Lee Dollery – Nurse Educator Portfolio

Bereavement and Therapeutic Communication in Fetal Loss

Context:

This session is part of a larger fetal loss workshop scheduled for June. This portion focuses specifically on bereavement and therapeutic communication, while other educators address additional clinical and educational components.

Learners:

Registered nurses and other interprofessional staff with varying levels of experience.

Learning Objectives:

  1. Describe the principles of therapeutic communication in bereavement care
  2. Identify non-therapeutic communication
  3. Demonstrate appropriate communication responses in fetal loss scenarios
  4. Reflect on their own comfort and approach to support grieving families

Teaching Strategies:

  • Brief interactive teaching
  • Scenario-based discussion
  • Role-play
  • Facilitated debrief
  • Guided reflection
  • Psychological safety check-in

Learning Activities:

  1. Open Discussion ( 5 minutes)
  2. Prompt: “What would you say when entering the room of a grieving family?”
  3. Purpose: Activate prior knowledge and set context
  • Brief Teaching (10 minutes)
  • Overview of therapeutic vs non-therapeutic communication
  • Emphasis on presence, silence, and avoiding harmful phrases
  • Breakout Session – Placemat Strategy (15 minutes)
  • Learners divide into small groups (3-4 per group)
  • Each group is given a fetal loss scenario

Instructions:

  • Each learner writes independently:

“What would you say?”

“What would you avoid saying?”

  • Group discusses responses
  • The group agrees on a shared response and writes it in the centre

Purpose:

  • Encourages participation from all learners
  • Promotes reflection before discussion
  • Builds confidence through shared thinking
  • Supports the application of communication skills
  • Role-Play (10-15 minutes)
  • Volunteers or pair practice communication responses
  • Focus on real-life application
  • Debrief (10 minutes)

Facilitated group discussion:

  • What stood out to you?
  • What felt comfortable or uncomfortable?
  • What would you say differently?
  • Psychological Safety Check and Support (5 minutes)
  • Acknowledge the emotional impact of the content
  • Normalize responses
  • Remind learners of available supports (e.g., employee assistant program at AHS, peer support resources)
  • Reflection (5 minutes)
  • Prompt:

What is one sentence you will use on your next shift to support a family experiencing fetal loss?

Assessment and Evaluation:

  • Pre-session and post-session confidence assessment
  • Observation during breakout and role-play activities
  • Participation in discussion and debrief
  • Reflection responses

Materials:

  • Slides
  • Scenario cards
  • Placemat templates
  • Evaluation forms

Bereavement and Therapeutic Communication in Fetal Loss Presentation:

Pre and Post-Evaluations:

Blank-Likert-Scale-Bereavement-Pre-testDownload
Blank-Likert-Scale-Bereavement-Post-testDownload

Rationale

This lesson plan was designed using a learner-centred approach that emphasizes engagement, reflection, and application to clinical practice. A variety of teaching strategies are incorporated, including scenario-based learning, role-play, breakout discussion using the placemat strategy, and facilitated debriefing.

The placemat strategy encourages participation from all learners by allowing individual reflection and collaborative discussion. This approach supports critical thinking and helps learners build confidence in their communication skills. The use of realistic clinical scenarios allows learners to connect the content directly to their own practice and apply therapeutic communication in a safe environment.

Debriefing is intentionally built into the session to provide timely feedback and support reflective learning. Given the sensitive nature of fetal loss, a psychological safety check is included to acknowledge the emotional impact of the content and to remind learners of available supports within the organization.

Multiple assessment approaches are used, including pre- and post-session self-assessments, observation during activities, and reflective responses. These methods allow for evaluation of knowledge, communication skills and attitudes, providing a more complete understanding of learning.

This session is delivered as part of a larger workshop alongside educators, supporting a collaborative approach to teaching and consistency in practice.

Reflection

My strength as a nurse educator has been in scholarly teaching, particularly in designing practical, clinically relevant learning experiences. Developing this session has challenged me to be more intentional in how I design learning, rather than relying primarily on clinical experience.

Incorporating strategies such as the placemat activity and role-play has helped me focus on engaging all learners and creating space for different perspectives. It has also reinforced the importance of allowing learners to practice communication in a safe environment, especially when dealing with emotionally difficult situations

I have also become more aware of the importance of building in evaluation, rather than assuming learning has occurred. Using pre- and post-assessments, reflection, and debriefing helps me better understand how the session affects confidence, communication, and readiness for practice.

Including a psychological safety check has also been an important consideration, recognizing that this content can affect learners personally and professionally.

This work reflects a shift in my practice from just delivering content to intentionally designing, evaluating, and improving learning experiences. Moving forward, I am interested in how this teaching translates into clinical practice and how I can continue to refine and share what I learn.