English Language Assessment

ICELBAN

Institutional Canadian

English Language

Benchmark Assessment for

Nurses Dr. Maria Berrafati

Institutional Canadian English Language Benchmark

Assessment for Nurses (ICELBAN)

Professional Practice Input

• This workshop will focus on professional language practice in

the IEN bridging program and how the ICELBAN assessment

can enhance language practice in the nursing field.

• We will have the opportunity for language and nursing faculty to

discuss specific areas of language in the nursing profession and

how the ICELBAN can be enhanced to evaluate and provide

feedback to foreign trained nurses on their language proficiency

• The primary focus of the workshop will be on speaking and

writing in the nursing field.

What are we looking for from our IEN’s?

• Good technical skills?

• Good communication skills which include:

• Reading

• Writing

• Listening

• Speaking

• Interpersonal/intercultural skills (soft skills) ?

Study:

22 BIEN students (+ 3 instructors) doing their clinical

placements at the Jurvavinski Hospital were interviewed. In

addition, 2 students were interviewed by telephone who had

done their clinical at St. Joseph’s Hospital.

Of the 24 students, six had attended little or no nursing-specific

language training. Of the other 18, 15 had participated in the

CWIEN courses offered at Mohawk in 2006-07.

How do BIEN students evaluate their ability to communicate in a clinical

setting? Mary Anne Peters & Dale Northcote, Professors at Mohawk College.

1. Tell me about your communication with clients: When have you had difficulty? (e.g. understanding what clients say, asking questions, explaining, offering empathy, comfort, reassurance,

dealing with difficult people)?

2. If you did nursing-specific language training, in what ways has the training

helped you? Are there gaps or deficiencies in the language training?

3. Tell me about your communication with colleagues: When have you had

difficulty (e.g. understanding instructions, taking orders, reporting, documenting,

communicating assertively, giving and receiving feedback appropriately)?

4. If you did nursing-specific language training, in what ways has the training

helped you? Are there gaps or deficiencies in the language training?

5. Looking back at the language training, what was most useful? Are there any

recommendations you can make?

BIEN Student Interview Questionnaire

1. What is your overall assessment of the communication skills of the

BIEN students? Where are they strongest? (understanding clients, asking

questions, explaining, offering empathy, comfort, reassurance, dealing

with difficult people, understanding you and other colleagues,

understanding instructions, taking orders, reporting, documenting,

communicating assertively, giving and receiving feedback appropriately)

2. What communication skills would you like them to develop further to

become effective nurses?

3. What are their communication weaknesses? (understanding clients,

asking questions, explaining, offering empathy, comfort, reassurance,

dealing with difficult people, understanding you and other colleagues,

understanding instructions, taking orders, reporting, documenting,

communicating assertively, giving and receiving feedback appropriately)

BIEN Clinical Instructor Interview Questionnaire

Results- Student Feedback

• Most students reported no problems, aside from not being as

fluent as they would like because of needing more time to think.

• There were some specific areas of communication with clients

and colleagues in which students reported feeling weak:

Finding the right words when explaining to clients,

especially lay terminology (Thrombus)

Knowing what to say in emotionally demanding situations;

being honest and sensitive and not just saying “It’s going to be

OK”

Needing more confidence (from practice) in dealing with all

kinds of people, especially difficult and rude people

Results- Student Feedback

•approaching clients /making small talk during care

•documentation: appropriate and specific terminology; organization;

passive voice

•assertive communication

•reporting: none of them had done much reporting during their clinical

•telephone communication

Results-Student Feedback

•Handling routine interactions / basic instructions, such as “roll

over towards me” and knowing the names of everyday hospital objects (e.g.

tweezers)

•More practice and more confidence in emotionally

demanding communication/ sometimes don’t know what to

say. (student didn’t know what to say to an anxious client until the instructor suggested

asking her about her experience)

• Relying on non-verbal communication ( One said that she didn’t know

the support services available.

Results- Student Feedback

While these students acknowledge that they would have benefited from the

communication course, they were not required to take it and the time

commitment for the course discouraged them.

Some useful skills they find important and need support:

•How to introduce oneself and begin an interview.

•Role plays and case scenarios to discuss and practice options and

right and wrong approaches

•Telephone communication, documentation, and medical vs. lay

terminology.

•Offering shorter courses on these different topics.

•Take the communication course in conjunction with Nursing Theory.

Results- Student Feedback

The students who had taken nursing-specific language training

reported more difficulties in general communication with clients and

colleagues, talking about problems when clients speak fast, aren’t

wearing their dentures, have strong accents, mumble, or are

“elderly”.

Feedback on writing:

• Reading others’ handwriting

• Using legible handwriting

• Most students said they still don’t feel confident with assertive

communication

• Found it difficult to find the right words at times: specific

descriptors and formal medical terms (e.g. saturated instead of

soaked)

• Difficulty with narrative charting, not DAR as practiced

• Lack of confidence with reporting

• More practice with documentation/ writing specific descriptions

• Learn names of objects/equipment (e.g. tongue depressor and

tweezers)

• Jargon such as brand names used for things like dressings.

• Basic communication/ instructions with clients, instructions for routine

actions and for explaining things like medications.

• Verb tenses

• Practice listening to different accents.

Student Recommendations

• More formal medical terminology in documentation

• Some weaknesses in grammar (suffixes and plurals)

• Pronunciation interferes with communication

• Appropriate Vocabulary

• Organizing reports to be “short and sweet” is a challenge

• Areas of therapeutic communication (empathy) and assertive

communication are still weak.

• Work more on phrasing requests and questions politely, because

without the “niceties of asking,” they sound abrupt.

• Body language needs attention/ not confident, they are too

reserved. (follow up in the interview and important points)

• Weak listening skills

• Positive- Strong reading skills

Instructor Recommendations

The communication requirements for entry into the nursing profession

were benchmarked at :

Speaking 8

Reading, 7

Writing 7

Listening 9

•The greater difficulties experienced by some of the students who had taken

CWIEN reflect their lower Canadian Language Benchmarks; instead of

having benchmarks 8 (or possibly higher), these students went into the

course with benchmarks of 6 and 7, with an occasional 5 in one of the skills.

Discussion

ICELBAN Assessment

• Speaking and writing Competencies

• Consider interpersonal/ cultural language

skills

• Do we assess all aspects of language

required in the nursing profession?

• Consider the following……….

Sample Writing

Sample Writing