Talking Their Way to Compassion: Communication Skills Drive Humanistic Nursing in Saudi Students

What makes a nurse truly humane? A new study from Riyadh suggests the answer may lie less in textbooks of ethics and more in the everyday mechanics of conversation. Researchers surveying 323 second-year undergraduate nursing students at a College of Nursing in the Saudi capital found that those who rated themselves highly on therapeutic communication also reported a markedly stronger capacity for humanistic practice — the blend of empathy, ethical sensitivity, aesthetic awareness and patient-centred caring that modern healthcare systems increasingly demand. The findings arrive at a pivotal moment for Saudi nursing education, which is undergoing rapid transformation under the country’s Vision 2030 reform agenda.

Humanistic practice ability has become a foundational competency in contemporary nursing curricula worldwide. It encompasses ethical and legal reasoning, interpersonal engagement, psychological adjustment, aesthetic sensitivity and practical caring behaviours. Yet educators have grown concerned that as healthcare becomes more technology-driven, technical proficiency may outpace the development of these human qualities, potentially eroding nurse–patient relationships and the delivery of holistic care. Therapeutic communication — purposeful interaction designed to build trust, understanding and collaboration among nurses, patients and other professionals — is widely regarded as the principal vehicle through which humanistic values are expressed at the bedside.

Previous research has typically examined communication skills and humanistic attributes in isolation from one another, leaving open the question of how tightly the two are intertwined. The new cross-sectional study, published in the journal Nursing Open, set out to fill that gap by measuring both constructs simultaneously and asking how much of the variation in students’ perceived humanistic practice ability could be explained by their communication competencies, over and above demographic and academic characteristics such as age, grade point average, English proficiency, caregiving responsibilities and whether nursing was their first-choice program.

The methodology was rigorous for a survey-based design. All eligible second-year students enrolled in the program’s Therapeutic Communication course were invited to participate, and 323 completed an online questionnaire. Therapeutic communication was assessed with the 28-item Global International Therapeutic Communication Scale, which spans six dimensions: setting the stage, building trust, active communication, communication skills, patient-centred communication and potential barriers. Humanistic practice ability was measured with the 29-item Humanistic Practice Ability of Nursing Scale, covering nursing communication, psychological adjustment, ethics and legal application, nursing aesthetics and caring practical ability. Both instruments showed excellent internal consistency in this sample, with Cronbach’s alpha values of 0.946 and 0.977 respectively, and a pilot study with 30 students confirmed the measures were clearly understood.

The descriptive results painted a confident picture of the cohort. Students reported a mean overall therapeutic communication score of 115.99 out of a possible 140, with communication skills and active communication scoring highest and perceived barriers rated only moderate. The mean humanistic practice ability score was 122.71 out of 145, with nursing aesthetic ability and ethics and legal application ability standing out as the strongest domains. The participants, whose ages ranged from 18 to 23 with a mean of 19.37 years, were academically strong — a mean grade point average of 3.80 on a five-point scale — and 71.2 percent said nursing had been their first choice of program. Notably, 57.9 percent carried responsibility for caring for dependents alongside their studies.

The correlational findings were striking. Every therapeutic communication dimension except potential barriers showed a moderate to strong positive association with humanistic practice ability, with correlation coefficients ranging from 0.53 for building trust to 0.65 for communication skills. Grade point average showed only a small positive correlation, and age, caregiving responsibilities and program choice showed no significant association at all. English proficiency, however, mattered considerably: students with advanced proficiency scored significantly higher on humanistic practice than those at the elementary level, with a mean difference of 14.48 points, and higher than intermediate-level peers by 7.65 points.

The most compelling evidence came from hierarchical multiple regression. Demographic and academic characteristics alone explained just 7.3 percent of the variance in perceived humanistic practice ability. When the six communication dimensions were added, the explained variance jumped to 48.7 percent — a change of 41.4 percentage points that was highly statistically significant. Within the final model, two dimensions emerged as the standout predictors: patient-centred communication, with a standardized coefficient of 0.253, and communication skills, at 0.233. English proficiency retained an independent, though smaller, association. The other communication dimensions, while correlated with the outcome on their own, did not add unique explanatory power once these two were accounted for — a pattern the authors attribute to the substantial overlap among communication competencies rather than to any lack of importance for trust-building or active listening.

The researchers are careful to frame these results as associations, not causal proof. Both constructs were measured by self-report within the same survey, raising the possibility of shared method variance: students confident in their interpersonal abilities may simply rate everything more positively, and perceptions of communication competence do not necessarily match objectively observed performance. The single-institution setting and narrow age range further limit generalizability, and voluntary participation may have introduced self-selection effects. Still, the magnitude of the association is difficult to dismiss, and it aligns with a growing international literature linking relational communication competence to compassionate, ethical and patient-centred care.

The English proficiency finding carries particular weight in the Saudi context, where English is the primary language of instruction in many nursing programs. Students more fluent in English may engage more easily with course materials, classroom discussion and communication-focused learning activities, and may feel greater confidence expressing themselves in interprofessional teams. The authors caution that language ability may also proxy broader educational advantages, but the independent survival of the effect in the regression model suggests that language support — clinical English modules, communication labs and scaffolded writing assistance — could help reduce inequities in how students develop and express humanistic competencies.

The practical implications reach well beyond Riyadh. The study’s authors argue that patient-centred communication and core communication skills should be woven longitudinally through nursing curricula rather than confined to a single course, using simulation with standardized patients, structured reflection, objective structured clinical examination stations and interprofessional education. At the policy level, the findings support embedding measurable communication and humanistic care indicators into national accreditation standards and competency frameworks, and aligning hospital orientation and continuing professional development with relational skills. For a region historically underrepresented in the international nursing literature, the study also offers context-specific evidence from the Middle East that may inform multi-institutional research worldwide. Whether better communicators become more humane nurses — or simply believe they have — is a question longitudinal and observational studies must now answer.

Subject of Research: The relationship between interprofessional therapeutic communication and humanistic practice ability among Saudi undergraduate nursing students

Article Title: Interprofessional Therapeutic Communication and Humanistic Practice Ability Among Saudi Nursing Students: A Cross‐Sectional Study

Article References: Andargeery, S. Y., & Alhowaish, O. A. (2026). Interprofessional Therapeutic Communication and Humanistic Practice Ability Among Saudi Nursing Students: A Cross‐Sectional Study. Nursing Open, 13(10), Article e70906. https://doi.org/10.1002/nop2.70906

Image Credits: AI Generated

DOI: 10.1002/nop2.70906

Keywords: nursing education, therapeutic communication, humanistic practice, patient-centred care, Saudi Arabia, cross-sectional study, English proficiency, nursing students, empathy, regression analysis, Vision 2030, clinical communication