Assessment of immigrant certified nursing assistants' communication when responding to standardized care challenges. Massey, M. & Roter, D., L. Patient education and counseling, 99(1):44-50, Elsevier Ireland Ltd, 1, 2016.
abstract   bibtex   
OBJECTIVE: Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. METHODS: A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. RESULTS: CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. CONCLUSION: Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. PRACTICE IMPLICATIONS: Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce.
@article{
 title = {Assessment of immigrant certified nursing assistants' communication when responding to standardized care challenges},
 type = {article},
 year = {2016},
 identifiers = {[object Object]},
 keywords = {Certified nursing assistant,Computer simulation,Immigrant workforce,RIAS},
 pages = {44-50},
 volume = {99},
 month = {1},
 publisher = {Elsevier Ireland Ltd},
 city = {National Center for Health Statistics, Hyattsville, MD, USA; Department of Health, Behavior and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; Department of Health, Behavior and Society, The Johns Hopkins Bloomberg Scho},
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 created = {2016-08-20T04:12:16.000Z},
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 last_modified = {2017-03-14T09:54:45.334Z},
 tags = {Administration,Cultural Factors},
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 source_type = {JOUR},
 notes = {CI: Copyright (c) 2015; JID: 8406280; OTO: NOTNLM; 2015/02/20 [received]; 2015/08/05 [revised]; 2015/08/06 [accepted]; 2015/08/12 [aheadofprint]; ppublish},
 folder_uuids = {2b37922a-dcb9-4553-b61e-6a6a7c79bf6f},
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 abstract = {OBJECTIVE: Certified nursing assistants (CNAs) provide 80% of the hands-on care in US nursing homes; a significant portion of this work is performed by immigrants with limited English fluency. This study is designed to assess immigrant CNA's communication behavior in response to a series of virtual simulated care challenges. METHODS: A convenience sample of 31 immigrant CNAs verbally responded to 9 care challenges embedded in an interactive computer platform. The responses were coded with the Roter Interaction Analysis System (RIAS), CNA instructors rated response quality and spoken English was rated. RESULTS: CNA communication behaviors varied across care challenges and a broad repertoire of communication was used; 69% of response content was characterized as psychosocial. Communication elements (both instrumental and psychosocial) were significant predictors of response quality for 5 of 9 scenarios. Overall these variables explained between 13% and 36% of the adjusted variance in quality ratings. CONCLUSION: Immigrant CNAs responded to common care challenges using a variety of communication strategies despite fluency deficits. PRACTICE IMPLICATIONS: Virtual simulation-based observation is a feasible, acceptable and low cost method of communication assessment with implications for supervision, training and evaluation of a para-professional workforce.},
 bibtype = {article},
 author = {Massey, M and Roter, D L},
 journal = {Patient education and counseling},
 number = {1}
}
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