Date of Completion


Embargo Period



Nursing, Student, Dedicated Education, Communication, Mixed-methods, Relationships, Magnet, Pragmatism, Bandura, SBAR

Major Advisor

E. Carol Polifroni

Associate Advisor

Deborah McDonald

Associate Advisor

Kathleen Stolzenberger

Field of Study



Doctor of Philosophy

Open Access

Campus Access


Effective communication and teamwork of caregivers is essential for quality healthcare. Poor communication has been identified as the primary cause of error in many medical mistakes. The American Association of Colleges of Nursing (AACN, 2008) describes communication competency acquisition as collaborative across professions. Communication and collaboration for improving patient health outcomes is one of the essentials for baccalaureate nursing education (AACN, 2008). Knowledge related to effective strategies for developing undergraduate nursing student communication skills is limited by the absence of studies related to communication skill development.

The aim of this mixed-methods study was to explore the effect of a dedicated education unit (DEU) experience on the development of communication competencies in senior capstone Bachelor of Science (BS) nursing students. Communication competency of undergraduates was compared to newly graduated nurses and nurses completing transition to practice. This study was aligned with the world-view philosophy of pragmatism and integrated both qualitative and quantitative methods. In addition, it was guided by Bandura’s theory of social learning in a community of practice.

This study was a convergent parallel QUAN + QUAL mixed methods design (Creswell & Plano Clark, 2011). Study sites were a community, a Magnet® designated hospital, and an urban non-Magnet® hospital. Participants were placed on similar DEU and control medical- surgical units at each hospital for one semester. Survey pre- and post-tests were administered, and qualitative data were obtained from DEU students and faculty through focus groups. Survey data were analyzed to describe the sample and for comparison utilizing t-tests. Qualitative focus groups were analyzed using methods described by Krueger and Casey (2008). The data were mixed to expand the understanding of the participant’s perception of communication and relationships in the acute care medical-surgical environment.

Quantitative survey results did not demonstrate significance when the total sample was compared. When separated by hospital, differences were noted. There was a finding of a statistically different decrease in survey scores in Hospital A (Urban/non-Magnet®). There were increases without statistical significance in all areas of the Relationships and Communication survey (1-27) at Hospital B (Community/Magnet®). Qualitative themes supported the results and brought a deeper understanding of the hospital environments.