An Interprofessional Branching Simulation to Introduce RN First Assistant Students to Their Role in the Perioperative Setting

Advance Care Planning and Communication Skills Improve after an Interprofessional Team Simulation with Standardized Patients

Background:

Improving rates of advance care planning (ACP) and advance directive completion is a recognized goal of health care in the United States. No prior study has examined the efficacy of standardized patient (SP)-based student interprofessional ACP trainings.

Objectives:

The present study aims to evaluate an interprofessional approach to ACP education using SP encounters.

Design:

We designed a pre–post evaluation of an innovative interprofessional ACP training curriculum using multimodal adult learning techniques to test the effects of completing ACP discussions with SPs. Three surveys (pre-training T1, post-training T2, and post-clinical encounter T3) evaluated student knowledge, Communication Self-Efficacy (CSES), ACP self-efficacy, and interprofessional teamwork (using SPICE-R2).

Setting/Subjects:

Students from the schools of medicine, nursing, and social work attended three training modules and two SP encounters focused on ACP.

Measurements/Results:

During academic year 2018–2019, 36 students participated in the training at University of Maryland. Results demonstrated statistically significant improvements in ACP self-efficacy, M_T1 = 2.9 (standard deviation [SD]_T1 = 0.61) compared with M_T3 = 3.9 (SD_T3 = 0.51), p < 0.001, and CSES, M_T1 = 4.6 (SD_T1 = 1.35) versus M_T3 = 7.3 (SD_T3 = 0.51), p < 0.001, from T1 to T3. There was a medium-to-large improvement in knowledge from an average score of 4.3 (SD = 1.0) at T1 to an average score of 5.5 (SD = 1.4) at T2, p = 0.005, d = 0.67.

Conclusions:

Our interprofessional training module and SP encounter was successful in improving medical, social work, and nursing students' self-reported communication skills and knowledge regarding ACP.

The effectiveness of branching simulations in improving nurses' knowledge, attitudes, practice, and decision-making related to sepsis assessment and management

BACKGROUND

Nurses have a key role in the early assessment and management of sepsis, which is crucial for optimal quality of care and better patient outcomes. However, sepsis in critical care patients is underrecognized and untreated due to nurses' poor knowledge, attitudes, practice, and decision-making skills related to sepsis assessment and management.

OBJECTIVES

This study aimed to test the effectiveness of branching simulations in improving nurses' knowledge, attitudes, practices, and decision-making related to sepsis assessment and management.

METHODS

This experimental study was conducted on a convenience sample of 70 nurses (35 nurses in each of the intervention and control groups) with at least one year of experience working in an emergency room at a university hospital. The nurses' knowledge, attitudes, and practices were measured using a knowledge, attitudes, and practices survey, whilst their decision-making modes were assessed using the Nursing Decision-Making Instrument.

RESULTS

Compared to the control group, a significant improvement in practices (F _{(1, 68)} = 10.77, p = 0.002, η² = 0.137) and decision-making (F _{(1, 68)} = 10.68, p = 0.002, η² = 0.136) was observed among the nurses in the intervention group both immediately and two weeks post the branching simulations intervention. Compared to the baseline data, a significant improvement in knowledge (F _{(2, 136)} = 27.93, p < 0.001, η² = 0.291), practices (F _{(2, 136)} = 41.00, p < 0.001, η² = 0.376), and decision-making modes (F _{(2, 136)} = 29.15, p < 0.001, η² = 0.300) was observed both immediately and two weeks post branching simulations only among the nurses in the intervention group.

CONCLUSIONS

Education programs integrated with an interactive strategy of learning (branching simulations) can improve nurses' knowledge, attitude, practice, and decision-making related to sepsis assessment and management. Therefore, continuous education and professional training programs following an evidence-based intervention protocol/guideline are recommended for better nurse and patient outcomes.