Abstract
Effective communication is a cornerstone of safe and high-quality healthcare delivery. Poor communication among healthcare professionals is a significant factor contributing to medication errors, therapy failure, and unnecessary adverse events. Inefficient or unclear information exchange can complicate patient care, delay critical interventions, prolong hospital stays, and increase healthcare costs. Given that to growing complexity of modern healthcare settings, fostering structured, standardised, and effective communication practices is consider an essential approach in ensuring patient safety, enhancing teamwork, and optimising collaborative clinical decision making.
The ISBAR (Identify, Situation, Background, Assessment, and Recommendation) communication tool has been widely adopted as a structured framework for improving the clarity and accuracy of clinical handovers, particularly in high-pressure environments such as hospitals’ emergency departments, and critical care units. Simulation has been shown to be a highly effective method for enhancing communication education in healthcare, through providing a controlled and immersive environment where learners can develop and refine their communication skills learning without the immediate risks associated with real-world clinical practice.
This study explored the impact of simulation-based education on communication skill development among pre-registration Graduate Entry Nursing (GEN) students, focusing on their experiences with the ISBAR communication tool. Given that GEN students often enter nursing with diverse academic and professional backgrounds, their prior disciplinary training may expose them to different professional communication norms and levels of familiarity with workplace environments. These factors may influence how nursing students interpret, adopt, and apply structured communication tools such as ISBAR during their clinical placements. Therefore, it is crucial to understand how GEN students engage with structured communication training and how this engagement influences their preparedness for communication in clinical practice.
An embedded mixed-methods approach was employed in this study, including two focus groups, 22 semi-structured interviews, and analysis of two sets of eleven audio-recordings of ISBAR conversations in simulated environments. These data sources provided insights into students’ perceptions of ISBAR training, the challenges they encountered, and the effectiveness of the simulations in enhancing their communication confidence in preparedness for practice. The findings of this study showed that simulation-based education allows learners to experience and respond to diverse clinical scenarios, reinforcing the importance of clear, concise, and structured communication. Engaging in simulated patient care scenarios helped students to develop confidence in delivering key patient information systematically and efficiently. Additionally, it provided opportunities for real-time feedback and guided reflection, enabling students to identify areas for improvement, address communication barriers, and refine their ability to interact effectively with interdisciplinary teams.
This study findings also highlighted that the structured nature of ISBAR tool enhanced participants’ ability to organise and present clinical information in a logical and standardised format, reducing anxiety and hesitation when communicating with nursing colleagues or doctors. However, challenges were noted, particularly in the consistent application of the Recommendation component of ISBAR. Participants often struggled with suggesting clear and confident clinical recommendations, which could be attributed to limited clinical experience and exposure, as well as uncertainty about their professional role boundaries when communicating with more experienced healthcare staff. This suggests a need for targeted interventions to strengthen their ability to formulate clinical decisions and communicate recommendations effectively.
To conclude, this study provides insight into the importance of designing simulation sessions that address the unique learning needs of GEN students. Given their diverse educational and professional backgrounds, incorporating decision-making frameworks and structured feedback mechanisms into simulation scenarios can enhance their ability to communicate assertively and effectively in clinical environments. Strengthening nursing students’ communication skills at this foundational stage can have a positive lasting influence on patient safety, interprofessional collaboration, and overall healthcare quality.