Simulation on the Enhancement of Clinical Communication Competencies in Nursing Students

Summary

Background: Clinical communication is a core competency in nursing practice and is pivotal to the quality, safety, and person-centred delivery of care. Effective communication supports treatment adherence, reduces errors, enhances patient and family satisfaction, and contributes to nurses' professional wellbeing. Despite the acknowledged importance of these skills, nursing students frequently report difficulties communicating with confidence and assertiveness in clinical settings. Although simulation is widely regarded as an innovative educational approach, evidence regarding its specific impact on the development of clinical communication skills-and on students' self-perceived communication competence-during the early stages of nursing education remains limited.

Methods: This protocol describes a parallel-group randomised controlled trial with 1:1 allocation, to be conducted at a private higher education institution in Portugal. First-year undergraduate nursing students enrolling for the first time in the Helping Relationship course unit will be eligible. The intervention group will participate in clinical simulation sessions, whereas the control group will receive conventional teaching comprising role-play, group discussion, and case analysis. Both groups will complete 10 contact hours delivered across three sessions over the semester. The primary outcomes will be: (a) clinical communication competence, assessed using the Interpersonal Communication Assessment Scale (ICAS), and (b) perceived self-efficacy, measured with the Self-Efficacy Questionnaire (SE-12), both administered pre- and post-intervention. Satisfaction with the educational experience will be assessed as a secondary outcome. Analyses will follow the intention-to-treat principle, complemented by a per-protocol analysis.

Discussion: This study will help to clarify whether clinical simulation is superior to conventional teaching in fostering communication skills and students' self-perceived communication competence during the early stages of undergraduate nursing education. The findings may support the early integration of simulation within nursing curricula and inform the design of educational interventions that promote the development of professionals who are more competent and confident in clinical communication, with a direct impact on the quality and safety of care delivery.

Conditions

• Communication

Interventions

OTHER

Clinical Simulation

Clinical simulation sessions using standardised patients portraying clients and/or their relatives, who will be attended by students in scenarios related to nursing clinical practice. Each session will include: a briefing (delivered by the academic staff member), hands-on simulation (performed by the students), and a structured debriefing using the TALK tool (facilitated by the academic staff member together with the students). Sessions will be delivered by academic staff trained in simulation. The number of participants per session will be limited to a maximum of 13 students. Simulation activities will take place at Simlab@Learn, within designated simulation facilities. The 10 contact hours will be delivered over the second semester, comprising two 4-hour blocks and one 2-hour block, in accordance with the course timetable. Scenarios may be adapted in terms of complexity according to students' observed performance, while maintaining consistency of the educational objectives.

Sponsors & Collaborators

• Escola Superior de Saúde Norte da Cruz Vermelha Portuguesa

  lead OTHER

Principal Investigators

• Joana Coelho, PhD · Escola Superior de Saúde Norte da Cruz Vermelha Portuguesa

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2026-02-01

Primary Completion

2028-06-30

Completion

2028-06-30

Countries

• Portugal

Study Locations