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Nurse Educ Today. 2013 Dec;33(12):1550-6. doi: 10.1016/j.nedt.2013.01.005. Epub 2013 Feb 8.

Enhancing communication with distressed patients, families and colleagues: the value of the Simple Skills Secrets model of communication for the nursing and healthcare workforce.

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Evidence-based Practice Research Centre, Faculty of Health and Social Care Edge Hill University, Ormskirk, Lancs., L39 4QP, UK. Electronic address:



Good communication skills in healthcare professionals are acknowledged as a core competency. The consequences of poor communication are well-recognised with far reaching costs including; reduced treatment compliance, higher psychological morbidity, incorrect or delayed diagnoses, and increased complaints. The Simple Skills Secrets is a visual, easily memorised, model of communication for healthcare staff to respond to the distress or unanswerable questions of patients, families and colleagues.


To explore the impact of the Simple Skills Secrets model of communication training on the general healthcare workforce.


An evaluation methodology encompassing a quantitative pre- and post-course testing of confidence and willingness to have conversations with distressed patients, carers and colleagues and qualitative semi-structured telephone interviews with participants 6-8 weeks post course.


During the evaluation, 153 staff undertook the training of which 149 completed the pre- and post-training questionnaire. A purposive sampling approach was adopted for the follow up qualitative interviews and 14 agreed to participate.


There is a statistically significant improvement in both willingness and confidence for all categories; (overall confidence score, t(148)=-15.607, p=<0.05 overall willingness score, t(148)=-10.878, p=<0.05) with the greatest improvement in confidence in communicating with carers (pre-course mean 6.171 to post course mean 8.171). There is no statistical significant difference between the registered and support staff. Several themes were obtained from the qualitative data, including: a method of communicating differently, a structured approach, thinking differently and additional skills. The value of the model in clinical practice was reported.


This model can be suggested as increasing the confidence of staff, in dealing with a myriad of situations which, if handled appropriately can lead to increased patient and carers' satisfaction. Empowering staff appears to have increased their willingness to undertake these conversations, which could lead to earlier intervention and minimise distress.


Communication; Education; Surveys

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