title: Comparison of communication skills between trained and untrained students using a culturally sensitive nurse-client communication guideline in Indonesia.
abstract: BACKGROUND
  A communication guideline that is sensitive to the local culture is influential in the process of nursing care. The Gadjah Mada nurse-client communication guideline, the "Ready-Greet-Invite-Discuss," was meant (1) to strengthen the relationship between the nurse and the client despite of socio-culturally hierarchical gap between health providers and clients in Indonesian context, (2) to provide attention to the unspoken concerns especially in the context of indirect communication which mostly using non-verbal signs and politeness etiquettes, and (3) to initiate dialog in the society which hold a more community-oriented decision making.
  
  
  OBJECTIVE
  Our aim is to compare the communication skills of nursing students who had and had not received a training using a culture-sensitive Gadjah Mada nurse-client communication guideline.
  
  
  METHODS
  This was a quasi experimental randomized control study to the fifth semester students of a nursing school at Yogyakarta, Indonesia. The intervention group was trained by the Gadjah Mada nurse-client communication guideline. Both intervention and the control group had learned general nurse-client communication guidelines. The training was 4h with role-plays, supportive information and feedback sessions. An objective-structured clinical examination (OSCE) was conducted 1week after the training, in seven stations, with seven simulated clients. Observers judged the communication skills of the students using a checklist of 5-point Likert scale, whereas simulated clients judged their satisfaction using 4-point Likert scale represented in colorful ribbons.
  
  
  RESULTS
  There were significant mean differences in each domain of communication guideline observed between the trained and the control groups as judged by the teachers (p≤0.05) and simulated clients.
  
  
  CONCLUSIONS
  Training using a culture-sensitive communication skills guideline could improve the communication skills of the nursing students and may increase satisfaction of the clients.
authors.affiliation: Faculty of Medicine, Department of Medical Education, Universitas Gadjah Mada Yogyakarta, Indonesia.
authors.forename: Mora
authors.initials: M
authors.lastname: Claramita
authors.affiliation: Faculty of Medicine, Department of Medical Education, Universitas Gadjah Mada Yogyakarta, Indonesia.
authors.forename: Rodianson
authors.initials: R
authors.lastname: Tuah
authors.affiliation: Faculty of Medicine, School of Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
authors.forename: Patricia
authors.initials: P
authors.lastname: Riskione
authors.affiliation: Faculty of Medicine, Department of Public Health, Universitas Gadjah Mada, Indonesia.
authors.forename: Yayi Suryo
authors.initials: YS
authors.lastname: Prabandari
authors.affiliation: Faculty of Medicine, School of Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
authors.forename: Christantie
authors.initials: C
authors.lastname: Effendy
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003466:Cultural Characteristics; D006801:Humans; D007214:Indonesia; D009723:Nurse-Patient Relations
keywords: Communication skills guidelines; Cross cultural communication skills; Nurse–client communication; Southeast Asian culture