Therapeutic Communication Training in Perinatal Loss: Simulation-Based Approaches

NCT06959875 | Completed

• 1 other identifier: 2025/05-188
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effect of simulation-based education on nursing students' therapeutic communication skills in managing perinatal loss. Perinatal loss, defined as early fetal loss before 20 weeks of gestation and late fetal loss at or after 20 weeks, is a traumatic experience that significantly impacts parents, especially mothers, on biological, psychological, social, and spiritual levels. Prolonged grief reactions can lead to complicated grief, anxiety, depression, hopelessness, and relationship disturbances. Nursing students are trained to adopt a biopsychosocial approach in patient care and are expected to support grieving individuals by normalizing emotions, identifying coping strategies, and facilitating healthy grief processing. Simulation is recognized as an effective teaching method in developing communication and therapeutic skills among nursing students. This research investigates how simulation-based training can enhance students' therapeutic communication competencies when supporting individuals experiencing perinatal loss.

Conditions

Simulation-based Learning; Communication Skills; Paper-Pencil Simulation; High-fidelity Simulation

Outcome Measures

Primary Outcomes (4)

• Therapeutic Communication Skills Performance

  Students' ability to effectively demonstrate therapeutic communication skills during a simulated patient encounter involving perinatal loss. Assessed using the Therapeutic Communication with Patients Experiencing Perinatal Loss Simulation Application Checklist, which evaluates competencies such as providing presence, empathy, active listening, calming guidance, providing psychological support, and applying therapeutic communication techniques. Performance is rated as "Yes," "Partially," or "No" based on observed behaviors.

  Immediately during scenario completion (Day 1)

• Perceived Communication Skills Self-Assessment

  Students' self-evaluation of their communication abilities following the simulation experience, measured by the Communication Skills Assessment Form. This form covers 20 communication techniques, both therapeutic and nontherapeutic, rated on a 10-point scale, with higher scores reflecting stronger perceived communication competencies.

  Immediately before debriefing session (Day 1)

• Student Satisfaction and Self-Confidence in Learning Scale (SCLS)

  Students' level of satisfaction with the simulation-based learning experience and their self-confidence in applying learned skills, assessed through the Student Satisfaction and Self-Confidence in Learning Scale (SCLS). The scale includes two subdimensions-Student Satisfaction and Self-Confidence in Learning-measured via a 5-point Likert scale. Higher scores indicate greater satisfaction with the simulation and higher confidence in using therapeutic communication skills.

  Immediately after debriefing session (Day 1)

• Simulation Execution Checklist Evaluation

  The degree to which the simulation was implemented according to planned steps and standards. This outcome measures the fidelity, completeness, and quality of the simulation process itself, as evaluated by observers using a checklist. It ensures consistency, scenario realism, and adherence to key components critical for achieving the intended learning objectives.

  During scenario execution (Day 1)

Secondary Outcomes (1)

• Reflection on Learning and Communication Effectiveness

  Immediately after debriefing session (Day 1)

Study Arms (2)

High-Fidelity Simulation-Based Therapeutic Communication Training

EXPERIMENTAL

Participants in this group engaged in a high-fidelity simulation scenario involving perinatal loss, using a realistic clinical setting with mannequins and role-play. The simulation aimed to provide an experiential learning environment that fosters emotional engagement and realistic practice of therapeutic communication techniques. Students received a structured debriefing session following the simulation.

Behavioral: High-Fidelity Simulation-Based Therapeutic Communication Training

Paper-Pencil Simulation-Based Therapeutic Communication Training

ACTIVE COMPARATOR

Participants in this group participated in a paper-pencil simulation that presented a written clinical scenario involving perinatal loss. Students were asked to analyze the situation, write down appropriate therapeutic communication responses, and discuss these in a guided session. This method focused on the cognitive application of theoretical knowledge in a reflective and structured manner.

Behavioral: Paper-Pencil Simulation-Based Therapeutic Communication Training

Interventions

High-Fidelity Simulation-Based Therapeutic Communication Training BEHAVIORAL

This intervention involves a structured, high-fidelity simulation scenario in a clinical skills lab setting using mannequins and standardized patients. The scenario focuses on communication with a patient experiencing perinatal loss. The session includes pre-briefing, simulation, and debriefing components.

High-Fidelity Simulation-Based Therapeutic Communication Training

Paper-Pencil Simulation-Based Therapeutic Communication Training BEHAVIORAL

This intervention utilizes a written clinical case scenario related to perinatal loss. Students read the scenario and write appropriate therapeutic communication responses, followed by group discussion and instructor feedback. The focus is on reflection and theoretical integration.

Paper-Pencil Simulation-Based Therapeutic Communication Training

Eligibility Criteria

• Age: 18 Years - 24 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Completion of the theoretical course on postpartum care in the Women's Health and Diseases Nursing course.
• Successful completion of the Human Behavior and Communication course.
• Completion of training on perinatal grief and therapeutic communication skills prior to the simulation training.

You may not qualify if:

• Medical or Psychological Conditions Impacting Communication
• Incomplete Training or Lack of Pre-Simulation Education
• Inability to Participate in the Debriefing Session
• Language Barriers

Sponsors & Collaborators

• Acibadem University: lead

Study Sites (1)

Merve Coşkun

Ataşehir, Istanbul, Turkey (Türkiye)

Location

Related Publications (9)

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  PMID: 31673466 BACKGROUND

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  PMID: 14769454 BACKGROUND

• Hanshaw SL, Dickerson SS. High fidelity simulation evaluation studies in nursing education: A review of the literature. Nurse Educ Pract. 2020 Jul;46:102818. doi: 10.1016/j.nepr.2020.102818. Epub 2020 Jun 9.

  PMID: 32623148 BACKGROUND

• Herbert D, Young K, Pietrusinska M, MacBeth A. The mental health impact of perinatal loss: A systematic review and meta-analysis. J Affect Disord. 2022 Jan 15;297:118-129. doi: 10.1016/j.jad.2021.10.026. Epub 2021 Oct 20.

  PMID: 34678403 BACKGROUND

• Kang SJ, Kim Y. The Impact of Perinatal Loss Nursing Simulation among Undergraduate Students. Int J Environ Res Public Health. 2022 Jul 14;19(14):8569. doi: 10.3390/ijerph19148569.

  PMID: 35886421 BACKGROUND

• Kim J, Park JH, Shin S. Effectiveness of simulation-based nursing education depending on fidelity: a meta-analysis. BMC Med Educ. 2016 May 23;16:152. doi: 10.1186/s12909-016-0672-7.

  PMID: 27215280 BACKGROUND

• Leyland A, Choucri L. Student midwives' lived experiences of caring for bereaved parents following perinatal loss using actor-based simulation: A phenomenological study. Midwifery. 2024 Mar;130:103913. doi: 10.1016/j.midw.2023.103913. Epub 2024 Jan 10.

  PMID: 38241799 BACKGROUND

• Li YY, Au ML, Tong LK, Ng WI, Wang SC. High-fidelity simulation in undergraduate nursing education: A meta-analysis. Nurse Educ Today. 2022 Apr;111:105291. doi: 10.1016/j.nedt.2022.105291. Epub 2022 Feb 3.

  PMID: 35158134 BACKGROUND

• Rudland JR, Golding C, Wilkinson TJ. The stress paradox: how stress can be good for learning. Med Educ. 2020 Jan;54(1):40-45. doi: 10.1111/medu.13830. Epub 2019 Sep 11.

  PMID: 31509282 BACKGROUND

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: In the single-blind method, subjects do not know which of the experimental or control groups they were selected and therefore which method was applied to them. The researcher knows the subjects selected for the experimental and control groups, and therefore which method was applied to which subjects.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant professor

Model Details: Parallel Assignment Randomized Controlled Experimental Design

Study Record Dates

• First Submitted: April 16, 2025
• First Posted: May 7, 2025
• Study Start: December 1, 2024
• Primary Completion: January 30, 2025
• Study Completion: January 30, 2025
• Last Updated: May 7, 2025

Record last verified: 2025-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)