Sat, Jul 19, 2025
[Archive]
Volume 18, Issue 2 (2025)
JMED 2025, 18(2): 36-45 |
Back to browse issues page
Ethics code: IR.BUMS.REC.1402.478
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Farahi F, Amouzeshi Z, Nazari H, Oudi D. The effect of blended role-playing and reflective training on nursing students’ communication skills with depressed patients. JMED 2025; 18 (2) :36-45
URL: http://edujournal.zums.ac.ir/article-1-2276-en.html
URL: http://edujournal.zums.ac.ir/article-1-2276-en.html
1- Department of Nursing, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
Abstract: (159 Views)
Background & Objective: Communicating with depressed patients is a crucial professional skill for nursing students, which they must learn during their studies. This study aimed to assess the effectiveness of blended training—incorporating both role-playing and reflective practice—on nursing students' communication skills in their interactions with depressed patients.
Materials & Methods: The present semi-experimental study was conducted in 2023 with a before and after two-group design. All sixth-semester nursing students at Torbat Jam Faculty of Medical Sciences were randomly selected and divided into two groups: an experimental group and a control group. The intervention included therapeutic communication skill training sessions with the role-playing and reflection blended method. The control group received the standard training method. Therapeutic communication skills in dealing with depressed patients before and after the intervention were evaluated by a communication skills questionnaire. Data were analyzed using the statistical software SPSS version 20, descriptive statistical tests and inferential tests (t-test, analysis of variance, and paired-t) at a significance level 0.05.
Results: The average communication skills scores before the intervention showed no statistically significant difference between the intervention and control groups (p > 0.05). However, the mean score of communication skills after the intervention was significantly different in the two groups (p < 0.05). The results also indicated that the mean communication skill score after the intervention significantly improved in the experimental group compared to before the intervention (p < 0.05). However, there was no statistically significant change in the mean communication skill score in the control group before and after the intervention (p > 0.05).
Conclusion: Educational system managers and planners are suggested to use a blend of these two methods to train nursing students' communication skills, especially in the psychiatric department and when dealing with depressed patients.
Materials & Methods: The present semi-experimental study was conducted in 2023 with a before and after two-group design. All sixth-semester nursing students at Torbat Jam Faculty of Medical Sciences were randomly selected and divided into two groups: an experimental group and a control group. The intervention included therapeutic communication skill training sessions with the role-playing and reflection blended method. The control group received the standard training method. Therapeutic communication skills in dealing with depressed patients before and after the intervention were evaluated by a communication skills questionnaire. Data were analyzed using the statistical software SPSS version 20, descriptive statistical tests and inferential tests (t-test, analysis of variance, and paired-t) at a significance level 0.05.
Results: The average communication skills scores before the intervention showed no statistically significant difference between the intervention and control groups (p > 0.05). However, the mean score of communication skills after the intervention was significantly different in the two groups (p < 0.05). The results also indicated that the mean communication skill score after the intervention significantly improved in the experimental group compared to before the intervention (p < 0.05). However, there was no statistically significant change in the mean communication skill score in the control group before and after the intervention (p > 0.05).
Conclusion: Educational system managers and planners are suggested to use a blend of these two methods to train nursing students' communication skills, especially in the psychiatric department and when dealing with depressed patients.
Article Type : Orginal Research |
Subject:
Medical Education
Received: 2024/09/16 | Accepted: 2025/05/21 | Published: 2025/07/13
Received: 2024/09/16 | Accepted: 2025/05/21 | Published: 2025/07/13
References
1. Suikkala A, Koskinen S, Katajisto J, Leino-Kilpi H. Congruence between nursing students’ and patients’ views of student–patient relationships. Advances in Health Sciences Education. 2021;26:79-115. [DOI]
2. Gutiérrez-Puertas L, Márquez-Hernández VV, Gutiérrez-Puertas V, Granados-Gámez G, Aguilera-Manrique G. Educational interventions for nursing students to develop communication skills with patients: a systematic review. International Journal of Environmental Research and Public Health. 2020;17(7):2241 [DOI]
3. Furnes M, Kvaal KS, Høye S. Communication in mental health nursing-bachelor students' appraisal of a blended learning training programme-an exploratory study. BMC Nursing. 2018;17:1-0 [DOI]
4. Novais F, Gananca L, Barbosa M, Telles-Correia D. Communication skills in psychiatry for undergraduate students: A scoping review. Frontiers in Psychiatry. 2022;13:972703 [DOI]
5. Maulana R, Siswoyo M, Wihayati W. Therapeutic communication between psychiatrists and patients with mental health disorders (mental illness) at Waled Hospital, Cirebon Regency. Journal Socio Humanities Review. 2021;1(2):69-80.
6. Li Z, Ruan M, Chen J, Fang Y. Major depressive disorder: advances in neuroscience research and translational applications. Neuroscience Bulletin. 2021;37:863-80 [DOI]
7. Segrin C. Interpersonal communication problems associated with depression and loneliness. InHandbook of communication and emotion 1996 Jan 1 (pp. 215-242). Academic Press.
8. He P, Liu X, Wen J, Zhang Y. Major clinical advances of depression: now and future. InE3S Web of Conferences 2021 (Vol. 292, p. 03102). EDP Sciences [DOI]
9. Geisner IM, Mallett K, Varvil-Weld L, Ackerman S, Trager BM, Turrisi R. An examination of heavy drinking, depressed mood, drinking related constructs, and consequences among high-risk college students using a person-centered approach. Addictive Behaviors. 2018;78:22-9. [DOI]
10. Zaini S, Sulaiman AH, Huri HZ, Hui K, Gill JS. Patient-centred communication in the use of antidepressants among people with depression: a scoping review. Sains Malaysiana. 2021;50(1):161-70 [DOI]
11. Dewi S. Communication skills teaching and learning in undergraduate medical education: from classroom to bedside. Newcastle, NSW, Australia University of Newcastle. 2021 Mar. [Online]. Available from: [Accessed: Mar. 1, 2025]. [DOI]
12. Lee HJ, Park BM, Shin MJ, Kim DY. Therapeutic communication experiences of nurses caring for patients with hematology. InHealthcare 2022 Nov 30 (Vol. 10, No. 12, p. 2403). MDPI. [DOI]
13. Elahi N. The effect of family nursing education using reflection method with the help of situation simulation through video screening on learning and perspective of nursing students. Journal of Nursing Education. 2022;11(2):12-22. [DOI]
14. Banisi P, Khoshgoftar Z, Shahbazi S. The effect of communication skills training on the anxiety and stress of covid-19 among the university students. Iranian Journal of Rehabilitation Research in Nursing. 2023;9(2):32-40. [DOI]
15. Rosenbaum ME. Dis-integration of communication in healthcare education: workplace learning challenges and opportunities. Patient Education and Counseling. 2017;100(11):2054-61. [DOI]
16. Farahani MA, Maserat A, haghani H. Effect of role-play training on the knowledge of nursing students on patient education. Iran Journal of Nursing. 2018; 31(115):29-40. [DOI]
17. Moradi E, Didehban H. Requirements for the proper use of role-playing methods at medical universities. Medicine and Spiritual Cultivation. [Online]. Available from: [Accessed: Mar. 1, 2025]. [DOI]
18. Jasemi M, Mirzaie R, Cheragi R, Alinejad V. Journal M. The effect of role- playing therapeutic communication training in nurses on patients' anxiety before surgery: a quasi- experimental study. 2023;21(5):415-423. [DOI]
19. Latif R, Mumtaz S, Mumtaz R, Hussain A. A comparison of debate and role play in enhancing critical thinking and communication skills of medical students during problem based learning. Biochemistry and Molecular Biology Education. 2018;46(4):336-42 [DOI]
20. Engerer C, Berberat PO, Dinkel A, Rudolph B, Sattel H, Wuensch A. Specific feedback makes medical students better communicators. BMC Medical Education. 2019;19:1-8. [DOI]
21. Pangh B, Jouybari L, Vakili MA, Sanagoo A, Torik A. The effect of reflection on nurse-patient communication skills in emergency medical centers. Journal of Caring Sciences. 2019;8(2):75. [DOI]
22. Rahimi M, Haghani F. Reflection in medical education: a review of concepts, models, principles and methods of teaching reflection in medical education. Research in Medical Education. 2017;9(2):24-13. [DOI]
23. Fakouri E, Poorhakak F. Group Reflection Based on the Boud et al.'s Model.
Journal of Medical Education and Development. 2023; 18(2): 493-504 [DOI]
24. Phua GL, Owyong JL, Leong IT, et al. A systematic scoping review of group reflection in medical education. BMC Medical Education. 2024;24(1):398. [DOI]
25. Khan HS, Sheikh NS. Role-play: a simulated teaching technique in physiology. Pakistan Journal of Physiology. 2021;17(4):46-50. [Online]. Available from: [Accessed: Mar. 1, 2025]. [DOI]
26. Bharti RK. Contribution of medical education through role playing in community health promotion: a review. Iranian Journal of Public Health. 2023;52(6):1121 [DOI]
27. Vakili MM, Hidarnia AR, Niknami S. Development and psychometrics of an interpersonal communication skills scale (ASMA) among Zanjan health volunteers. Hayat. 2012;18(1):5-19. [Online]. Available from: [Accessed: Mar. 1, 2025]. [DOI]
28. Zahidova M. The role play methods in medical education. Pediatrics. 2023; 1(1): 277-280. [DOI]
29. Mezirow J, Taylor EW, editors. Transformative learning in practice: Insights from community, workplace, and higher education. John Wiley & Sons; 2009 Oct 26. [Online]. Available from: [Accessed: Mar. 1, 2025]. [DOI]
30. Huang SM, Fang SC, Lee SY, Yu PJ, Chen CJ, Lin YS. Effects of video-recorded role-play and guided reflection on nursing student empathy, caring behavior and competence: a two-group pretest-posttest study. Nurse Education in Practice. 2023;67:103560. [DOI]
31. Shorey S, Kowitlawakul Y, Devi MK, Chen HC, Soong SK, Ang E. Blended learning pedagogy designed for communication module among undergraduate nursing students: a quasi-experimental study. Nurse Education Today. 2018;61:120-6. [DOI]
32. Chung JY, Li WH, Cheung AT, Ho LL, Chung JO. Efficacy of a blended learning programme in enhancing the communication skill competence and self-efficacy of nursing students in conducting clinical handovers: a randomised controlled trial. BMC Medical Education. 2022;22(1):275 [DOI]
33. Sadhuwong K, Koraneekij P, Natakuatoong O. Effects of a blended learning model integrating situated multimedia lessons and cognitive apprenticeship method on the clinical reasoning skills of nursing students. Journal of Health Research. 2017;30(6):421-431. [DOI]
34. Hojjati H, Sharifinia H, Nazari R. The effect of blended clinical teaching on nursing students’ attitude toward psychiatric patients. Iranian Journal of Medical Education. 2011;11(3):238-44. [Online]. Available from: [Accessed: Mar. 1, 2025]. [DOI]
35. Shahsavari IS. Designing and implementing the integrated learning program in nursing education: the integration of problem-based learning and role playing methods in teaching the practical part of patient education. Teb va Tazkieh. 2017; 26(3): 219-227
36. Ilic D, Nordin RB, Glasziou P, Tilson JK, Villanueva E. A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine. BMC Medical Education. 2015;15:1-0. [DOI]
37. Parandavar N, Rezaee R, Mosallanejad L, Mosallanejad Z. Designing a blended training program and its effects on clinical practice and clinical reasoning in midwifery students. Journal of Education and Health Promotion. 2019;8(1):131 [DOI]
38. Choi E, Lindquist R, Song Y. Effects of problem-based learning vs. traditional lecture on Korean nursing students' critical thinking, problem-solving, and self-directed learning. Nurse Education Today. 2014;34(1):52-6. [DOI]
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
