Nursing studies

How a simulation exercise improved my communication skills

A learning activity with a service user helped to bridge the theory-practice gap for student Leah Butler

A learning activity with a service user helped to bridge the theory-practice gap for student Leah Butler


Sometimes completing an exercise can help us to piece things together. Source: Alamy

Good communication skills are required by all nurses and underpin everything we do to ensure service users receive the best possible person-centred care. But while we can learn the theory about communication, and put it into practice in our placements, patients can be too poorly or worried, or feel too vulnerable, to offer students constructive feedback on the way they communicate.

During my second year as a nursing student at Bournemouth University, we took part in a simulated activity where we carried out an admission assessment of a service user, then handed over to our peers – in front of our lecturers and staff from practice.

PIER partnership

The university is involved in a Public Involvement in Education and Research (PIER) partnership, where people from the community who regularly access healthcare services participate in some areas of the curriculum. 

At the time, I couldn’t understand how this simulation activity would enhance my skills because it felt like something I had practised during my placements. But I didn’t anticipate how powerful the feedback from the PIER member, staff and my peers would be. Writing a critical reflective essay about the simulation activity, and linking it to the literature, helped to close the theory-practice gap.

‘This simulation allowed me to see the importance of effective communication, not just with the patient but also during handover and with colleagues’

As nurses, our aim is to facilitate a patient’s ability to communicate so they can be provided with the optimum level of individualised care and support. It was interesting, therefore, to hear the PIER partner’s feedback, in particular when he pointed out that he had to prompt me to explain what would happen next on his surgical journey.

Breaking barriers

Reflecting on this, I realised that my focus had been on completing the task instead of his needs. I had been unaware of the anxiety he was experiencing about his future care. I could see that this is also something I do in practice so it taught me to be mindful. 

I find it hard as a nursing student not to focus constantly on the clinical aspects of care. Doing so can form barriers and prevent the development of a therapeutic relationship, and it was interesting to hear that the patient would have liked to chat more before being asked clinical questions. He said this would have put him more at ease and made his care more individual. 

I have learned from this and taken it with me into practice.

Importance of handover

The simulation activity also showed me how important correct contemporaneous documentation is in completing a comprehensive handover. Documentation is a legal requirement and it needs to be accurate. But I found it difficult to complete during the admission assessment as I kept mishearing because of the speed of the conversation with the patient. This then made the handover difficult and inaccurate. 

If this were to happen in practice it could lead to incorrect care being given. Developing a good rapport with the patient and having a general conversation can help slow things down.

This simulation allowed me to see the importance of effective communication, not just with the patient but also during handover and with colleagues. It also showed me the importance of building a trusting therapeutic relationship to put the patient at ease.  

The simulation activity was a valuable part of my nurse training, and I have engaged with what the service user said and learned from the mistakes I made. In doing so, I gained confidence in my nursing practice and will continue striving to become the best nurse I can be.


Leah Butler is a third-year nursing student at Bournemouth University

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