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Résumé :
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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.
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