Blended Learning to Enhance Elderly Communication Skills in Nursing Students and New Nurses

Official title

Application of Blended Learning Model to Improve the Communication Skills of Nursing Students and New Nurses With the Elderly: Development and Effectiveness Verification

Overview

The study will recruit new nurses from the hospital to evaluate the effectiveness of learning communicating skills in elderly care through a hybrid learning model. Participants will be randomly assigned to either an experimental group receiving hybrid method course or a control group using written materials, with both groups participating in a 60-minute educational session. The research will employ a multi-stage assessment approach, beginning with a pre-test to measure baseline knowledge of aging, attitudes toward older adults, willingness to serve the elderly, and communication skills. Immediately following the intervention, participants will complete a post-test, with a follow-up delayed assessment conducted three months later to evaluate knowledge retention. Clinical preceptors will systematically assess the nurses' elderly communication skills using a standardized rating scale. To gain deeper insights, selected nurses will also participate in qualitative interviews, sharing their learning experiences, reflections, and recommendations for improving the teaching materials, thereby providing a comprehensive understanding of the training's effectiveness and potential areas of enhancement.

Detailed description

This study is a randomized controlled trial designed to evaluate the effectiveness of a hybrid learning model communication training program for newly recruited nurses interacting with older adults. The intervention group receives a self-directed learning experience using an online multimedia module and an AI chatbot learning assistant, while the control group studies equivalent content through printed educational materials. The training aims to enhance nurses' knowledge of aging, improve attitudes toward older adults, increase willingness to serve the elderly, and develop geriatric communication skills.

The digital course content includes five core themes: (1) knowledge related to aging, (2) application of empathy, (3) the impact of hospitalization on older adults and communication barriers, (4) fundamental principles of elderly communication, and (5) simulated scenario-based dialogues. Each unit is under 10 minutes and followed by an online quiz. Participants may continue practicing using an AI chatbot tutor that reinforces learning.

Participants are randomly assigned in a 1:1 ratio stratified by gender and educational background. Following baseline assessments, the intervention is conducted during the fourth day of an onboarding training program. The post-test is planned to be done immediately after the 60-minute learning session, and follow-up assessments are conducted one, two, and three months later to evaluate knowledge retention and real-world skill application. Quantitative outcome measures include pre-post changes in: knowledge of aging questionnaire, attitudes toward older adults questionnaire, willingness to care for elderly questionnaire, self-reported and preceptor-assessed geriatric communication skills questionnaire, motivation for learning via instructional material.

In addition to self-report questionnaires, trained clinical preceptors assess geriatric communication skills during actual clinical settings using the KEECC Checklist (Kalamazoo Essential Elements Communication Checklist).

A final qualitative component includes semi-structured interviews with 10 participants from the experimental group, selected until data saturation is reached, to explore learning experiences and gather feedback on the instructional design.

This mixed-method study aims to provide evidence for scalable, technology-enhanced training solutions that prepare early-career nurses for competent and compassionate elder care communication.

Interventions

• Other Hybrid Digital Learning with AI Chatbot for Geriatric Communication
  A web-based, self-directed learning program integrated with a conversational AI chatbot. The chatbot reinforces learning and allows for flexible post-training practice.
• Other Traditional Learning: Printed Educational Materials
  Traditional teaching materials, printed document including structured readings on aging knowledge, empathy, communication barriers, and case-based communication strategies with older adults.

Primary outcome measures

• Change in Knowledge of Aging Questionnaire Score [Time frame: Baseline (Pre-test): Prior to intervention. Immediate Post-test: Directly after the 60-minute learning session. First Follow-up: 1 month after intervention. Second Follow-up: 2 months after intervention. Third Follow-up: 3 months after intervention.]
• Change in Kogan's Attitudes Toward Older People (KAOP) Scale Score [Time frame: Baseline (Pre-test): Prior to intervention. Immediate Post-test: Directly after the 60-minute learning session. First Follow-up: 1 month after intervention. Second Follow-up: 2 months after intervention. Third Follow-up: 3 months after intervention.]
• Change in Willingness to Serve Older Adults Scale Score [Time frame: Baseline (Pre-test): Prior to intervention. Immediate Post-test: Directly after the 60-minute learning session. First Follow-up: 1 month after intervention. Second Follow-up: 2 months after intervention. Third Follow-up: 3 months after intervention.]
• Change in Self-Reported Communication Skills Scale Score [Time frame: Baseline (Pre-test): Prior to intervention. Immediate Post-test: Directly after the 60-minute learning session. First Follow-up: 1 month after intervention. Second Follow-up: 2 months after intervention. Third Follow-up: 3 months after intervention.]
• Change in Kalamazoo Essential Elements Communication Checklist (KEECC) Score [Time frame: Baseline (Pre-test): Prior to intervention. Immediate Post-test: Directly after the 60-minute learning session. First Follow-up: 1 month after intervention. Second Follow-up: 2 months after intervention. Third Follow-up: 3 months after intervention.]

Eligibility criteria

Inclusion criteria

• At least 20 years old
• Graduated from a nursing school
• Full-time employee
• Less than six months of nursing work experience
• Working in a medical ward

Exclusion criteria

• Job nature does not involve direct patient contact, such as working in the supply room.
• Not engaged in clinical nursing work, such as a research assistant.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Health services research

Study locations

Taiwan · 2 centers

• Tzeng — Taichung
• Ya-Ling Tzeng — Taichung

Identifiers

NCT: NCT07026136 · CMUH111-REC1-110

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗