Abstract
Objective: Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. Methods: A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. Results: CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. Conclusion: Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. Practice implications: Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce.
Original language | English (US) |
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Pages (from-to) | 44-50 |
Number of pages | 7 |
Journal | Patient Education and Counseling |
Volume | 99 |
Issue number | 1 |
DOIs | |
State | Published - Jan 1 2016 |
Keywords
- Certified nursing assistant
- Computer simulation
- Immigrant workforce
- RIAS
ASJC Scopus subject areas
- General Medicine