Theses and Dissertations

Date of Award

2026

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Education (EdD)

Department

Abraham S. Fischler College of Education and School of Criminal Justice

Advisor

Mary Lynn Vogel

Committee Member

William Edmonds

Committee Member

Kimberly Durham

Keywords

communication, cultural competence, emergency department, patient-provider

Abstract

This phenomenological study explored the lived experiences of eight emergency department (ED) practitioners to understand how they perceive communication within the patient–provider relationship. Four research questions examined providers’ past communication interactions, the influence of cultural competence, the impact of ED subculture, and their definitions of high-quality relationships. Using Braun and Clarke’s thematic analysis, seven themes emerged. Providers described ED communication as highly adaptive, requiring real-time adjustments to address patients’ linguistic, cognitive, and emotional needs. They also reported frequent, overlapping communication barriers shaped by limited English proficiency, low health literacy, and developmental or cognitive challenges. Cultural competence was viewed as developed primarily through experience, with cultural norms guiding communication behaviors and influencing trust. Participants emphasized that the ED’s chaotic, time-scarce environment restricts communication, yet trust remains central to high-quality relationships. Findings highlight the need for experiential cultural training, structural communication supports, and recognition of trust-building as a critical clinical skill.

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