelli, Ph.D. Associate Professor of Nursing and Allied Health Professions ___________________ _________________________________________ DeAnna M. Laverick, D.Ed. Associate Professor of Professional Studies in Education ___________________ _________________________________________ Anne D. Creany, D.Ed. Professor of Professional Studies in Education, Retired ACCEPTED _________________________________________ ____________________ Timothy P. Mack, Ph.D Dean School of Graduate Studies and Research iii Title: Nursing Students’ Lived Experiences in Learning Communication Skills in a Theater Class Taught by Theater Faculty Author: Pamela S. O’Harra Dissertation Chair: Dr. Kelli R. Paquette Dissertation Committee: Dr. Theresa Gropelli Dr. DeAnna M. Laverick Dr. Anne D. Creany This qualitative phenomenological study describes the “lived experiences” of ten junior and senior baccalaureate nursing students after learning nursing communication practices in a theater course taught by theater faculty. Researcher observation of the students during the interviews, the students’ reported experiences, and journal writings were used to determine if the methods used in the theater course were beneficial to their overall abilities in practicing effective communication in the health care setting. The analysis of the researchers’ observations and the students’ responses and journal writings showed that students’ felt unprepared and unable to effectively communicate prior to taking the theater course. After the theater course, the analysis of the data revealed an overall increase in the students’ perceptions of their ability to effectively communicate in the health care setting. The data also revealed that the teaching methods used in the theater course increased students’ confidence levels and heightened the students’ inner self-awareness during the communication process. The results of the study showed that students felt their communication abilities were heightened mostly in the areas of empathy, assertiveness, and the use of body language. The results also revealed that the students contributed their new found communication practices to the teaching methods used in the theater course. The students reported that meditation, iv relaxation techniques, journaling, and role-playing with the theater students using nurse-patient scenarios were the reasons they felt their overall communication abilities improved. v ACKNOWLEDGMENTS I would like to acknowledge my husband, Leroy, children Max and Karlee, my parents, Max and Linda, and sisters, Bonnie and Lynn, for seeing me through this process and being understanding of the time and work that was needed to finish my doctoral degree. They have all helped in so many ways and dedicated their time to helping me succeed. This has been a long journey and I would especially like to acknowledge my dissertation chair, Dr. Paquette and my dissertation committee, Dr. Gropelli, Dr. Creany, and Dr. Laverick for the dedication and guidance that they have given me through the dissertation process. Their commitment and passion in helping me succeed will not be forgotten. I would also like to acknowledge my friends and colleagues in the nursing department who have all at one time or another either taught me or mentored me in some way. They have contributed to my success in nursing in so many ways and have willingly helped me through this process by sharing their knowledge and words of wisdom. Additionally, I would like to acknowledge those in the education department who also taught and guided me through the journey of obtaining my Doctoral Degree in Education. vi TABLE OF CONTENTS Chapter Page I STATEMENT OF THE PROBLEM .......................................................................1 Theoretical Framework ............................................................................................4 Significance of the Study .........................................................................................6 Statement of the Purpose .......................................................................................10 Research Questions ................................................................................................10 Definition of Terms................................................................................................10 Limitations .............................................................................................................11 Summary ................................................................................................................12 II REVIEW OF THE RELATED LITERATURE ....................................................13 The Historical Progression of Caring, Empathetic Communication Skills and Behaviors in Nursing ................................................................14 Madeleine Leininger’s Theory ...................................................................15 Jean Watson’s Theory ................................................................................17 American Nurses Association ....................................................................18 The Impact of Effective Communication on Patient Outcomes and Patient Satisfaction.....................................................................................20 Utilizing Standardized Patients and Role-Play as a Teaching Method of Nursing Communication ......................................................................22 Utilizing Simulation as a Teaching Method of Nursing Communication .............25 Summary ................................................................................................................26 III METHODOLOGY ................................................................................................28 Setting of the Study ................................................................................................29 Baccalaureate Nursing Program Enrollment .............................................29 Increase in Nursing Standards ...................................................................30 Site Convenience .......................................................................................31 Participants .............................................................................................................32 Procedure for Data Collection ...............................................................................33 vii Chapter Page Method of Data Analysis .......................................................................................37 Conclusion .............................................................................................................39 IV ANALYSIS OF THE STUDY...........................................................................................40 Description of the Participants ...............................................................................41 Conducting the Interview .......................................................................................44 Decision Trail.........................................................................................................47 Theme 1: Struggling with Communicating Effectively ........................................50 Theme 2: Knowing Identity of “Self” ...................................................................54 Theme 3: Believing in Oneself .............................................................................56 Theme 4: Becoming Familiar with Good Practices ..............................................59 Theme 5: Engaging in “Lifelike” Experiences .....................................................62 Research Questions ................................................................................................65 Validation of the Findings .....................................................................................71 Summary ................................................................................................................73 Conclusion .............................................................................................................74 V SUMMARY, DISCUSSION, AND RECOMMENDATIONS .............................76 Preconceptions and Assumptions ..........................................................................77 Meanings and Understandings ...............................................................................79 Theme One: Struggling with Communicating Effectively .......................80 Theme Two and Theme Three: Knowing Identity of “Self,” and Believing in Oneself ................................................................80 Theme Four: Becoming Familiar with Good Practices ............................83 Theme Five: Engaging in “Lifelike” Experiences ....................................83 Research Question One ..............................................................................84 Research Question Two .............................................................................85 Research Question Three ...........................................................................85 Implications for Nursing Faculty ...........................................................................86 Implications for Nursing Students .........................................................................87 Nursing Faculty Recommendations ...........................................................88 viii Chapter Page Suggestions for Future Research ...........................................................................89 Strengths of the Study ............................................................................................90 Limitations of the Study.........................................................................................91 Reliability, validity, trustworthiness, and rigor. ............................92 Credibility ..................................................................................................92 Dependability .............................................................................................92 Confirmability ............................................................................................92 Generalizability ..........................................................................................93 Authenticity................................................................................................93 Summary ................................................................................................................93 REFERENCES ..............................................................................................................................95 APPENDICES .............................................................................................................................106 Appendix A - Research/Interview Question Matrix ............................................106 Appendix B - Invitation to Participate .................................................................107 Appendix C- THTR 481 Faculty Letter ...............................................................109 Appendix D - Informed Consent Form ................................................................111 Appendix E - Permission From Site Faculty .......................................................112 Appendix F - Complete Listing of Significant Interview Statements..................113 Appendix G - Significant Statements with Formulated Meanings ......................125 Appendix H - Emergent Themes .........................................................................141 Appendix I - Complete Listing of Significant Journal Statements .................... 142 Appendix J - Researcher Observations ................................................................147 ix