"It's the little things that count": the value in receiving therapeutic letters.

The focus of this qualitative study was to explore patient's perceptions of having received a therapeutic letter (TL) from a nursing student. Patient feedback contributes to student learning and is especially salient when students are trying to understand complex relationships and to deliver care that is individualized and personalized. Four themes from recipient interviews were identified, which show the influence of TLs on the student-patient relationship and the benefits of TLs to patients who receive them. Strategies to promote relationship building, such as TL writing are needed, particularly when students are required to work with patients who have long-standing psychiatric and social disabilities and find these relationships challenging. Findings are discussed in light of the value of TLs to patients and as a powerful strategy for student learning.