A Handbook for Teaching and Learning in Higher Education Enhancing academic and Practice

Nursing and midwifery
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the activities in which they are embedded. However, good communication is essential to
promoting the well-being of patients/clients and for effective service delivery. Thus
healthcare curricula contain learning outcomes related to communication to highlight
this professional skill.
There may be teaching sessions labelled as ‘communication skills’, addressing such
topics as: the psychology of communication, verbal and non-verbal communication;
cultural diversity, language barriers and working through interpreters or advocates;
communication with relatives, and breaking bad news. Ideally, most sessions are
conducted with small groups in an undisturbed environment, with a supportive
facilitator, and opportunities to experiment and practise this core skill. Discussion and role
play are the dominant teaching strategies, each requiring participants to be active learners.
Such ‘props’ as telephones or one-way mirrors may support role play; or where resources
permit, input from specially trained professional actors. The actors simulate patients and
then come out of role to provide feedback to the students. A communications suite
permits video-recording for later self-analysis or tutor feedback. Cooke et al. (2003)
described an interprofessional learning experience for senior students, using simulated
patients and extending existing curricula in relation to breaking bad news (see also Case
study 2 in Chapter 2).
Timetabled slots for the development of communication skills do not obviate the need
for attention to communication issues to be integral to other teaching and learning
activities. For example, it is essential to discuss and practise appropriate communication
while teaching junior nursing students the practical skills of washing and feeding
patients. Some teaching sessions concern psychomotor skills that are inevitably
uncomfortable or embarrassing procedures. Supportive verbal and non-verbal
communication is an important part of nursing and midwifery practice in these
circumstances and should be considered alongside the development of the psychomotor
skill. Furthermore, tutors who support students in their placements are well placed to
discuss communication challenges, to observe student performance and provide
formative feedback.
Communication skills are rarely the sole focus of an assessment. Since communication
is integral to other activities it is entirely appropriate to assess communication skills in
parallel with knowledge or psychomotor skills. The main assessment vehicles are essays,
reports, practice-based assessments, OSCEs, presentations and posters. Whatever the
assessment mode it is important to develop clear assessment criteria; otherwise
communication assessment may be cursory and unreliable. The complex and nuanced
nature of communication makes it challenging to assess.
Interprofessional collaboration
Students need to appreciate that multidisciplinary teams deliver care, possibly spanning
the NHS, social services, the private sector and the voluntary sector. Effective, efficient,
client-centred care requires interprofessional and inter-agency collaboration. Each team