Effect of Stepwise Communication Education Program using SBAR among Nursing Students: Focusing on Scenarios and Nursing Case-based Role Playing

간호대학생의 SBAR를 이용한 단계별 의사소통 교육프로그램의 효과: 시나리오와 간호사례기반 역할극을 중심으로

  • Received : 2018.03.12
  • Accepted : 2018.04.23
  • Published : 2018.05.31


Purpose: This study intends to examine the effects of a stepwise communication education program among nursing college students, focusing on scenarios and nursing case-based role playing. Methods: The study design was a one-group repeated measure ANOVA. Participants were 27 nursing students in practice. Students participated in 5-week stepwise communication education program using SBAR; including 1 week of lecture education, 4 weeks of scenarios and nursing case-based role playing. The data were collected at each level of the education process: pre-education, after 1 week of lectures, and after completion of scenarios and nursing case-based role playing. Repeated measures ANOVA was used to determine changes in SBAR technique knowledge and communication self-efficacy. Results: The stepwise communication education program using SBAR was effective in increasing SBAR technique knowledge, and communication self-efficacy. The lecture-based education was effective only in the area of SBAR technique knowledge and its subscale, attitudes towards SBAR. However, scenarios and nursing case-based role playing was broadly effective across communication self-efficacy, SBAR technique knowledge, and its subscale, knowledge of the SBAR. Conclusion: Based on this study, we propose that it is necessary to confirm the effect of long-term SBAR communication education using scenarios and nursing case-based role playing in nursing students' practice.


Communication programs;Self efficacy;Knowledge;Role playing;Nursing students


  1. Ayres, H. W. (2005). Factors related to motivation to learn and motivation to transfer learning in a nursing population (Unpublished doctoral dissertation). North Carolina State University, Raleigh, NC.
  2. Beckett, C. D., & Kipnis, G. (2009). Collaborative communication: integrating SBAR to improve quality/patient safety outcomes. Journal for Healthcare Quality, 31(5), 19-28.
  3. Berg, B. W., Wong, L., & Vincent, D. S. (2010). Technology -enabled interprofessional education for nursing and medical students: A pilot study. Journal of Interprofessional Care, 24(5), 601-604.
  4. Bong, E. J. (2013). Effect of interpersonal relationships and communication curriculum were utilized group activities on interpersonal relationships and communication self-efficacy among nursing student. Journal of the Korea Contents Association, 13(10), 394-402.
  5. Cho, I. Y. (2015). The relationship of communication skill, communication self-efficacy and communication related educational needs. Journal of the Korea Academia-Industrial Cooperation Society, 16(4), 2593-2601.
  6. Cho, Y. H. (2014). Development and effects of team-based learning program on enhance of communication competence for nursing students (Unpublished doctoral dissertation). Chosun University, Gawangju.
  7. Dingley, C., Daugherty, K., Deriey, M. K., & Persing, R. (2008). Improving patient safety through provider communication strategy enhancements. In: K. Henriksen, J. B. Battles, M. A. Keyes, & M. L. Grady (Ed.), Advances in patient safety: New directions and alternative approaches (Vol 3: Performance and Tools) (pp. 80-98). Rockville, MD: Agency for Healthcare Research and Quality.
  8. Dunsford, J. (2009). Structured communication: Improving patient safety with SBAR. Nursing for Womens Health, 13(5), 384-390.
  9. Foronda, C., Gattamorta, K., Snowden, K., & Bauman, E. B. (2014). Use of virtual clinical simulation to improve communication skills of baccalaureate nursing students: A pilot study. Nurse Education Today, 34(6), e53-e57.
  10. Guise, J. M., & Lowe, N. K. (2006). Do you speak SBAR?. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(3), 313-314.
  11. Ha, Y. K., Lee, Y. J., & Lee, Y. H. (2017). Simulation training applying SBAR for the improvement of nursing undergraduate students' interdisciplinary communication skills. Journal of the Korean Data and Information Science Society, 28(2) 407-419.
  12. Holahan, C. K., & Holahan, C. J. (1987). Life stress, hassles, and self‐efficacy in aging: A replication and extension. Journal of Applied Social Psychology, 17(6), 574-592.
  13. Jeong, C. Y., & Seo, Y. S. (2017). Effect of the convergence communication training program for communication self efficacy, communicative competence, and interpersonal relations of nursing students. Journal of Digital Convergence, 15(5), 271-280.
  14. Kang, H. (2005). Sample size determination for repeated measures design using G power software. Anesthesia and Pain Medicine, 10(1), 6-15.
  15. Kesten, K. S. (2011). Role-play using SBAR technique to improve observed communication skills in senior nursing students. Journal of Nursing Education, 50(2), 79-87
  16. Kim, E. J. (2014). Nursing students' clinical judgment skills in simulation: Using tanner's clinical judgment model. The Journal of Korean Academic Society of Nursing Education, 20(2), 212-222.
  17. Kim, W. J., & Kim, S. Y. (2016). A study on the effects of the nursing management practice using SBAR on nursing students' self-expressiveness, communication skills, and abilities to think critically. Journal of Learner-Centered Curriculum and Instruction, 16(9), 1-16.
  18. Korea Institute for Health Accreditation. (2014, December 09). Standard investigation for approval accreditation in critical health institute (ver.2.1.). Retrieved from
  19. Krautscheid, L. C. (2008). Improving communication among healthcare providers: Preparing student nurses for practice. International Journal of Nursing Education Scholarship, 5(1), 1-13.
  20. Lancaster, R. J., Westphal, J., & Jambunathan, J. (2015). Using SBAR to promote clinical judgment in undergraduate nursing students. Journal of Nursing Education, 54(3), S31-S34.
  21. Lee, E. H., Jung, Y. H., Kim, J. S., Song, R. Y., & Hwang, G. U. (2008). Statistical methods for health care research. Seoul: Koonja.
  22. Marshall, S., Harrison, J., & Flanagan, B. (2009). The teaching of a structured tool improves the clarity and content of interprofessional clinical communication. Quality and Safety in Health Care, 18(2), 137-140.
  23. Moon, M. Y. (2017). Effects of convergence-based integrated simulation practice program on the clinical decision making, problem solving process, clinical competence and confidence of core fundamental nursing skill performance for nursing students. Journal of Digital Convergence, 15(7), 271-284.
  24. Nam, K. A., Kim, E. J., & Ko, E. J. (2017). Effects of simulated interdisciplinary communication training for nursing students on self-confidence in communication, communication behavior and technical skill performance. Journal of Korean Academic Society of Nursing Education, 23(4), 409-418.
  25. Oh, Y. J. (2008). Development and effectiveness of the communication empowerment program for nursing students: Based on the theory of transfer of learning (Unpublished doctoral dissertation). Korea University, Seoul.
  26. Song, J. E., & Park, B. L. (2010). The changing pattern of physical and psychological health, and maternal adjustment between primiparas who used and those who did not use sanhujori facilities. Journal of Korean Academy of Nursing, 40(4), 503-514.
  27. Street, M., Eustace, P., Livingston, P. M., Craike, M. J., Kent, B., & Patterson, D. (2011). Communication at the bedside to enhance patient care: A survey of nurses' experience and perspective of handover. International Journal of Nursing Practice, 17(2), 133-140.
  28. Thomas, C. M., Bertram, E., & Johnson, D. (2009). The SBAR communication technique: Teaching nursing students professional communication skills. Nurse Educator, 34(4), 176-180.
  29. Vardaman, J. M., Cornell, P., Gondo, M. B., Amis, J. M., Townsend-Gervis, M., & Thetford, C. (2012). Beyond communication: The role of standardized protocols in a changing health care environment. Health care management review, 37(1), 88-97.
  30. Wang, W., Liang, Z., Blazeck, A., & Greene, B. (2015). Improving chinese nursing students' communication skills by utilizing video-stimulated recall and role-play case scenarios to introduce them to the SBAR technique. Nurse Education Today, 35(7), 881-887.