The Effect of SBAR Communication Program on Nursing Students' Perceptions of Clinical Decision Making and Medical Error Prevention Levels: A Mixed Methods Study

The main purpose of handover communication is stated to provide accurate and up-to-date information about patient care, treatment, service use, current status and expected changes in this situation. Ineffective handovers, such as not providing all necessary information, can pose a danger to patients and staff, lead to irrelevant, repetitive and hypothetical information being communicated in the shift report and can cause misuse of resources. The aim of this study, designed as a mixed method, is to develop and implement a role-playing program with scenarios for nursing students using the SBAR communication technique. In addition, it is to examine students' clinical decision-making and medical error awareness as a result of the program. In this direction, when the literature is examined, it is concluded that the role-playing program conducted by Yu and Kang in 2017 using the SBAR technique with nursing students can be used to improve communication skills in nurse-doctor handover and to develop communicative competence in nursing students. In another study examining the experiences and perspectives of nurses who use the SBAR technique to improve patient care, it has been revealed that there are significant improvements in active patient controls and documentation control. It has also been shown that the use of standard protocols and communication tools for bedside handover improves patient care continuity.

A review of the literature on teaching SBAR to nursing students reveals that a variety of teaching methods are used. Methods such as standard patient video recording and feedback, role playing, and computer training have been used to teach communication skills. Several studies have used a combination of didactic and interactive teaching methods (such as role playing) to teach SBAR and have demonstrated positive effects on nurses' communication knowledge, attitudes, and abilities.

Clinical decision making, data analysis, and the application of these skills in a clinical context are important components of the nursing profession. Rapid decision making by nurses shortens treatment time, promotes care, and reduces treatment costs. On the other hand, failure to make timely and appropriate decisions leads to delays in treatment and waste of resources. Therefore, it affects the quality of care. Moreover, in the organizational context, nurses are members of a clinical team. Teamwork requires continuous decision-making. These decisions can affect teamwork and determine the quality of care. When the literature is examined, a study examining the effect of the SBAR communication program on the clinical decision-making levels of nursing students has shown that SBAR-based education can improve nursing students' communication skills and clinical decision-making skills. Similarly, Oh et al. (2021) showed that SBAR-based simulation learning can improve nursing students' clinical judgments and increase confidence in interprofessional communication. Medical errors often occur after breakdowns in handover communications. An analysis of assessment notes conducted by the Joint Commission shows that more than two-thirds of on-call incidents are caused by communication breakdowns, and at least 50% of them occur during handover. To avoid communication breakdown, the SBAR (Situation, Background, Assessment, and Recommendation) technique provides a standardized communication framework for conveying information to healthcare professionals, especially in critical situations that require immediate intervention. Both the Institute for Healthcare Improvement and the Joint Commission recommend the SBAR tool as one of the ways to improve patient and staff safety with its standardized and easy-to-use format for organizing and sharing clinical data among clinicians.