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Deaf-led Deaf Awareness Training in the Emergency Department: A Pre-Post Evaluation of Staff Knowledge, Confidence, and Communication Preparedness
Journal article   Open access   Peer reviewed

Deaf-led Deaf Awareness Training in the Emergency Department: A Pre-Post Evaluation of Staff Knowledge, Confidence, and Communication Preparedness

Sarah Hazelwood, Jennifer Dermer, Neil Wood, Faye Jordan, Karen Hay and Stephen Neville
Journal of Emergency Nursing, Vol.Advanced access
17-Sep-2026
DOI: https://doi.org/10.1016/j.jen.2026.08.005
PMID: 42752063
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Deaf-led Deaf Awareness Training in the Emergency Department: A Pre-Post Evaluation of Staff Knowledge, Confidence, and Communication Preparedness513.96 kBDownloadView
Published Version (Advanced Access) Open Access CC BY V4.0

Abstract

Communication barriers Cultural competency Deaf Emergency service–hospital Health education Sign language
Introduction Communication access is essential for safe emergency care, but D/deaf patients (D/deaf used here to include people identifying as culturally Deaf and those with audiological difference) frequently experience barriers that limit their ability to participate in decision-making. Emergency clinicians often lack formal training in Deaf cultural and linguistic needs, interpreter use, and visually accessible communication strategies. This study evaluated whether a brief deaf awareness training session could improve emergency department staff’s self-rated knowledge and confidence in caring for D/deaf patients. Methods This study used a 1-group pre-post survey design. A total of 36 emergency department staff members completed matched surveys immediately before and immediately after a single 30-minute Deaf-led training session. Surveys included 5-point Likert items assessing self-rated knowledge, confidence, and preparedness. Of note, 7 prespecified paired items were analyzed using Wilcoxon signed-rank tests, and a summed composite score (range 7-35) was analyzed using a paired t test. Additional analyses examined differences in composite scores by experience, sex, and cultural background and assessed whether experience level moderated the change from pre- to posttraining. Results All 7 outcomes improved after training (all P < .001). Median responses increased from 1-2 at baseline to 4-5 after the training. The composite score increased from a mean of 13.0 to 32.0 (mean change, +19.0). Improvements were consistent across experience, sex, and cultural background categories at posttraining (all P ≥ .25 for posttraining group differences). Most participants (97%) wanted further Deaf culture education, and 100% supported integrating the training into routine staff development. Discussion Deaf-led deaf awareness training was associated with statistically significant improvements in ED staff’s self-rated knowledge, confidence, and preparedness to care for D/deaf patients. Findings suggest that brief Deaf community-led education is a feasible and scalable strategy for strengthening staff-reported capacity to provide accessible communication in emergency care. Note Terminology: In this paper, Deaf refers to culturally Deaf Auslan users, and deaf to those with audiological difference who may or may not use Auslan as their preferred communication method; D/deaf is used where both groups are included.

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