Efficacy of a blended learning programme in enhancing communication skill competence and self-efficacy among nursing students in clinical handover : a randomised controlled trial

Abstract

 Clinical handover is one of the most common routine practices of nurses and extremely important to all patients. Besides passing patients’ specific information, the practice also maintains patient safety and the quality of nursing care. However, most of the new graduate nurses (NGNs) are struggling in conducting clinical handovers. The aims of the thesis were as follows: (1) to summarise the current evidence relating to the efficacy of interventions used in clinical handover training; (2) to explore the experience and learning needs of NGNs in clinical handover; and (3) to examine the efficacy of a blended learning programme (BLP) in enhancing the communication skill competence and self-efficacy of nursing students. Before the intervention study, existing evidence to enhance communication skill competence of clinical handover was synthesised in a literature review, and a descriptive qualitative study was conducted to understand the NGNs’ perception, experience, and learning needs in clinical handover. A customised clinical handover training programme using a blended learning approach was developed. A total of 96 students studying in the final year of a Bachelor of Nursing programme were recruited from a local university for a randomised controlled trial. These participants were randomly assigned either to the experimental group (n = 50) to receive a blended learning programme that contained a face-to-face handover training workshop plus an online module on handover practice or to the waitlist control group (n = 46) to receive face-to-face clinical handover workshop only. Participants in the waitlist control group would receive an online module right after data collection was completed. The outcomes were the participants’ communication skill competence, self-efficacy in conducting clinical handover, and their satisfaction with the programme they received. The literature review found that simulation-based interventions were frequently used in clinical handover training for nursing students. However, due to class size restrictions and the time-consuming arrangement, it cannot effectively address the large classes of nursing programmes nowadays. Using the online component was found to be effective in teaching medical residents about clinical handovers. However, this method has not been used for nursing students. The qualitative study identified three barriers to clinical handover of the NGNs, including inadequate professional judgement, weakness in synthesising the critical information, and unsystematic clinical handover reporting. The intervention study revealed that the participants in the experimental group who received the BLP scored higher in communication skill competence, improved more in self-efficacy, and had a higher satisfaction rate with the training programme. The literature review and the qualitative study provided evidence-based support for developing the training programme. The intervention study was the first randomised controlled trial that applied BLP to clinical handover training. The results indicated that this programme effectively enhanced nursing students’ communication skill competence and self-efficacy in clinical handover. The findings proved that a blended learning approach in clinical handover training is vital to nursing students. Nurse educators are recommended to integrate a BLP for clinical handover training into the undergraduate nursing curriculum.