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Effects of student-led drama on nursing students' attitudes to interprofessional working and nursing advocacy: A pre-test post-test educational intervention study

Kyle, Richard G.; Bastow, Fiona; Harper-Mcdonald, Bruce; Jeram, Trisha; Zahid, Zahida; Nizamuddin, Maira; Mahoney, Catherine


Richard G. Kyle

Trisha Jeram

Zahida Zahid

Maira Nizamuddin


Nursing educators need to equip students to work in interprofessional teams and advocate for patients in increasingly integrated health and social care settings. Drama-based education has been used in nursing to help students understand complex concepts and practices, including communication, empathy, and patient safety. However, few studies have evaluated drama-based education to promote understanding of interprofessional care and advocacy, and none have involved student-led drama where students create dramatic performances to support learning.

To examine the effects of student-led drama on student nurses' attitudes to interprofessional working and advocacy.

Pre-test post-test educational intervention study.

Public university in Scotland.

400 undergraduate student nurses enrolled on a 15-week module focussed on health and social care integration and interprofessional working.

Students completed paper questionnaires at the start (n = 274, response rate: 80.1 %) and end (n = 175, 63.9 %) of the module. Outcome measures were the validated Attitudes Towards Healthcare Teams Scale (ATHCTS) and Protective Nursing Advocacy Scale (PNAS). Change in mean ATHCTS and PNAS scores were assessed using paired samples t-tests, with Cohen's d to estimate effect size.

ATHCTS scores significantly increased from 3.87 to 4.19 (p < 0.001, d = 0.52). PNAS scores increased from 3.58 to 3.81 (p < 0.001, d = 0.79), with significant improvements in the ‘acting as an advocate’ (4.18 to 4.51, p < 0.001, d = 0.81) and ‘environmental and educational influences’ subscales (3.79 to 4.13, p < 0.001, d = 0.75). Statements focussed on promoting holistic, dignified care and enabling health professionals to be responsive to emotional and financial needs of patients, showed greatest change.

Education based on plays created and performed by student nurses led to significant improvements in student nurses' attitudes towards interprofessional working and nursing advocacy. Student-led drama should be embedded in nursing curricula to enable students to understand the realities and complexities of health and social care integration and interprofessional working.

DramaNursing studentsAdvocacyEmpathyHealth and social care integrationTeamworkCo-production

Journal Article Type Article
Acceptance Date Jan 29, 2023
Online Publication Date Feb 2, 2023
Publication Date 2023-04
Deposit Date Feb 8, 2023
Publicly Available Date Feb 8, 2023
Journal Nurse Education Today
Print ISSN 0260-6917
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 123
Article Number 105743
Keywords Drama, Nursing students, Advocacy, Empathy, Health and social care integration, Teamwork, Co-production


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