Speak for Success: A Pilot Intervention Study on Communication Competence of Post-Hire International Nurses

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Speak for Success was a research study designed to test the effectiveness of an evidence-based, comprehensive communication training program for international nurses. A total of 79 registered nurses from two hospitals in southern Nevada participated in this quasi-experimental, two-phase study. Two interventions were included: a 10-week linguistics course focusing on phonology (pronunciation and accent reduction) by a certified speech pathologist and four workshops on the social and cultural aspects of communication conducted by intercultural communication experts. This study indicated that a short-term linguistic intervention was effective in reducing phonologic errors of international nurses regardless of gender, age, country of origin, or length of residency in the United States. For the second intervention, despite a tendency of improvement for some communication variables, differences in between-group and within-group comparisons were not significant, possibly because of the high level of acculturation among the sampled nurses as a result of living and working in the United States for an extended period of time.

Section snippets

Need for Successful Transitions

Because international nurses play an increasingly important role 42 Journal of Nursing Regulation in health-care delivery, they need a successful transition into what are often unfamiliar practice environments with different or even conflicting professional and sociocultural expectations. A growing body of literature has documented a wide range of challenges experienced by international nurses during their transition to the U.S. health-care environment and the American society (Lopez, 1990,

Theoretical Framework: Model of Communicative Proficiency

Based on adaptation and synthesis of research on the acquisition of English as a second language, the Center for Canadian Language Benchmarks published the Canadian Language Benchmarks (CLB) (Pawlikowska-Smith, 2000). CLB is based on a functional view of language, language use, and language proficiency. Such a view relates language to the contexts in which it is used and the communicative functions it performs. The focus of CLB is on communicative proficiency in English as a second language.

Study Design

This study used a quasi-experimental design with two independent phases, each of which included an intervention. Pretests and posttests were conducted for the two interventions during each phase. Participants in both the intervention and comparison groups, who were international nurses, regardless of gender, age, race, and country of origin, were recruited at two urban hospitals in a single health-care system. Hospital administrators and nurse managers at the partner hospitals facilitated

Results

The demographic characteristics of the participants in Phase I are detailed in Table 1. On average, the participants in the intervention group were relatively older than those in the comparison group (ages 46 and 42 years, respectively) and arrived in the United States at an older age (ages 32 and 28 years, respectively). Three quarters of the participants in both groups originally came from the Philippines, where English is one of the official languages.

Results of the linguistic intervention

Implications for Practice

This study indicates that the short-term linguistic intervention was effective in reducing phonological errors by international nurses, thus improving their communication accuracy and effectiveness, which in turn could minimize risks to patient safety and improve quality of care in the clinical setting. This intervention may prove useful and helpful to all international nurses regardless of gender, age, country of origin, and length of time living and working in the United States. Yet,

Limitations

This study has limitations. Although the short-term linguistic class appeared to reduce phonological errors in international nurses, the study was a pilot in nature. The small sample size and other potential factors may have magnified the effect of the linguistic intervention. Also, because of budget constraints, the speech therapist who delivered the linguistic class also performed the pre- and post-assessments. Future studies should use independent evaluators whenever possible to minimize

Acknowledgment

This study was supported by the National Council of State Boards of Nursing.

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