Call it an inspired meeting of the Arts and the Sciences.

Fairfield University School of Nursing professors were looking for an innovative way to teach students how to better communicate with patients. That's because many errors in healthcare are caused by poor communication between healthcare professionals and patients, leading to sometimes life-threatening mistakes. Professors say this sad new norm has to do in part with healthcare givers having less time to converse with patients. Compounding the problem is the growing use of electronic medical records, leading to less interaction between doctors and nurses.

Enter undergraduate Zachary Tesoriero, a member of Fairfield's improvisational comedy troupes, "On The Spot" and "Your Mom Does Improv." Tesoriero, who has also acted in student productions like "The Rocky Horror Picture Show" and "Body and Sold," put his improv skills to good use and pretended to be a patient.

With just an outline of a script in hand, both Tesoriero and the students - undergraduate learners in the School of Nursing's bachelor of science in nursing program - were told that the simulation would involve Tesoriero playing a terminally ill teenager talking about dying with his "nurses."

Working in pairs, the nursing students spoke to the "patient," taking ample time to understand his symptoms and concerns. "Our goal is to enhance student nurses' interpersonal communication so that they will be better prepared to enter the workforce upon graduation," said Eileen O'Shea, assistant professor of nursing.

All of the interactions were videotaped so faculty and students could later observe what communication efforts worked well to access the patient's information and where improvement was needed.

The results were interesting - and eye-opening.

From the simulations, student Krislin Yosuico discovered that communication might be the most difficult part of nursing. It also helped that she didn't know what to expect when she first saw the patient. "There is so much to consider when dealing with patient and family," she said. "It's important to remember that even though silence may seem awkward, it's sometimes what is needed within a conversation. Now when speaking to a patient, I think in my mind what he or she may be feeling and what type of conversation they want to have."

Among the many simulations senior Michelle Anderson has done at Fairfield, she found this particular one the most helpful. "This was a sensitive topic - end of life care for a child and teenager," she said. "In that situation, the students really had to react quickly and we were all able to see how awkward of a situation this can be for a nurse."

The effort fit right into the School of Nursing's approach to teaching. That is, supplementing classroom study and clinical rotations with simulation learning exercises, undertaken in the school's Robin Kanarek '96 Learning Resource Center, a state of the art facility resembling a hospital with high tech mannequins representing patients of all ages.

As for Tesoriero, a New York City native and a seasoned comedian, the experience was no laughing matter. "If you put two people in the setting of a burger joint in Heaven or a French mad scientist's lab, the result is bound to be funny," he noted. "However, myself and the two nursing students I interacted with were given very specific circumstances in a very serious situation with the goal not of entertaining but educating."

Michael Pagano, a physician assistant and associate professor of communication who helped teach the course, said there are so many communication barriers in healthcare, especially as it becomes so cost and time-driven. "That's why it's vital to work on enhancing nursing students skills in communicating - not only how they speak to patients but just as importantly how they listen to them and respond back with meaningful questions to gauge their needs such as pain management."

Nursing faculty said "On The Spot" students add emotions and nonverbal behaviors to the simulations. "The spontaneity of the acting adds an incredible interactive realism that we cannot simulate with the use of mannequins," said O'Shea.

Pagano said it was ultimately an "amazing opportunity" to instruct students about the often ignored "bio-psycho-social model" of patient care. "This is not about instructing students to 'Go draw some blood,' " he said. "This is about helping future nurses improve the quality of patients' lives, about giving their patients time to tell their stories."

Image: Simulation learning at Fairfield University's School of Nursing involves improv comedy troupe member Zach Tesoriero '11. Pictured with him is Andrew Nealis ' 14, left. "As an actor or improviser, I'm a representative of issues, ideas, and thoughts - mine or otherwise," Tesoriero noted. "Sometimes they're funny, sometimes they're not."

Posted On: 05-17-2011 11:05 AM

Volume: 43 Number: 307