Therapeutic Communication Training in Perinatal Loss: Simulation-Based Approaches

Acibadem University70 enrolled

Overview

This study aims to evaluate the effect of simulation-based education on nursing students' therapeutic communication skills in managing perinatal loss. Perinatal loss, defined as early fetal loss before 20 weeks of gestation and late fetal loss at or after 20 weeks, is a traumatic experience that significantly impacts parents, especially mothers, on biological, psychological, social, and spiritual levels. Prolonged grief reactions can lead to complicated grief, anxiety, depression, hopelessness, and relationship disturbances. Nursing students are trained to adopt a biopsychosocial approach in patient care and are expected to support grieving individuals by normalizing emotions, identifying coping strategies, and facilitating healthy grief processing. Simulation is recognized as an effective teaching method in developing communication and therapeutic skills among nursing students. This research investigates how simulation-based training can enhance students' therapeutic communication competencies when supporting individuals experiencing perinatal loss.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Enrollment

Conditions

Simulation-based Learning Communication Skills Paper-Pencil Simulation

Interventions

High-Fidelity Simulation-Based Therapeutic Communication TrainingBEHAVIORAL

This intervention involves a structured, high-fidelity simulation scenario in a clinical skills lab setting using mannequins and standardized patients. The scenario focuses on communication with a patient experiencing perinatal loss. The session includes pre-briefing, simulation, and debriefing components.

Paper-Pencil Simulation-Based Therapeutic Communication TrainingBEHAVIORAL

This intervention utilizes a written clinical case scenario related to perinatal loss. Students read the scenario and write appropriate therapeutic communication responses, followed by group discussion and instructor feedback. The focus is on reflection and theoretical integration.

Outcomes

Primary Outcomes

Therapeutic Communication Skills Performance

Students' ability to effectively demonstrate therapeutic communication skills during a simulated patient encounter involving perinatal loss. Assessed using the Therapeutic Communication with Patients Experiencing Perinatal Loss Simulation Application Checklist, which evaluates competencies such as providing presence, empathy, active listening, calming guidance, providing psychological support, and applying therapeutic communication techniques. Performance is rated as "Yes," "Partially," or "No" based on observed behaviors.

Time frame: Immediately during scenario completion (Day 1)

Perceived Communication Skills Self-Assessment

Students' self-evaluation of their communication abilities following the simulation experience, measured by the Communication Skills Assessment Form. This form covers 20 communication techniques, both therapeutic and nontherapeutic, rated on a 10-point scale, with higher scores reflecting stronger perceived communication competencies.

Time frame: Immediately before debriefing session (Day 1)

Student Satisfaction and Self-Confidence in Learning Scale (SCLS)

Students' level of satisfaction with the simulation-based learning experience and their self-confidence in applying learned skills, assessed through the Student Satisfaction and Self-Confidence in Learning Scale (SCLS). The scale includes two subdimensions-Student Satisfaction and Self-Confidence in Learning-measured via a 5-point Likert scale. Higher scores indicate greater satisfaction with the simulation and higher confidence in using therapeutic communication skills.

Time frame: Immediately after debriefing session (Day 1)

Simulation Execution Checklist Evaluation

The degree to which the simulation was implemented according to planned steps and standards. This outcome measures the fidelity, completeness, and quality of the simulation process itself, as evaluated by observers using a checklist. It ensures consistency, scenario realism, and adherence to key components critical for achieving the intended learning objectives.

Time frame: During scenario execution (Day 1)

Secondary Outcomes

Reflection on Learning and Communication Effectiveness

Students' ability to critically reflect on their learning experiences and assess the effectiveness of their communication during the simulation. Reflection focuses on recognizing strengths and areas for improvement in therapeutic communication, understanding emotional responses during patient interactions, and identifying strategies for enhancing future clinical practice. This outcome promotes self-awareness, deeper learning, and the internalization of communication skills through structured debriefing and written or verbal reflections.