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Effect of Sign Language Training on Sign Language Knowledge among Healthcare Workers in Nigeria

Abstract

Effective communication between healthcare workers and patients is essential for accurate assessment, diagnosis, treatment, health education, informed decision-making, and quality healthcare delivery. Deaf and hard-of-hearing patients may experience communication barriers when healthcare workers lack knowledge of sign language or appropriate communication strategies. These barriers may result in misunderstanding of symptoms, difficulty obtaining medical histories, reduced access to health information, dissatisfaction with healthcare services, and potential compromises in patient safety. Sign language training provides healthcare workers with basic communication skills that may improve their ability to interact with deaf and hard-of-hearing patients and promote more inclusive healthcare services. Against this background, this study investigates the effect of sign language training on sign language knowledge among healthcare workers in Nigeria. The study will be anchored on the Social Model of Disability, Health Belief Model, and Social Cognitive Theory. The Social Model of Disability emphasizes that communication barriers may arise from limitations within social and healthcare environments rather than from the individual's hearing impairment alone. The Health Belief Model explains how healthcare workers' perceptions of the importance and benefits of inclusive communication, perceived barriers to learning sign language, and cues to action may influence participation in sign language training. Social Cognitive Theory emphasizes learning through observation, demonstration, practice, feedback, reinforcement, and self-efficacy, which are important components of acquiring basic sign language skills. Collectively, these theoretical perspectives provide a suitable framework for explaining how sign language training may influence sign language knowledge among healthcare workers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise healthcare workers, including nurses, doctors, community health officers, medical laboratory personnel, pharmacists, health educators, and other relevant healthcare staff working in selected public and private healthcare facilities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, healthcare facilities, departments, and eligible healthcare workers. Sign language training will be assessed using indicators such as training duration, frequency of sessions, training content, practical demonstrations, supervised practice, use of standardized Nigerian Sign Language materials where appropriate, trainer qualifications, availability of learning resources, attendance, and opportunities for continued practice. Sign language knowledge will be assessed using indicators such as knowledge of common healthcare-related signs, greetings, basic questions, body parts, symptoms, medications, common medical conditions, emergency-related communication, instructions, and ability to understand or produce basic signs relevant to healthcare encounters. Data will be collected using structured questionnaires, standardized sign language knowledge assessment tools, practical sign-recognition or production assessments, training attendance records, and relevant healthcare facility training documents. Descriptive statistics will be used to summarize participants' characteristics, previous exposure to sign language, training participation, and knowledge scores. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of sign language training on healthcare workers' sign language knowledge. Where a quasi-experimental design is adopted, knowledge scores before and after the training intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that sign language training has a significant positive effect on sign language knowledge among healthcare workers in Nigeria. Healthcare workers who participate in structured sign language training are expected to demonstrate improved knowledge and practical understanding of basic signs relevant to healthcare communication compared with workers without comparable training. Training may improve healthcare workers' ability to greet deaf or hard-of-hearing patients, ask basic questions, understand common symptoms, communicate simple instructions, provide health information, and respond appropriately during healthcare encounters. Practical demonstrations, repeated practice, and feedback may strengthen retention and increase healthcare workers' confidence in using sign language. However, limited training time, shortage of qualified sign language instructors, inadequate learning materials, large workloads, lack of opportunities for continued practice, and differences in sign-language proficiency may reduce the effectiveness of training. The study therefore expects structured, practical, culturally appropriate, and continuous sign language training to contribute significantly to improved sign language knowledge among healthcare workers in Nigeria. The study is expected to contribute to the literature on sign language training, disability-inclusive healthcare, deaf health, healthcare communication, health equity, health education, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Commission for Persons with Disabilities, state ministries of health, hospitals, primary healthcare centres, healthcare professional regulatory bodies, training institutions, deaf and hard-of-hearing organizations, and policymakers regarding strategies for improving communication accessibility within healthcare settings. The study will also provide evidence-based recommendations for integrating basic Nigerian Sign Language training into healthcare worker education and continuing professional development, developing standardized healthcare sign language training materials, strengthening practical communication training, increasing the availability of qualified sign language instructors, promoting collaboration with deaf communities, and establishing inclusive communication policies across healthcare facilities in Nigeria.

Keywords: Sign language training, sign language knowledge, healthcare workers, deaf patients, hard-of-hearing patients, disability-inclusive healthcare, healthcare communication, health equity, health education, Nigeria, public health.