Nursing explanation skills in education and practice: Development skills and influence on incident occurrence

Inaccurate explanations to patients, their families, and other healthcare professionals can adversely affect the quality of healthcare and patient safety. Despite the significance of good explanatory skills in nursing education and practice, supporting empirical data are limited. This study aimed to develop a psychological scale and investigate the impact of explanatory skills on patient safety by statistically testing the validity of hypothetical models derived from previous studies. In the preliminary investigation, 87 items were obtained from 109 experienced nurses. Study 1 involved an online explanatory skills survey with a sample of 1,000 nursing professionals. Study 2 comprised a field survey of 159 nursing staff working in a comprehensive hospital. Nine sub-skills, including seven common sub-skills and one specific sub-skill for each patient/family and staff, were identified and categorized under “compassion” and “shared mental model.” Clinical ladder progression was associated with both compassion and a shared mental model. Furthermore, compassion was identified as a factor that increased the probability of various incidents through interactional failures. Contrastingly, the shared mental model enhanced the probability of severe incidents due to judgmental and minor incidents from conceptual failures. This study developed a psychological scale to measure nursing explanation skills in communicating with patients, their families, and other medical staff and elucidated their impact on incident occurrence through miscommunication. Finally, the importance of accountability skills in nursing education and practice was discussed.