INTERPERSONAL PROCESS ANALYSIS & RUBRIC
Introduction
Interpersonal Process Analysis (IPA) is a way to identify patterns in student and patient communication. It is not
an intake assessment nor question and answer session but a time to listen and demonstrate caring concern,
and a time to recognize and identify a patient’s emerging feelings. IPA is a written record of a segment of the
nurse-patient conversation that reflects as closely as possible the verbal, non-verbal, coping, and defense
mechanisms utilized during the interaction. IPA has some disadvantages because it relies on memory and is
subject to distortions, however, it can be a useful tool for identifying communication patterns. The purpose of
the conversation is to give an opportunity to identify and practice communication strategies correctly. Note that
the goal is not to solve the patient’s problems but to explore and use interactive therapeutic communication.
The student selects goals prior to the interactions that are realistic and measurable. Topics include such areas as
behavioral issues (triggers like getting angry when called or made to feel “stupid”), replacing negative with
positive coping mechanisms (reframing), identification of feelings (hungry, angry, lonely, tired, happy, etc.),
plans for discharge, presence/absence delusions/hallucinations, etc. Therapeutic Communication demonstrates
the use of mostly broad open-ended questions, clarification, confronting, reflecting, empathy, immediacy,
focusing, etc. Identify the techniques used with rationales for use, and the effect of these techniques. Read and
follow guidelines (template and rubric) and chapters on therapeutic communication. Is the patient able to
answer? Are responses congruent with your statements?
Instructions
Select a patient to participate. Do not use a “script” for this interaction. Listen and respond to the patient
without taking notes. Taking notes is distracting for both the student and the patient and the patient may
resent or misunderstand the student’s intent or feel like a project. Write out and analyze a segment of the
nurse-patient interaction using quotation marks around what both you and the patient said. Identify non-verbal
actions such as body position changes, mood/affect changes, or conversation factors (looking down when
discussing an uncomfortable subject). Describe the environmental setting where the interaction took place – did
they contribute to a therapeutic (ease of conversation) or non-therapeutic setting (too cold, smoky, etc.). The
interpretation sections will be completed later because these sections take time and reflection. Utilize ATI or the
textbook for communication and defense/coping strategies.
The selected interaction is based upon the parts of the conversation most meaningful or therapeutic. Allow the
interaction to flow, documented so that the Instructor can easily follow the content. As soon as the interaction is
completed, thank the patient and excuse yourself. Begin to write the conversation verbatim (word for word) to
the best of your recollection. Document both parties’ non-verbal behaviors. During documentation, insert
information about any discontinuity, i.e. “patient needed to get ready for group therapy;” “patient left to use
the bathroom;” or “we agreed to meet up directly after group.” If the student continues a conversation later and
wishes to include parts of both conversations, identify the change or time lapse. (Always account for how an
interaction ended when it is unplanned and abrupt, i.e., “patient stood up and said he didn’t want to talk about
this anymore.”)
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Version Update: January 2018
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
Steps:
1. Complete the patient demographic information and the environmental setting. (Was the setting
conducive to talking?). In the patient description section, the patient should be described in such a way
that no one can identify him or her (first and last initials only). Never use patient’s name in your papers.
2. Include grooming, affect, posture, and mood.
3. Quote both sides of the conversation and the non-verbal information. Verbal communication is
concerned with the spoken word, including inflection and tone of voice. Non-verbal communication is
concerned with gestures, body movements, posture and other unspoken forms of relaying ideas and
feelings.
4. Identify student thoughts and feelings during the interaction. For example, “I was feeling nervous and
scared. He had attempted suicide and I didn’t know if what I said would hurt him.” Focus on what is
happening to you and the patient that has communication value.
5. The rest of the template will be completed later with time to analyze. Once all columns are complete,
the student will have gained insight needed to look back and decide if the technique was therapeutic or
non-therapeutic. If the patient responded favorably, yet a non-therapeutic statement was used such as
closed statements (“why did you do that?”), document what could have been said that was more
therapeutic. For example, I could have said, “Tell me more about what happened.”
6. The ability to look back and analyze conversation errors/ non-therapeutic responses is as valuable as
providing therapeutic responses during the conversation and can provide insight into what is customarily
used in your conversations.
7. Complete the type of communication techniques used and identify whether therapeutic or nontherapeutic. (Therapeutic communication is defined as a face-to-face process of interacting, focusing on
advancing the patient’s physical and emotional well-being, and is used to support or inform.)
8. Identify coping or defense mechanisms the patient probably used in this interaction and whether these
were adaptive or maladaptive.
9. Evaluate the effectiveness of this interaction.
a. Evaluate the goals. Are the responses relevant to the goal?
b. Did the patient initiate the conversation or did you?
c. Did you or the patient change the subject due to discomfort with the topic (like self-harm or
abuse)? Did the patient answer you, look away, or hesitate?
d. Were only meaningless/social topics discussed (football teams, music, food, etc.)? Did you use
closed communications, and if so was it because the patient was not cognitively communicative
(Alzheimer, stroke, or dementia patient)? What communication techniques were used the most?
e. Is there congruence between the verbal and nonverbal communications?
f. Interpret behaviors. These relate to the perception of meaning behind the words.
g. Identify feelings involved. When possible, document the reasoning behind the feelings.
h. Identify and evaluate themes and strategies.
i. What did the communication mean to you and the patient? If you were to redo this interaction,
what would you change?
10. These assignments are typed. Extra pages/rows may be added as needed for the conversation. Include a
reference page in APA form.
REV 5/2017
Page 2 of 8
Version Update: January 2018
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
INTERPERSONAL PROCESS ANALYSIS
Student:
Date:
Clinical Instructor:
Name (initials only):
Unit:
Current Legal Status (Vol., 5150, 5250, 30 day, T-Con, LPS-Conservatorship):
Multiaxial Diagnostic System: Axis I (Clinical Disorder):
Axis II (Personality Disorder / Mental Retardation):
Axis III (General Medical Conditions):
Axis IV (Psychosocial and Environmental Problems):
Axis V (Global Assessment of Functioning Scale):
1.
Description of the patient: Age? Sex? Ethnicity? Marital Status? What precipitated hospitalization?
Number of days in the hospital? Mental Status, etc.
2.
Description of environmental setting where interaction took place. Explain the reasons for a supportive or
non-supportive environment. (e.g. noise, distractions, light, temperature, etc.)
Page 3 of 8
Version Update: January 2018
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
INTERPERSONAL PROCESS ANALYSIS
NAME:
Student:
• Verbal (quotes) and Nonverbal
Communication (behavior, tone of
voice, eye contact, mannerisms, etc.)
• Document at least 5 interactions
• Goal for each interaction (realistic and
measurable)
DATE:
Patient:
Communication Techniques
Verbal (quotes) and
• Identify communication technique
Nonverbal Communication
used then define your communication
(behavior, tone of voice, eye
techniques
contact, mannerisms, etc.) • Was the communication therapeutic or
non- therapeutic?
• Which defense and coping
mechanisms didthe patient use?
Rationale based on your patient.
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
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Version Update: January 2018
Critique and Analysis
(effective or not effective? Could
have said…) Document your
thoughts and feelings during the
interaction.
Was your goal met?
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
INTERPERSONAL PROCESS ANALYSIS SUMMARY
1. Evaluation: After analyzing the interaction, provide a description on how the interaction progressed. Identify the reasons for successful process or
unsuccessful process. What did you learn from the interaction with your patient?
2. How did you personally feel about the interaction? What would you change if you had to redo the interaction?
Page 5 of 8
Version Update: January 2018
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
INTERPERSONAL PROCESS ANALYSIS RUBRIC
Program Learning Outcome #7: Utilize effective communication to interact with patients, families, and the interdisciplinary health team.
Course Learning Outcome #3: Initiate therapeutic nurse-client relationship then analyze verbal and non-verbal interactions, defense mechanisms, and coping
mechanisms.
Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcome.
Environment
Description
Clearly and accurately
describes the environment
with clear detail of where
the interaction took place.
Adequately describes the
environment with
adequate detail where the
interaction took place.
2
(Approaching
Expectations)
Vaguely describes the
environment with some
detail regarding where the
interaction took place.
Client Description
Clearly and accurately
describes the client’s
description in detail.
Adequately describes the
client’s description with
adequate detail.
Vaguely describes the
client’ description with
some detail.
Communication
Goals
Clearly and accurately
identifies realistic and
measurable
communication goals.
Adequately identifies
realistic and measurable
communication goals.
Vaguely identifies realistic
and measurable
communication goals.
Fails to identify to identify
realistic and measurable
communication goals.
Student
Communication
Clearly and accurately
identifies all verbal and
non-verbal
communications.
Adequately identifies
verbal and non-verbal
communications.
Vaguely identifies some,
but not all of the verbal
and non-verbal
communications.
Fails to identify either the
verbal and non-verbal
communications.
CRITERIA
4
(Exceeds Expectations)
3
(Meets Expectations)
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Version Update: January 2018
1-0
Score
(Does Not Meet
Expectations)
Lack description of the
environment and presents
no detail of where the
interaction took place.
Lack description of the
client and presents no
detail.
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
CRITERIA
Client
Communication
Communication
Techniques
Defense
Mechanism
Coping
Mechanism
Critique and
Analysis
CRITERIA
4
(Exceeds Expectations)
Clearly and accurately
identifies all verbal and
non-verbal
communications.
Clearly and accurately
identifies therapeutic and
non-therapeutic
communication
techniques. Consistently
able to explain the
rationale for using selected
techniques.
Clearly and accurately
identifies client’s defense
mechanisms.
Clearly and accurately
identifies client’s coping
mechanisms.
3
(Meets Expectations)
Adequately identifies
client’s verbal and nonverbal communications.
Progressively identifies
therapeutic and nontherapeutic
communication
techniques. Progressively
able to explain majority of
the rationale for using
selected techniques.
Progressively identifies
client’s defense
mechanisms.
Progressively identifies
client’s coping
mechanisms.
Clearly and accurately
interprets if the
communication technique
was effective or not.
Clearly interpretation of
thoughts and feelings
regarding statements.
Progressively interprets if
the communication
technique was effective or
not. Identifies
interpretation of thoughts
and feelings regarding
statements.
4
(Exceeds Expectations)
3
(Meets Expectations)
2
(Approaching
Expectations)
Vaguely identifies some
but not all of the client’s
verbal and non-verbal
communications.
Vaguely identifies some,
but not all therapeutic and
non- therapeutic
communication
techniques. Able to
explain some of the
rationale for using
selected techniques.
Vaguely identifies some
but not all defense
mechanisms.
Vaguely identifies some
but not all coping
mechanisms.
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Version Update: January 2018
Fails to identify any of the
therapeutic and nontherapeutic
communication
techniques used. Fails to
explain the rationale for
using the selected
communication
techniques.
Score
X2
Fails to identify client’s
defense mechanisms.
X2
Vaguely interprets if the
communication technique
was effective or not.
Vague interpretation of
thoughts and feelings
regarding statements.
2
(Approaching
Expectations)
1-0
(Does Not Meet
Expectations)
Fails to identify either
client’s verbal and nonverbal communications.
Fails to identify client’s
coping mechanisms.
X2
Fails to interpret if the
communication technique
was effective or not. Lack
justification of one’s
analysis and interpretation
of feelings regarding his or
her statements.
1-0
(Does Not Meet
Expectations)
X2
Score
INTERPERSONAL PROCESS ANALYSIS & RUBRIC
Evaluation
General Organization
Expresses clear and
precise point of view.
Responds strongly
regarding personal
feelings regarding the
interaction.
Accurate APA format,
appropriate citations and
references.
No spelling or grammar
errors.
Progressively expresses
own point of view and
own personal feelings
during the interaction.
Adequate APA format.
Minimal citations and
references are
appropriate.
Few spelling or grammar
errors.
Difficulty expressing own
point of view, vague
response regarding
personal feelings during
the interaction.
Fails to clearly express
own point of view and
describe personal
feelings during the
interaction.
Fails to utilize APA
format.
No citations or
references included
numerous spelling and
grammar errors.
Numerous APA format
errors,
inaccurate citations and
references.
Few spelling and
grammar errors.
X2
Total
STUDENT SIGNATURE:
DATE:
INSTRUCTOR SIGNATURE:
DATE:
COMMENTS:
/64 = %
_______
Page 8 of 8
Version Update: January 2018
Interpersonal Process Analysis 1
Introduction
Interpersonal Process Analysis (IPA) is a way to identify patterns in student and patient
communication. It is not an intake assessment nor question and answer session but a
time to listen and demonstrate caring concern, and a time to recognize and identify a
patient’s emerging feelings. IPA is a written record of a segment of the nurse-patient
conversation that reflects as closely as possible the verbal, non-verbal, coping, and
defense mechanisms utilized during the interaction. IPA has some disadvantages
because it relies on memory and is subject to distortions, however, it can be a useful
tool for identifying communication patterns. The purpose of the conversation is to give
an opportunity to identify and practice communication strategies correctly. Note that the
goal is not to solve the patient’s problems but to explore and use interactive therapeutic
communication.
The student selects goals prior to the interactions that are realistic and measurable.
Topics include such areas as behavioral issues (triggers like getting angry when called
or made to feel “stupid”), replacing negative with positive coping mechanisms
(reframing), identification of feelings (hungry, angry, lonely, tired, happy, etc.), plans for
discharge, presence/absence delusions/hallucinations, etc. Therapeutic Communication
demonstrates the use of mostly broad open-ended questions, clarification, confronting,
reflecting, empathy, immediacy, focusing, etc. Identify the techniques used with
rationales for use, and the effect of these techniques. Read and follow guidelines
(template and rubric) and chapters on therapeutic communication. Is the patient able to
answer? Are responses congruent with your statements?
Instructions
Select a patient to participate. Do not use a “script” for this interaction. Listen and
respond to the patient without taking notes. Taking notes is distracting for both the
student and the patient and the patient may resent or misunderstand the student’s intent
or feel like a project. Write out and analyze a segment of the nurse-patient interaction
using quotation marks around what both you and the patient said. Identify non-verbal
actions such as body position changes, mood/affect changes, or conversation factors
(looking down when discussing an uncomfortable subject). Describe the environmental
setting where the interaction took place – did they contribute to a therapeutic (ease of
conversation) or non-therapeutic setting (too cold, smoky, etc.). The interpretation
sections will be completed later because these sections take time and reflection. Utilize
ATI or the textbook for communication and defense/coping strategies.
The selected interaction is based upon the parts of the conversation most meaningful or
therapeutic. Allow the interaction to flow, documented so that the Instructor can easily
follow the content. As soon as the interaction is completed, thank the patient and
excuse yourself. Begin to write the conversation verbatim (word for word) to the best of
your recollection. Document both parties’ non-verbal behaviors. During documentation,
insert information about any discontinuity, i.e. “patient needed to get ready for group
therapy;” “patient left to use the bathroom;” or “we agreed to meet up directly after
group.” If the student continues a conversation later and wishes to include parts of both
conversations, identify the change or time lapse. (Always account for how an interaction
ended when it is unplanned and abrupt, i.e., “patient stood up and said he didn’t want to
talk about this anymore.”)
Steps
Complete the patient demographic information and the environmental setting. (Was the setting conducive to
talking?). In the patient description section, the patient should be described in such a way that no one can identify
him or her (first and last initials only). Never use patient’s name in your papers.
2. Include grooming, affect, posture, and mood.
3. Quote both sides of the conversation and the non-verbal information. Verbal communication is concerned with the
spoken word, including inflection and tone of voice. Non-verbal communication is concerned with gestures, body
movements, posture and other unspoken forms of relaying ideas and feelings.
4. Identify student thoughts and feelings during the interaction. For example, “I was feeling nervous and scared. He
had attempted suicide and I didn’t know if what I said would hurt him.” Focus on what is happening to you and the
patient that has communication value.
5. The rest of the template will be completed later with time to analyze. Once all columns are complete, the student
will have gained insight needed to look back and decide if the technique was therapeutic or non-therapeutic. If the
patient responded favorably, yet a non-therapeutic statement was used such as closed statements (“why did you do
that?”), document what could have been said that was more therapeutic. For example, I could have said, “Tell me
more about what happened.”
6. The ability to look back and analyze conversation errors/ non-therapeutic responses is as valuable as providing
therapeutic responses during the conversation and can provide insight into what is customarily used in your
conversations.
7. Complete the type of communication techniques used and identify whether therapeutic or non-therapeutic.
(Therapeutic communication is defined as a face-to-face process of interacting, focusing on advancing the patient’s
physical and emotional well-being, and is used to support or inform.)
8. Identify coping or defense mechanisms the patient probably used in this interaction and whether these were adaptive
or maladaptive.
9. Evaluate the effectiveness of this interaction.
a. Evaluate the goals. Are the responses relevant to the goal?
b. Did the patient initiate the conversation or did you?
c. Did you or the patient change the subject due to discomfort with the topic (like self-harm or abuse)? Did the patient
answer you, look away, or hesitate?
d. Were only meaningless/social topics discussed (football teams, music, food, etc.)? Did you use closed
communications, and if so was it because the patient was not cognitively communicative (Alzheimer, stroke, or
dementia patient)? What communication techniques were used the most?
e. Is there congruence between the verbal and nonverbal communications?
f. Interpret behaviors. These relate to the perception of meaning behind the words.
g. Identify feelings involved. When possible, document the reasoning behind the feelings.
h. Identify and evaluate themes and strategies.
i. What did the communication mean to you and the patient? If you were to redo this interaction, what would you
change?
10. These assignments are typed. Extra pages/rows may be added as needed for the conversation. Include a reference
page in APA form.
1.
Course: NURS 223L
INTERPERSONAL PROCESS ANALYSIS TEMPLATE
Student:
Date:
Clinical Instructor:
Name (initials only):
Unit:
Current Legal Status (Vol., 5150, 5250, 30 day, T-Con, LPS-Conservatorship):
Multiaxial Diagnostic System: Axis I (Clinical Disorder):
Axis II (Personality Disorder / Mental Retardation):
Axis III (General Medical Conditions):
Axis IV (Psychosocial and Environmental Problems):
Axis V (Global Assessment of Functioning Scale):
1.
Description of the patient: Age? Sex? Ethnicity? Marital Status? What precipitated hospitalization?
Number of days in the hospital? Mental Status, etc.
2.
Description of environmental setting where interaction took place. Explain the reasons for a supportive or
non-supportive environment. (e.g. noise, distractions, light, temperature, etc.)
Page 1 of 3
Course: NURS 223L
INTERPERSONAL PROCESS ANALYSIS TEMPLATE
INTERPERSONAL PROCESS ANALYSIS
NAME:
Student:
• Verbal (quotes) and Nonverbal
Communication (behavior, tone of
voice, eye contact, mannerisms, etc.)
• Document at least 5 interactions
• Goal for each interaction (realistic and
measurable)
DATE:
Patient:
Communication Techniques
Verbal (quotes) and
• Identify communication technique
Nonverbal Communication
used then define your communication
(behavior, tone of voice, eye
techniques
contact, mannerisms, etc.) • Was the communication therapeutic or
non- therapeutic?
• Which defense and coping
mechanisms didthe patient use?
Rationale based on your patient.
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Goal:
Verbal:
Nonverbal:
Verbal:
Nonverbal:
Page 2 of 3
Critique and Analysis
(effective or not effective? Could
have said…) Document your
thoughts and feelings during the
interaction.
Was your goal met?
Course: NURS 223L
INTERPERSONAL PROCESS ANALYSIS TEMPLATE
INTERPERSONAL PROCESS ANALYSIS SUMMARY
1. Evaluation: After analyzing the interaction, provide a description on how the interaction progressed. Identify the reasons for successful process or
unsuccessful process. What did you learn from the interaction with your patient?
2. How did you personally feel about the interaction? What would you change if you had to redo the interaction?
Page 3 of 3
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