• Jones Aled.
• School of Health Science, Swansea University, Singleton Park, Swansea, Wales, UK. aled.jones@swan.ac.uk
• J Clin Nurs. 2007 Dec 1; 16 (12): 2297-307.

AimTo understand student nurse-patient interaction better and to assess the effectiveness of a teaching and learning resource consisting of tapes and transcriptions of actual nurse-patient interaction.DesignApplied conversation analysis and analysis of semi-structured lecture evaluation forms.BackgroundLittle research discusses interpersonal skills (IPS) of student-nurses, even though policy initiatives and literature internationally promote patient-centred communication as being an indicator of high-quality healthcare. Literature also suggests that nursing education is often far removed from the realities which students experience during clinical practice.MethodsPhase 1 of the study saw 10 student nurse-patient interactions audio recorded and transcribed and the data subjected to conversation analysis. Phase 2 saw tapes and transcripts of similar interactions used as a teaching resource with the same cohort of students (n = 48), student evaluations of the lecture were quantitatively and qualitatively analysed.ResultsPhase 1 demonstrated that, in variance to 'best-practice' recommendations, student nurse-patient interactions were task-centred and bureaucratically organized. In phase 2, after listening to and reading a transcript of similar interaction, students were able to identify the limitations of undertaking such an approach with patients, strongly suggesting that classroom-based knowledge is not always easily transferred into clinical practice. This teaching approach was positively evaluated, with written evaluations emphasizing the effectiveness of bringing the realities of clinical practice into the classroom.ConclusionThis study suggests that students have difficulty in transferring the principles of 'good' communication from the classroom into their own interactions with patients. Students' written and spoken evaluations were reminiscent of the previous work performed in discussing the concept of a 'hidden curriculum' in professional training.Relevance To Clinical PracticeThe use of empirical data in the practice of IPS teaching is recommended as a means of closing the theory-practice gap. Student nurses and mentors need to consider the effect of the hidden curriculum on their IPS.

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