Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Sep 28, 2024
Date Accepted: Mar 11, 2025
Advancing Politeness and Assertive Communication through Tone of Voice in Crisis Team Situations: A Pre–Post Acoustic Analysis Study of TeamSTEPPS Virtual Simulation for Interprofessional Education in Healthcare Undergraduate Students
ABSTRACT
Background:
Effective interprofessional communication, including politeness, respect for coworkers, and self-control, is crucial in emergency care. These values are emphasized by both Thai and U.S. cultures. Notably, nurses place greater significance on respect and self-control than physicians, underscoring the need for physicians to recognize and adopt these attributes, especially in interactions with nursing staff. To develop these competencies, interprofessional education (IPE) programs are essential, with simulation-based IPE, particularly virtual simulations, showing promise in enhancing teamwork and communication. However, research on the tone of voice in emergency communication is limited, especially in Thailand, where standardized IPE curricula are lacking.
Objective:
This study aimed to assess the effectiveness of TeamSTEPPS virtual simulation in enhancing interprofessional communication among healthcare students, focusing on politeness and assertiveness in the tone of voice.
Methods:
An experimental design was employed with 30 healthcare students from five disciplines, including medical, nursing, medical technology, radiological technology, and pharmacy students. Participants were recorded during pre- and post-training TeamSTEPPS sessions. Acoustic analysis focused on three cues: duration, intensity, and fundamental frequency (F0). Duration measured the length of utterances, whereas intensity (loudness) and F0 (pitch) were analyzed using parameters, such as maximum, minimum, mean, standard deviation, and range. Using the Wilcoxon signed-rank test, these 11 acoustic parameters were extracted and statistically analyzed to compare pre- and post-training differences.
Results:
Significant improvements in the tone of voice were observed. Medical and nursing students exhibited changes in pitch (F0_SD and F0_mean, P < .001) and loudness (Int_mean, P < .001), suggesting more attentive communication. Medical technology and radiological technology students showed reduced pitch (F0_mean, P < .05 in medical technology students and P < .01 in radiological students) and intensity (Int_mean, P < .01 in medical technology students), reflecting calmer more controlled communication. Pharmacy students showed minor changes.
Conclusions:
TeamSTEPPS virtual simulation IPE effectively enhances interprofessional nonverbal communication by improving key acoustic features related to politeness and assertiveness within Thai culture context. Medical and nursing students showed the most notable gains, whereas quieter more controlled communication styles emerged among the other groups. These findings highlight the significance of tailored virtual simulation IPE programs for improving teamwork and patient outcomes across healthcare disciplines. Clinical Trial: None
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