{"id":347,"date":"2024-11-06T16:20:40","date_gmt":"2024-11-06T16:20:40","guid":{"rendered":"https:\/\/iims.uthscsa.edu\/isrn\/?page_id=347"},"modified":"2026-01-27T18:22:32","modified_gmt":"2026-01-27T18:22:32","slug":"clinician-communication-how-confident-are-we-and-does-it-differ-by-role","status":"publish","type":"page","link":"https:\/\/iims.uthscsa.edu\/isrn\/resources\/ereading-room\/abstracts\/clinician-communication-how-confident-are-we-and-does-it-differ-by-role\/","title":{"rendered":"Clinician Communication: How Confident Are We and Does It Differ By Role?"},"content":{"rendered":"

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Primary Author:<\/td>\nAnne Marie Kotzer<\/td>\n<\/tr>\n
Co-Principal Investigators\/Collaborators:<\/td>\nMaree Burke, ADN, RNC-NIC, Sharon Sables-Baus, PhD, RN<\/td>\n<\/tr>\n
Organization<\/td>\nChildren’s Hospital Colorado<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Abstract<\/h2>\n

Purpose<\/h3>\n
    \n
  1. Evaluate communication self-efficacy among clinicians in the NICU;<\/li>\n
  2. Determine whether clinicians\u2019 communication self-efficacy differs based on role.<\/li>\n<\/ol>\n

    Background<\/h3>\n

    Direct care nurses in the Neonatal Intensive Care Unit (NICU) identified inconsistencies in practice related to measuring and treating pain\/sedation in infants. The question also arose as to the nurse\u2019s confidence level in approaching the physician or neonatal nurse practitioner (NNP) about their concerns. It was suggested that nurses\u2019 confidence with their communication skills may be lacking and may differ based on provider (MD vs. NNP)<\/p>\n

    Materials & Methods<\/h3>\n

    RNs, therapists, pharmacists, dieticians, etc. in the NICU were invited to complete a Communication Self-Efficacy Scale (CSES) to assess clinician\/physician and clinician\/NNP communication. The CSES measures communication confidence on two subscales, \u201cassertiveness\u201d and \u201csystematic\u201d.<\/p>\n

    Results<\/h3>\n

    104 clinicians completed the CSES with the largest groups being nurses (N=73), NNPs (N=12), and therapists (N=8); 79% reported providing direct patient care \u2265 75% of the time. Mean age was 38.26 \u00b1 10.71 yrs and 62.1% held a baccalaureate degree and 22.1% a master\u2019s degree.
    \nMean \u201cassertiveness\u201d score when communicating with an MD was 36.15 \u00b1 6.20 and the mean \u201csystematic\u201d score was 37.98 \u00b1 5.96. Communication with an NNP was significantly higher (assertive: 37.14 \u00b1 5.52; systematic: 38.8 \u00b1 5.15) than with the MD (p < .0001). Significant differences were seen between MD and NNP communication for RNs alone (p < .0001), with greater confidence when communicating with the NNP. Therapists\u2019 subscale scores were statistically higher when communicating with the NNP than MD.<\/p>\n

    Conclusion<\/h3>\n

    Much is written about nurse-physician communication and its impact on patient safety and outcomes, yet little information exists about other disciplines\u2019 communication self-efficacy. This study revealed differences across all clinicians and provider groups, demonstrating less confidence when communicating with physicians. While staff education on specific clinical practice issues is needed, the impact will be optimized if education and training are provided around assertive\/systematic communication, with dedicated content on communication self-efficacy.<\/p>\n

    Bibliography<\/h3>\n

    Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W.H. Freeman and Company.<\/p>\n

    Benjamin, D.M., (2001). Reducing medication errors and increasing patient safety through better communication. Focus on Patient Safety, 4(4), 6, 8.<\/p>\n

    Beyea, S.C. (2004). Improving verbal communication in clinical care. AORN Journal, 79(5), 1053-1057.<\/p>\n

    Casanova, J., Day, K., Dorpat, D., Hendricks, B., Theis, L., & Wiesman, S. (2007). Nurse-physician work relations and role expectations. Journal of Nursing Administration, 37(2), 68-70.<\/p>\n

    Hallas, D.M. (2004). Attitudes and beliefs for effective pediatric nurse practitioner and physician collaboration. Journal of Pediatric Health Care, 18(2), 77-86.<\/p>\n

    Raica, D.A., (2009). Effect of action-oriented communication training on nurses\u2019 communication self-efficacy. MEDSURG Nursing, 18(6), 343-360.<\/p>\n

    Rothstein, W.G., & Hannum, S. (2007). Profession and gender in relationships between advanced practice nurses and physicians. Journal of Professional Nursing, 23(4), 235-240.
    \n\u00a9 Improvement Science Research Network, 2012<\/p>\n

    The ISRN\u00a0published this as received and with permission from the author(s).<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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