Interprofessional simulation in undergraduate nursing program: An integrative review

Unveiling the impact of interprofessional education on shaping students' interprofessional identity and collaboration perception: a mixed-method study

BACKGROUND

Interprofessional education (IPE) has the potential to shape students' collaboration perception and interprofessional identity but remains understudied. This study aims to understand the effects of the IPE program as a contextual trigger to promote collaboration perception change and interprofessional identity formation among healthcare professional students.

METHODS

Using concurrent triangulation mixed-methods, we examined the relationship between collaboration perception and interprofessional identity change among health profession students (N = 263), and explored their perspectives on how their IPE experiences influenced their perception and identity. Participants completed the Interdisciplinary Education Perception Scale and Extended Professional Identity Scale and responded to open-ended questions before and after the IPE intervention. Pearson's correlation, t-tests, regression (quantitative), and thematic analysis (qualitative) were conducted.

RESULTS

Teams with initially lower collaboration perception (M = 3.59) and lower interprofessional identity (M = 3.59) showed a significant increase in collaboration perception (M = 3.76, t = 2.63; p = .02) and interprofessional identity (M = 3.97, t = 4.86; p < .001) after participating in IPE. The positive relationship between collaboration perception and interprofessional identity strengthened after participating in IPE, as evident from the correlation (Time 1: r = .69; p < .001; Time 2: r = .79; p < .001). Furthermore, collaboration perception in Time 1 significantly predicted the variance in interprofessional identity at Time 2 (β = 0.347, p < .001). Qualitative findings indicated that 85.2% of students expressed that IPE played a role in promoting their interprofessional identity and collaboration attitudes.

CONCLUSIONS

Incorporating the IPE program into the curriculum can effectively enhance students' collaboration perception and interprofessional identity, ultimately preparing them for collaborative practice in the healthcare system. By engaging students in interprofessional teamwork, communication, and joint decision-making processes, the IPE program provides a valuable context for students to develop a sense of belonging and commitment to interprofessional collaboration.

Relationship between readiness for interprofessional learning and academic self-efficacy among nursing students: a cross-sectional study

BACKGROUND

Modern medicine emphasizes that medical professionals engage in interprofessional collaboration to better meet the diverse needs of patients from physical, psychological, and social perspectives. As nursing students are the future reserve of the clinical nursing workforce, nursing educators worldwide should pay close attention to nursing students' interprofessional learning attitudes and take responsibility for training qualified interprofessional nursing personnel. However, little is known about the relationship between nursing students' readiness for interprofessional learning and academic self-efficacy. Thus, this study aims to investigate the level of readiness for interprofessional learning and academic self-efficacy among nursing students, and to explore the relationship between the two.

METHODS

A cross-sectional survey was conducted with a sample of 741 undergraduate nursing students pursuing four-year degrees from a school in Jinan, Shandong Province, China from November to December 2021. The social-demographic questionnaire, Readiness for Interprofessional Learning Scale, and Academic Self-efficacy Scale were used for data collection. Descriptive statistics used to analyze the data included: Cronbach's alpha, t-test, one-way ANOVA, Pearson's correlation, and multiple linear regression analysis.

RESULTS

Readiness for interprofessional learning mean score was (3.91 ± 0.44) and mean academic self-efficacy was (3.47 ± 0.42). Significant differences were found in the research variables according to participants' sex, grade, choice of nursing profession, and frequency of communication with health-related major students in studies (p < 0.05, p < 0.001). Pearson correlation analysis showed that academic self-efficacy was positively related to readiness for interprofessional learning (r = 0.316, p < 0.01). The hierarchical regression analysis showed that academic self-efficacy was positively related to readiness for interprofessional learning (β = 0.307, p < 0.001), The model explained 15.6% of the variance in readiness for interprofessional learning (F = 18.038, p < 0.001).

CONCLUSIONS

Readiness for interprofessional learning and academic self-efficacy were in the middle level among nursing students. Moreover, there was a significant positive correlation between the two. Therefore, it is very important for nursing educators to improve nursing students' academic self-efficacy before improving their readiness for interprofessional learning.

Integrated virtual simulation and face-to-face simulation for clinical judgment training among undergraduate nursing students: a mixed-methods study

BACKGROUND

Virtual simulation and face-to-face simulation are effective for clinical judgment training. Rare studies have tried to improve clinical judgment ability by applying virtual simulation and face-to-face simulation together. This study aimed to evaluate the effect of an integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program on enhancing nursing students' clinical judgment ability and understanding of nursing students' experiences of the combined simulation.

METHODS

A sequential exploratory mixed-methods study was conducted in a nursing simulation center of a university in Central China. Third-year nursing students (n = 122) taking clinical training in ICUs were subsequentially assigned to the integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program arm (n = 61) or the face-to-face simulation-only arm (n = 61) according to the order in which they entered in ICU training. Clinical judgment ability was measured by the Lasater Clinical Judgment Rubric (LCJR). Focus group interviews were conducted to gather qualitative data.

RESULTS

Students in both arms demonstrated significant improvement in clinical judgment ability scores after simulation, and students in the integrated arm reported more improvement than students in the face-to-face simulation-only arm. The qualitative quotes provided a context for the quantitative improvement measured by the LJCR in the integrated arm. Most of the quantitative findings were confirmed by qualitative findings, including the domains and items in the LJCR. The findings verified and favored the effect of the combination of non-immersive virtual simulation and high-fidelity face-to-face simulation integrated program on enhancing nursing students' clinical judgment ability.

CONCLUSIONS

The integrated virtual simulation and face-to-face simulation program was feasible and enhanced nursing students' self-reported clinical judgment ability. This integrated non-immersive virtual simulation and high-fidelity face-to-face simulation program may benefit nursing students and newly graduated nurses in the ICU more than face-to-face simulation only.

Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea

Interprofessional education (IPE) for patient safety is becoming increasingly important worldwide. However, Korea lacks a systematic approach toward patient safety, despite the high demand for teamwork and patient communication education. This study aims to determine the effectiveness of a patient safety IPE program using medical error scenarios. The program was developed to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students, and evaluate the design of the program and students' satisfaction levels. The program comprises two modules, each consisting of lectures, team-based case analysis, role-play, and high-fidelity simulation activities. This study followed a quasi-experimental pre-post test design to determine program outcomes. An online survey for the Readiness for Interprofessional Learning Scale (RIPLS), patient safety motivation, program design evaluation, and program satisfaction was conducted before and after the program. Data were analyzed using descriptive statistics, paired sample t-tests, and Pearson's correlation. The pre-post RIPLS and patient safety results were significant (t = -5.21, p < .001;t = -3.20, p = .002). The results of the medical scenario examination of the patient safety IPE program showed improved motivation for patient safety among students, and contributed to the improvement of IPE learning attitudes by improving team work and collaboration.

Senior nursing student's confidence in learnt competencies and perceptions of patient safety competency: a multisite cross-sectional study

OBJECTIVE

Nursing students' attainment of patient safety (PS) competency has always been a global concern among health and educational organisations. Therefore, this study was conducted to determine senior nursing students' confidence of their PS competencies, and associated predictive factors.

DESIGN

Cross-sectional study.

SETTING

Four faculties from the nursing faculties of East Azerbaijan province.

PARTICIPANTS

253 senior nursing students in Iran.

PRIMARY AND SECONDARY OUTCOME MEASURES

Using the modified version of the Health Professional Education Patient Safety Survey, data related to the level of confidence of nursing students in acquired competencies in seven sociocultural dimensions of PS in classroom learning and clinical settings were collected. In addition, the predictors of the patient's safety competencies were identified by linear regression statistics.

RESULTS

Mean scores of all dimensions of PS competencies both in the classroom and in clinical settings were higher than 3.11 (out of 5). The nursing students were most confident in their learning of 'understanding human and environmental factors' in the classroom and the clinical setting. Nursing students displayed the least confidence in learning 'work in teams with other health professionals' in both the classroom and the clinical settings. Type of university, prior experience with PS competencies education, and coverage of PS competency issues in the curriculum predicted the students' perceived competency scores in the classroom (R2=0.53, p<0.001). Also, perceived competence in the clinical settings was predicted by the variables of reporting errors to personnel and peers and the type of university (R2=0.65, p<0.001).

CONCLUSION

Study findings emphasise the role of learning environments and educational experiences of nursing students especially the clinical environment, clinical instructors and the hidden curriculum in improving safety competence. Nursing educators can use this information to revise and develop the undergraduate nursing curriculum, paying close attention to lesson plans and content in relation to teaching safety issues.

The effect of interprofessional simulation practice on collaborative learning: A randomized controlled trial

This study examined the effect of simulation on readiness for collaborative practice and learning using a randomized-controlled trial design that used the same education protocol with interprofessional and uniprofessional groups. The sample consisted of 43 students from four different majors. The students were assessed with the Readiness for Interprofessional Learning Scale, and a care plan measurement instrument. The interprofessional group showed a small increase (0.1 ± 0.43; p = .02) in readiness for teamwork and collaboration; the uniprofessional group showed a smaller increase for teamwork and collaboration (0.04 ± 0.31; p = .04) and for patient-centred care (0.0 ± 0.35; p = .01). The enriching work of interprofessional learning was evident within the care plan activity, suggesting that interprofessional simulation is an effective learning method for interprofessional education.

Effectiveness of interprofessional simulation-based education programs to improve teamwork and communication for students in the healthcare profession: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Factors, such as the dynamic and variable structure of healthcare services, the introduction of new care models and technological developments, and requirements for patient safety, quality, and accreditation, require new content, goals, and models in the education and practice of health disciplines. Curriculum studies should be planned by today's requirements and competencies to be gained in interprofessional simulation-based education.

OBJECTIVES

This systematic review and meta-analysis study was conducted to evaluate the effectiveness of interprofessional simulation-based education programs for improving teamwork and communication among students in the healthcare profession.

METHODS

In this study, Web of Science, Cochrane Library, Springer Link, Science Direct, Ovid, PubMed, Scopus, ProQuest, EBSCOhost/CINAHL Complete, and MEDLINE databases were searched without year limitations until April 2022. Two independent researchers reviewed the studies and analyzed the data. Two researchers evaluated the methodological quality of the studies using the Cochrane Collaboration tool (RoB 2.0). This study was prepared in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Comprehensive Meta-Analysis (CMA) 3 software was used for meta-analysis.

RESULTS

Eight randomized controlled trials conducted with 819 participants were included in this study. The evaluation of meta-analysis data showed that interprofessional simulation-based education programs significantly improved teamwork (Hedge's g = 0.41, p < 0.001, 95 % CI = 0.25 to 0.56) and communication (Hedge's g = 0.54, p < 0.001, 95 % CI = 0.26 to 0.82). The results of the sensitivity analysis showed that teamwork and communication were stable.

CONCLUSION

Interprofessional simulation-based education programs seem to be an appropriate method for improving teamwork and communication among healthcare students. In the future, it is thought that there is a need to individualize interprofessional simulation-based education programs based on cultural differences and socio-demographic characteristics of healthcare students and to plan studies that examine long-term results.

REGISTRATION NUMBER

CRD42022325514 (PROSPERO).

Interprofessional team-based education: A comparison of in-person and online learner experiences by method of delivery and health profession

BACKGROUND

Building capacity for teamwork, communication, role clarification and recognition of shared values is essential for interprofessional healthcare workforce development. Requirements to demonstrate interprofessional practice competencies have coincided with pivots to online delivery. Comparison of in-person and online delivery models for interprofessional education is important for future curriculum design.

PURPOSE

This article presents an evaluation of in-person and online delivery modes for interprofessional team-based education and compares learner experiences across different health professions.

METHODS

Students from 13 health professions (n = 2236) participated between Spring 2020 and Fall 2021. In-person and online delivery models were compared, assessing learner perceptions of efficacy for interprofessional practice, using reflective pre-post responses to the Interprofessional Collaborative Competency Attainment Scale (ICCAS).

RESULTS

Mean ICCAS scores improved for in-person and online delivery (0.79 vs 0.66), with strong effect (Cohen's D 2.03 and 1.31 respectively; p < 0.001). Statistically significant differences were observed across professions, although all experienced ICCAS score improvements. Logistical benefits were evident for online delivery.

CONCLUSION

In-person and online interprofessional team-based education can provide valuable learner experiences for large student cohorts from multiple professions. ICCAS score differences should be weighed against potential logistical benefits of online delivery. Timing of delivery and determinants of differences in student response across professions warrant evaluation for future curriculum design.

A scoping review of clinical skill development of preregistration registered nurses in Australia and five other English-speaking countries

AIM

The aim of this scoping review is to synthesise current evidence around the clinical skill development of preregistration registered nurses (RNs) in Australia, United Kingdom (UK), Ireland, United States (US), Canada and New Zealand, to inform nurse education, policy and clinical practice.

BACKGROUND

Nursing is a practical profession, and registered nurses require specific skills, knowledge and attributes in order to care for patients safely. The context for health care delivery is shifting, and the education of nurses must adapt to effectively equip the registered nurse of the future.

DESIGN

A scoping review was conducted of clinical skill development in preregistration nurses. CINAHL Plus, MEDLINE, Health Source (Nursing/Academic edition) and Scopus were searched. Included studies were primary Australian studies and international literature reviews, which focussed on preregistration nursing education. Papers were written in the English language and focussed on clinical skill development. Results were synthesised narratively. The review is reported here in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses Scoping Review extension (PRISMA-ScR) guidelines.

RESULTS

One hundred fifty-five Australia studies and 89 international reviews were included in the review. Six key themes were identified, namely clinical skills, approaches to teaching and learning, interprofessional education, assessment of learning, clinical placement and simulation.

CONCLUSION

There is substantial variation in strategies and programmes to facilitate clinical skill development both within Australia and internationally, indicating a genuine shift away from traditional didactic pedagogy. New graduate registered nurses were expected to be "work-ready," albeit at a novice level, when they enter the workplace. Future research should consider measures of impact on actual clinical practice and focus on developing work-ready graduates for the range of clinical settings in which they may practice. Educators, policymakers and educational institutions can use these findings to inform curriculum developments to ensure that clinical skill development is evidence-based.

Evaluating the effects of simulated interprofessional teaching on the development of clinical core competence in nursing students: a mixed methods study

BACKGROUND

While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design.

METHODS

A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied "Clinical Critical Thinking Training" together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann-Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience.

RESULTS

The students' interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p < 0.05). Three themes emerged regarding simulated interprofessional teaching: clarifying team positioning, improving team efficiency, and optimizing the learning experience.

CONCLUSION

SIPE can build students' critical thinking, teamwork, and interprofessional core competencies, which makes it a useful teaching design.

Interprofessional Identity in Health and Social Care: Analysis and Synthesis of the Assumptions and Conceptions in the Literature

Interprofessional identity (IPI) development is considered essential in reducing incongruency and improving interprofessional collaboration. However, noticeable differences in conceptualizations are being put forward in the literature, hindering interpretation of research findings and translation into practice. Therefore, a Concept Analysis and Critical Interpretative Synthesis of empirical research articles were conducted to explore the assumptions and conceptions of IPI. Independent literature screening by two researchers led to the inclusion and extraction of 39 out of 1334 articles. Through critical analysis, higher order themes were constructed and translated to a synthesizing argument and a conceptual framework depicting what constitutes IPI (attributes), the boundary conditions (antecedents) and the outcomes (consequences) of its development. The attributes refer to both IPI's structural properties and the core beliefs indicative of an interprofessional orientation. The antecedents inform us on the importance of IPI-fitting constructivist learning environments and intergroup leadership in enabling its development. This development may lead to several consequences with regard to professional wellbeing, team effectiveness and the quintuple aim. Given the educational orientation of this study, ways for facilitating and assessing the development of IPI among learners across the professional continuum have been proposed, although empirical research is needed to further validate links and mediating and moderating variables.

Using Large-Group Simulation Incorporating a Variety of Media Formats in Innovating Interprofessional Education

ABSTRACT

Innovative teaching strategies incorporated into curricula can prepare students for interprofessional practice and have a positive impact on patient outcomes and team dynamics in health care. Our team of faculty from nursing, social work, and pharmacy developed and implemented an activity using simulation in the large classroom to improve students' perceptions of working in interprofessional teams. Effectiveness was assessed using the Interprofessional Collaborative Competencies Attainment Survey with a pretest-posttest design. Our experience indicated that this teaching approach can be an effective strategy for maximizing resources and providing meaningful interprofessional student experiences.

Using an interprofessional competency framework to enhance collaborative pediatric nursing education and practice

Background

Interprofessional education (IPE) provides healthcare students with the knowledge and skills necessary to provide safe and effective collaborative care in a variety of clinical settings. Inclusion of IPE in nursing curricula is required for program accreditation in Canada; a variety of learning strategies at varied levels are used to meet this requirement. As this formal requirement only occurred over the last decade, development, facilitation, and evaluation of IPE interventions are ongoing.

Purpose

The purpose of this study was to examine if exposure to an introductory IPE activity influenced third-year undergraduate nursing students’ perceived ability to practice competent interprofessional collaboration (IPC).

Methods

The introductory IPE activity included ten-hours of interactive lectures and related case studies, grounded in the National Interprofessional Competency Framework, delivered by various healthcare professionals in a third-year nursing theory and clinical course. Following completion of the courses, quantitative data were collected via the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) which was used to evaluate nursing students’ change in competencies for IPC. Frequencies, percentages, and means were used to analyze the demographic data, the Cronbach’s alpha coefficient was used to evaluate the internal reliability of the ICCAS, and paired t-tests were conducted to measure the difference from pre- to post-participation for all 20 items and 6 subscales of the ICCAS.

Results

Study participants (n = 111) completed the ICCAS at the end of the courses to measure change in six competencies. The survey results indicated improvements in all competencies following the IPE activity.

Conclusions

The significant findings demonstrate that exposure to introductory IPE activities, involving nursing students and other healthcare professionals, hold promise for enhancing IPC in pediatric clinical settings. These findings can be used to inform the development of formal IPE interventions.

How does interprofessional education influence students' perceptions of collaboration in the clinical setting? A qualitative study

BACKGROUND

Interprofessional education (IPE) aims to improve students' collaborative competencies and behaviour. The effect of classroom IPE on students' perceptions of collaboration in clinical practice, and how knowledge is possibly transferred, has yet to be investigated. The research question of this study was: How does IPE in a classroom setting influence students' perceptions of collaboration in clinical practice? Social capital theory is used as the theoretical lens. Social capital theory describes how social relationships generate benefits for the individuals involved. Social capital can be divided into three forms of social cohesion: bonding, bridging and linking social capital. Bonding refers to connections that are close and strong, such as family. Bridging social capital occurs in more distant relationships. Linking social capital refers to relationships between individuals with different power or social status.

METHODS

A qualitative study with semi-structured face-to-face interviews was conducted to explore students' perceptions and experiences. Nursing and medical students who had participated in four classroom IPE-sessions were asked about the perceived influence of the IPE-sessions they had attended on their interprofessional collaboration. Thematic analysis was conducted, with sensitising concepts of 'bonding', 'bridging' and 'linking social capital' from the social capital theory.

RESULTS

Twenty-two interviews were conducted. Students experienced: 1) exchange of discipline specific knowledge, 2) general knowledge about each other's responsibilities, 3) reduction of hierarchy, and 4) improvement in patient care. The first two themes reflect bridging social capital, since students experience that the other student is from a different group. The third theme reflects linking social capital, since students experience a difference in (social) status. The fourth theme most explicitly reflects 'getting ahead' or doing better, what is referred to as an effect of increased social capital.

CONCLUSION

This study reveals new insights regarding how increased social capital of undergraduate students after IPE-sessions in a classroom setting influences the way they conceptualise and experience interprofessional collaboration in clinical practice. These insights contribute to the understanding of the effectiveness of IPE in undergraduate curricula. Further research on long-term effects is underway.

Development and validation of the first performance assessment scale for interdisciplinary chest tube insertion: a prospective multicenter study

PURPOSE

Chest tube insertion requires interdisciplinary teamwork including an emergency surgeon or physician in conjunction with a nurse. The purpose of the study was to validate an interdisciplinary performance assessment scale for chest tube insertion developed from literature analysis.

METHODS

This prospective study took place in the simulation center of the University of Paris. The participants included untrained emergency/intensivist residents and trained novice emergency/intensivist physicians with less than 2 years of clinical experience and 6 months following training in thoracostomy, and nursing students. Each interdisciplinary pair participated in a high-fidelity simulation session. Two independent observers (O1 and O2) evaluated 61 items. Internal coherence using the Cronbach's α coefficient, intraclass correlation coefficient (ICC), and correlation of scores by regression analysis (R2) were analyzed. Comparison between O1 and O2 mean scores used a t test and F test for SDs. p Value < 0.05 was significant.

RESULTS

From an initial selection of 11,277 articles, 19 were selected to create the initial scale. The final scale comprises 61 items scored out of 80, including 24 items for nursing items, 24 items for medical competence, and 13 mixed items for the competence of both. 40 simulations including 80 participants were evaluated. Cronbach's α = 0.76, ICC = 0.92, R2 = 0.88. There was no difference between the observers' assessments of means (p = 0.82) and SDs (p = 0.92). Score was 51.6 ± 5.9 in the group of untrained residents and nursing student, and 57.2 ± 2.8 in the trained group of novice physicians and nursing students (p = 0.0003).

CONCLUSIONS

This first performance assessment scale for interdisciplinary chest tube insertion is valid and reliable.

Simulation interprofessional education in health professions education: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to identify, collate, and map the evidence on simulation interprofessional education activities in any setting for the education of health professional students.

INTRODUCTION

Simulation interprofessional education activities comprise in-person and collaborative online learning embedded in formal curricula. Though the number of simulation interprofessional education activities has increased with the knowledge of the importance of effective interprofessional collaboration, the literature still lacks a description of the characteristics of existing activities.

INCLUSION CRITERIA

This scoping review will consider interprofessional education activities taking place within a simulation environment. Included papers will report on activities with two or more types of learners in health professional programs.

METHODS

The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. Databases searched will include PubMed, CINAHL, and ERIC. Results will be limited to English-language publications from 2016 to the present year. Data extraction will be performed using a purposefully developed data extraction tool. Teams of reviewers will screen abstracts and full texts of articles for potential inclusion, and decisions will be determined via consensus of two out of three reviewers. Extracted data will be presented in diagrammatic or tabular form in a manner that aligns with the objective of this scoping review. A narrative summary will accompany the tabulated and/or charted results and will describe how the results relate to the review's objective and questions, and how the results might inform future simulation interprofessional education activities in health professions education.

Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses

BACKGROUND

As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored.

AIM

This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction.

METHODS

This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman.

RESULTS

Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations.

CONCLUSION

Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes.

IMPLICATIONS FOR NURSING MANAGEMENT

Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.

Comparing evaluation responses of an interprofessional education initiative with students in undergraduate nursing and medical programmes

BACKGROUND

Interprofessional education initiatives can be used as effective means to influence students' perceptions of their own and others' roles and interactions as health professionals. There is a need to better understand how interprofessional education learning outcomes are appreciated by students.

AIM

The aims of this study were to describe and compare evaluation feedback from students in undergraduate nursing and medicine programmes about the learning outcomes of an interprofessional education initiative.

METHODS

A mixed methods pre-post-study design was used to collect data using evaluation questions about the initiative and two interprofessional learning outcomes: communication and teamwork. Ratings were analysed with a two-way repeated measures analysis of variance or a t-test. Written responses were analysed using a general inductive approach.

RESULTS

Data from 30 nursing students and 12 medical students were analysed. A noteworthy finding was a significantly higher average rating for nursing students than medicine students before and after the session for the statement about valuing interprofessional learning. Three themes represented comments from both groups: positive experiences, relevance to practice, and learning design issues.

DISCUSSION

Findings were interpreted to indicate that students from both programmes valued the learning outcomes session and was greater at the end of the session. Notably, the perceived value of interprofessional learning was higher for nursing students than medical students before and after the session. This finding may be related to the familiarity nursing students may have with the teaching methods used in the initiative. Further exploration of this finding is needed so educators can better understand how they can provide optimal learning experiences for all students who participate in interprofessional education.

CONCLUSION

Nursing and medicine students appear to value the interprofessional learning outcomes in an undergraduate health professional initiative. However, differences between these two groups of students are an area for further exploration.

Use of Simulation in Teaching Nursing Leadership and Management Course: An integrative review

Nursing education is strategically positioned to prepare nursing students for management and leadership skills necessary for future professional nursing roles. This review appraised and synthesised the outcomes of using simulation in pre-licensure nursing management and leadership courses. This is an integrative review of original articles published between 2008 and 2018. In January 2019, PsychINFO, CINAHL, PubMed and SCOPUS were searched to identify relevant articles using the following terms: ‘management’, ‘leadership’, ‘simulation’, ‘nursing’, ‘education’ and ‘student’. A total of 10 articles were included in the review. Four essential themes were identified from the content analysis: acquisition of skills or understanding of delegation, enhanced teamwork or collaboration capacities, improved decision-making and problem-solving skills and increased communication skills. Incorporation of simulation in the nursing management and leadership courses has the potential to enhance nursing students’ skills regarding delegation, problem-solving capacities, decision-making and communication and teamwork.

Institutionalizing an interprofessional simulation education program: an organizational case study using a model of strategic change

Initiatives to implement interprofessional simulation education programs (ISEP) often fail due to lack of support, resources from management or proper integration into the organization system. This paper aims to identify factors that ensure the successful implementation of an ISEP. Further, the study explores the potential effects an ISEP can have on organizational processes and culture. The case study describes the implementation process of an ISEP in a non-academic community hospital using interviews, participative observations and archival data over six years. A thematic approach has been used to analyze the data guided by Kotter's 8-step model for organizational change. Strategies for a successful implementation of an ISEP include: 1) make a case for interprofessional simulation-based education (SBE), 2) search for healthcare champions, 3) define where the ISEP will lead the organization, 4) spread the word about interprofessional SBE, 5) ensure that structures, skills and supervisors align with the change effort, 6) win over smaller entities, 7) enable peer feedback and create more change, 8) institutionalize the ISEP. Indicators of how the ISEP impacted hospital culture are presented and discussed. ISEPs - if implemented effectively - provide powerful opportunities to span boundaries between professional groups, foster interprofessional collaboration, and eventually improve patient care.

Mixed-method study on the satisfaction of a high-fidelity simulation program in a sample of nursing-degree students

BACKGROUND

Training emotionally complex communication skills with standardized patients brings realism to simulation scenarios, and moreover, is associated with high levels of satisfaction among the students.

OBJECTIVES

(1) To measure the satisfaction of nursing students and factors related to their satisfaction and (2) to explore the effects perceived by nursing students after having a high-fidelity simulation training program using standardized patients.

DESIGN AND PARTICIPANTS

Mixed design. Pre-post quasi-experimental phase in which the Satisfaction Scale Questionnaire with High-Fidelity Clinical Simulation was administered in 156 students; a second, semi-structured interview qualitative phase was completed by 11 students.

RESULTS

Nursing students showed high satisfaction scores. The scores for utility and communication were correlated with the students' attitudes towards communication. In the second phase, two main themes and four sub-themes emerged.

CONCLUSIONS

Teachers could implement high-fidelity simulation programs with standardized patients for training emotionally complex communication skills to nursing students. These programs allow students to participate in their own learning processes and help them to feel motivated and satisfied about the usefulness of their learning experiences.

Interprofessional simulation to promote teamwork and communication between nursing and respiratory therapy students: A mixed-method research study

BACKGROUND

Collaboration and teamwork are vitally important for safe patient care. Experiential learning through interprofessional simulation helps prepare students for the expansive requirements of today's complex healthcare environment.

PURPOSE

To develop and evaluate an interprofessional simulation educational activity to promote teamwork and communication between respiratory therapy and nursing students.

DESIGN

A mixed method design employing surveys, observation, and focus groups with educators and students was used. Thirty-six students from two institutions in Western Canada participated in this study. Data was analyzed using descriptive statistics and content analysis.

RESULTS

Baseline assessment revealed students were most familiar and comfortable with team functioning and communication interprofessional competencies, familiar but uncomfortable with collaborative leadership, conflict resolution, patient-centered care, and role clarification competencies. Correlation between communication and teamwork and collaborative leadership suggests these competencies play an important role in students' ability to enact more complex skills, such as conflict resolution competency. Overall, participants were highly satisfied and shared invaluable insights for improving this simulation experience in the future.

CONCLUSION

This evaluation study demonstrated feasibility of interprofessional simulation and its potential to enhance acquisition of interprofessional competencies. A future study will incorporate additional disciplines, such as medicine and pharmacy, applying a controlled evaluation design.

Core educational components of interprofessional education in pediatric emergencies: An integrated review

PURPOSE

This study was conducted to explore the core educational components of interprofessional education (IPE) for pediatric emergencies to establish a basis for interprofessional simulation education.

METHODS

Using Whittemore and Knafl's integrative review method, we searched for studies in PubMed, Embase, Cochrane Library, CINAHL, and four South Korean databases (RISS, NDSL, DBpia, and KISS).

RESULTS

We identified 21 studies on the general characteristics of IPE in pediatric emergency situations and integrated the core components of IPE according to a PRISMA flowchart. Three core components were identified (individual-competent professionals, team-cooperative professions, and outcome-optimal achievement), with the subthemes of role and responsibility, clinical judgment, performance, leadership, communication, teamwork, patient safety, and quality improvement.

CONCLUSION

We recommend that IPE pediatric emergencies should contain the three dimensions of these core components to enhance individual and team performance and to promote optimal achievement in terms of patient outcomes. IPE programs should consider these characteristics and include a valid tool for evaluating the programs' effectiveness.

Has "The Ceiling" Rendered the Readiness for Interprofessional Learning Scale (RIPLS) Outdated?

PURPOSE

The present study aimed to investigate the preliminary effects of collaborative learning and simulation on readiness to engage in and attitudes toward future interprofessional learning activities. We translated into Norwegian and validated the original Readiness for Interprofessional Learning Scale (RIPLS) (part 1) to measure the efficacy and feasibility of a structured collaborative learning activity (part 2).

MATERIALS AND METHODS

Undergraduate social and health care professional students from five Norwegian universities (n = 307) participated in the validation stage of this study (part 1). A Norwegian version of the RIPLS was developed using forward and backward translation. An expert panel discussed discrepancies between the translations and professional concepts. We planned to conduct a principal component analysis to evaluate the structure, reliability, and internal consistency of the Norwegian version of the RIPLS, after investigating the skewness, kurtosis, and range of items included. One hundred fifty students participated in collaborative learning activities; 72 (48%) of these individuals answered the translated RIPLS questionnaire.

RESULTS

We found a substantial ceiling effect in the majority of items in the RIPLS, making it difficult to use the instrument as a measure of change. We evaluated the efficacy and feasibility of the collaborative activities based on the changes in the single items that had sufficient univariate normality and ultimately confirmed positive changes in two of these items.

CONCLUSION

Norwegian students appear ready for interprofessional learning; however, due to significant ceiling effects, the majority of items in the RIPLS no longer seem suitable for measuring and evaluating the effects of interprofessional learning (part 1). Single-item analysis revealed a potential effect of collaborative learning (part 2). A new questionnaire is needed where readiness is instead understood as self-efficacy in areas such as role awareness and interprofessional communication. Researchers should be aware that even previously validated questionnaires may lose their applicability over time and require revision. Demands for interprofessional learning and practice are continuously evolving, and evaluation methods should be adjusted accordingly.

Measuring the effect of simulation experience on perceived self-efficacy for interprofessional collaboration among undergraduate nursing and social work students

Barriers to effective interprofessional collaboration may include insufficient knowledge of other professional roles and inexperience using effective communication skills. Improving self-efficacy for interprofessional collaboration may enhance the ability to practice expertly within the interprofessional environment of healthcare. This article examines the results of a multiple methods pretest/posttest study that used the Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale to determine self-reported perceptions of self-efficacy development following participation in a trauma simulation. Participants included 74 undergraduate nursing students and nine undergraduate social work students. Findings included a significant increase in perceived self-efficacy from pretest to posttest for both groups. Nursing majors and participants who reported previous interaction with a member of another profession scored significantly higher on the posttest. Qualitative data were analyzed through thematic content analysis which produced three themes: an improved understanding of the importance of communication and the interconnection of interprofessional roles; a realistic simulation which challenged the students; and an increased appreciation for teamwork. These findings suggest that challenging simulations with pre-licensure students can increase undergraduate students' perceived self-efficacy for interprofessional collaboration and contribute to an improved understanding of interprofessional team roles and communication.

Influence of nurse managers' toxic leadership behaviours on nurse-reported adverse events and quality of care

AIM

To assess the impact of toxic leadership behaviours among nurse managers on nurse-reported adverse events and quality of care.

BACKGROUND

Toxic leadership, a form of ineffective leadership, is increasingly becoming rampant in the field of nursing and has been strongly linked to poor nurse job outcomes including job dissatisfaction, higher stress levels, and increased turnover intention. To date, no studies have been conducted to examine how this type of leadership behaviours affects patient outcomes and care quality.

METHODS

A multicentre, cross-sectional study. This study involved a sample of 1,053 registered nurses working in 20 hospitals in the Philippines. Three standardized scales were deployed, including the Toxic Leadership Behaviors of Nurse Managers Scale, the Adverse Patient Events Scale and the single-item quality-of-care-measure.

RESULTS

Overall, nurses (96.2%) appraised the quality of care of their respective units as 'good to excellent' and cited complaints from patients and their families as the most commonly reported adverse events. Toxic leadership behaviours in nurse managers were strongly associated with increased nurse-reported adverse events including reports of complaints (β = .619; p < .001) and verbal mistreatment from patients and their families (β = .407; p < .001), patient falls (β = .834; p < .001), health care-associated infections (β = .629; p < .001) and errors in administering medication (β = .708; p < .001) and with decreased quality of care (β = -.216; p < .001).

CONCLUSION

Nurses who experience working under a nurse manager exhibiting toxic behaviours reported an increased frequency of nurse-reported adverse events and poorer quality of care in the unit.

IMPLICATIONS FOR NURSING MANAGEMENT

Organizational measure to reduce the occurrence of adverse events and enhance the quality of care provided in medical units may include intervention to develop positive leadership practices among nurse managers.

The impact of simulation-based triage education on nursing students' self-reported clinical reasoning ability: A quasi-experimental study

Few studies have comprehensively examined the effectiveness of simulation-based triage education on clinical reasoning of nursing students. This study evaluated the impact of a simulation-based triage exercise on nursing students' self-reported clinical reasoning ability. Three cohorts of third-year nursing students were divided into intervention group a (IG a, n = 62), intervention group b (IG b, n = 57), and a control group (CG, n = 53). Students in IG a and IG b participated in a simulation-based triage education consisting of 2 h of multiple patient triage simulations and an hour of structured debriefing. The CG participated in a traditional didactic triage course consisting of a 3-h lecture. Self-reported clinical reasoning ability in pre and post-triage education was measured by the Nurses Clinical Reasoning Scale. There was no significant difference in mean clinical reasoning ability scores between the three groups in pre-test (p > 0.05). Clinical reasoning ability scores in post-test among students in IG a and IG b were significantly higher than those in CG (p < 0.001). Nursing students exposed to a simulation-based triage education had more improvement in self-reported clinical reasoning ability as compared with students who participated in a lecture-based triage education program.

Nursing and medical students' perceptions of an interprofessional simulation-based education: a qualitative descriptive study

PURPOSE

The purposes of this study were to describe the development and implementation of an interprofessional simulation-based education (IPSE) for undergraduate nursing and medical students, their perceptions of the impact of IPSE, and identify their changes in attitudes toward each other's health professions after participating in IPSE in South Korea.

METHODS

This study used a qualitative descriptive design. A purposive sample of 43 third-year medical students and a convenient sample of 44 fourth-year nursing students participated in a 2-day IPSE program that consisted of ice-breaking and patient safety activities, and 4-hour three interprofessional team-based high-fidelity simulation education sessions. Data were collected through reflective journal after the IPSE program and keywords before and after the IPSE program, and were analyzed using the content analysis and word cloud analysis.

RESULTS

Three themes emerged: "positive experience" with understanding roles and responsibilities and learning by doing in simulation environments being reported. In the second theme, "positive learning outcomes" participants reported enhancing collaboration and confidence in communication skills. The final theme "benefits to patients of interprofessional collaborative practice" included high quality of care and patient safety. Before the IPSE experience, most medical students perceived the nurse as nightingale and syringe, and nursing students perceived the doctor as order, expert, and knowledge. After their IPSE experience, both nursing and medical students viewed each other as colleagues.

CONCLUSION

These results suggest that the use of high-fidelity team-based simulation in IPE is effective in practicing and developing undergraduate nursing and medical students' interprofessional collaboration through hands-on experience.

Interprofessional Simulation: From the Classroom to Clinical Practice

Interprofessional simulation (IPS), frequently referred to in the literature as simulation-enhanced interprofessional education (IPE), has been widely studied in nursing and medical education. For decades, the literature has suggested IPE as a valuable strategy for enhancing communication and collaboration among health professionals. Interprofessional collaborative practice (IPCP) is foundational to developing high-functioning healthcare teams and can lead to reduced medical errors and increased patient safety. This chapter addresses IPS from both the academic and practice perspectives. The foundations of IPE and IPCP are reviewed, as well as the standards of best practice in simulation. Planning, development, and implementation will be discussed, including benefits, barriers, and possible solutions. Recommendations from relevant research on debriefing and evaluation of IPS are also reviewed. Outcomes from the growing body of research on IPS will be presented and include perceptions of interprofessional practice, better understanding of professional roles and responsibilities, development of communication and teamwork skills, and shared problem-solving and decision-making. Future implications and recommendations are provided based on the state of the science on IPS. Optimum design, implementation, and evaluation of IPS, along with a thorough understanding of the benefits, barriers, and opportunities, can help faculty and clinical educators prepare a collaborative healthcare workforce and reduce medical errors to ultimately improve patient outcomes.

Effectiveness of simulation-based interprofessional education for medical and nursing students in South Korea: a pre-post survey

BACKGROUND

Effective collaboration and communication among health care team members are critical for providing safe medical care. Interprofessional education aims to instruct healthcare students how to learn with, from, and about healthcare professionals from different occupations to encourage effective collaboration to provide safe and high-quality patient care. The purpose of this study is to confirm the effectiveness of Interprofessional education by comparing students' attitudes toward interprofessional learning before and after simulation-based interprofessional education, the perception of teamwork and collaboration between physicians and nurses, and the self-reported competency differences among students in interprofessional practice.

METHODS

The survey responses from 37 5th-year medical students and 38 4th-year nursing students who participated in an interprofessional education program were analyzed. The Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation scale, the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration, and the Interprofessional Education Collaborative competency scale were used for this study. The demographic distribution of the study participants was obtained, and the perception differences before and after participation in interprofessional education between medical and nursing students were analyzed.

RESULTS

After interprofessional education, student awareness of interprofessional learning and self-competency in interprofessional practice improved. Total scores for the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration did not change significantly among medical students but increased significantly among nursing students. Additionally, there was no significant change in the perception of the role of other professions among either medical or nursing students.

CONCLUSIONS

We observed an effect of interprofessional education on cultivating self-confidence and recognizing the importance of interprofessional collaboration between medical professions. It can be inferred that exposure to collaboration situations through Interprofessional education leads to a positive perception of interprofessional learning. However, even after their interprofessional education experience, existing perceptions of the role of other professional groups in the collaboration situation did not change, which shows the limitations of a one-time short-term program. This suggests that efforts should be made to ensure continuous exposure to social interaction experiences with other professions.

Health care students' perceptions about learning of affective interpersonal communication competence in interprofessional simulations

BACKGROUND

Health professionals need interpersonal communication competence (ICC) in their work with patients and other professionals. Interprofessional simulation provides health care students with an opportunity to practice communication skills in a safe and authentic environment.

OBJECTIVE

The purpose of this study was to describe the perceptions of health care students of interprofessional simulations in acquiring affective interpersonal communication competence (AICC).

DESIGN

This study was conducted using the quantitative descriptive research method.

SETTINGS

The data were collected from health care students participating in interprofessional simulations at a university of applied sciences in Finland using a questionnaire titled Student questionnaire on a multiprofessional simulation exercise. The health care students included nursing, physical therapy and practical nursing students.

PARTICIPANTS

This study was participated by 149 health care students with a response rate of 41.2%.

METHODS

The quantitative data were analysed using the SPSS 24.0 for Windows statistical software. Frequencies, percentages, averages, and standard deviation were used to describe the data. Two mean sum variables were formed using factor analysis from the variables describing AICC.

RESULTS

The students' perceptions of learning AICC (attitude, motivation, emotions) in interprofessional simulations were largely positive; for example, the simulations reduced prejudice against, and increased appreciation of, other occupational groups. Even though the interprofessional simulations were sometimes perceived as stressful, stress could also be a positive source of learning and effectively fostered personal understanding of others in a team.

CONCLUSION

Interprofessional simulations increased knowledge of the activities of other professional groups for students in different fields of education. This encourages them to work together after completing their education and entering the workforce. Knowledge of the simulation process and the creating a safe learning environment also promoted students' AICC.

Interprofessional simulation effects for healthcare students: A systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review of studies describing the effects of interprofessional education (IPE) on collaborative competence using simulated-based training of undergraduate healthcare students.

DESIGN

A systematic review and meta-analysis based on PRISMA guidelines.

DATA SOURCES

PubMed and Cumulative Index to Nursing and Allied Health Literature databases were searched to identify articles in all languages published up to 2018. The systematic review protocol was registered at PROSPERO under number 133330.

REVIEW METHODS

In total, 419 articles were identified. The following articles were excluded: non-English articles, articles for which the full text was not available, articles that did not employ a validated tool, articles that did not use quasi-experimental methods and that did not assess healthcare student populations. Eleven studies were included, and 6 were submitted to meta-analysis using forest plots through RevMan 5.3.

RESULTS

Interprofessional simulation analysis yielded results regarding participants, protocols, scenarios, validated tools, collaborative competencies and primary outcomes. The meta-analysis was organized based on assessment tool, and summary value, confidence interval, and Z test results for the random-effects model are presented.

CONCLUSION

Quantitative analysis reveals a positive impact and the effectiveness of interprofessional simulation. However, more research should be conducted utilizing clinical trials with distinguished analyses for each collaborative competency factor to assess long-term effects on the outcome.

Teaching interprofessional competencies using virtual simulation: A descriptive exploratory research study

BACKGROUND

Interprofessional education provides a venue for the acquisition of interprofessional competencies. Virtual reality experiences may allow students from different health professions the opportunity to work together to develop these competencies for safe patient outcomes.

OBJECTIVE

The purpose of this study was to determine if virtual reality supports the development of interprofessional competency knowledge for Bachelor of Science in Nursing, Practical Nursing and Health Care Assistant students.

DESIGN

A descriptive qualitative study using semi structured pre and post questionnaires were administered to students in their senior semesters of their respective program.

SETTING

Mid-sized western Canadian University.

PARTICIPANTS

Twenty-seven Bachelor of Science in Nursing students, twelve Practical Nursing students and seven Health Care Assistant students.

RESULTS

Three themes emerged from the analysis: Intentional Collaboration, Role Awareness, and Positions of Power.

CONCLUSIONS

Virtual reality provides students with the opportunity to collaborate for safe patient care. Students were able to strengthen their knowledge of interprofessional competencies. Further work is needed to determine if these experiences carry through post-graduation and impact work relationships.

Radiotherapy-specific interprofessional learning through simulation

INTRODUCTION

Interprofessional learning (IPL) is a vital aspect of training in radiation oncology professions, yet is rarely delivered to those professionals who work most closely together in clinical practice. Scenario-based learning using simulation facilities provides a unique opportunity to facilitate this learning and this project aimed to determine the impact and value of this initiative.

METHODS

Small groups comprising post-graduate diploma pre-registration therapeutic radiographers, medical physics trainees and radiation oncology registrars were challenged with 4 plausible and challenging radiotherapy scenarios within an academic simulation centre. Pre- and post-event completion of the "Readiness for Interprofessional Learning Scale" measured impact and a Likert-style survey gathered feedback from participants.

RESULTS

The session increased participants' teamwork and collaboration skills as well as strengthening professional identities. Participants reported high levels of enjoyment related to collaborative working, communication and observing other professionals deploying their technical skills and specialist knowledge.

CONCLUSION

Although beneficial, simulated scenarios offering equal opportunities for engagement across the professions are challenging to plan and timetabling issues between the 3 groups present significant difficulties. The safe environment and unique opportunity for these groups to learn together was particularly well received and future oncology-specific simulated scenario sessions are planned with larger cohorts.

IMPLICATIONS FOR PRACTICE

Simulated scenario training can be used to improve team working across the radiotherapy interprofessional team and may have wider use in other specialist interdisciplinary team development.

Interprofessional learning in social and health care-Learning experiences from large-group simulation in Finland

Aim

This study aimed to describe the learning experiences of social and healthcare students and professionals of an interprofessional large‐group simulation. A simulation on sudden infant death syndrome (SIDS) was organized in collaboration between a Finnish university, university hospital and university of applied sciences.

Design

A case study.

Methods

The research data were collected at the large‐group simulation with a questionnaire containing variables on a five‐point Likert scale and open questions. The questionnaire was filled out by 350 students and professionals participating in the simulation. The quantitative data were analysed using descriptive statistical methods and the open‐ended questions by inductive content analysis.

Results

The large‐group simulation proved to be a valid teaching and learning method for collaborating with other professionals and interacting with clients and the method can be considered as cost‐effective compared with small‐group simulations. The produced knowledge can be used in planning simulations in basic and in‐service training.

Introduction to Interdisciplinary Roles in a Nursing Leadership Course: If I Understand You, Then I Know How to Work With You

ABSTRACT

Active learning experiences for undergraduate nursing students build upon their understanding of concepts that transfer to new learning skills throughout the curriculum. Faculty implemented a leadership simulation in the classroom focusing on communication skills as a nurse leader to better understand the role of the nurse in the interdisciplinary team. The classroom setting is an ideal platform to teach interdisciplinary collaboration when opportunities do not present in the clinical setting. Scaffolding simulation experiences throughout the curriculum helps bridge the knowledge and skills gap between classroom and clinical experiences.

High-fidelity simulation-based education in pre-registration healthcare programmes: a systematic review of reviews to inform collaborative and interprofessional best practice

Simulation-based education (SBE) is recognized as an effective interprofessional teaching and learning method. Whilst there is a large volume of research evidence concerning elements of SBE there is a lack of clarity concerning foundational principles of best practice. This is important for educators wishing to utilize high-quality SBE to deliver interprofessional education. The aim of this review is to synthesize review evidence of SBE best practice in a broad range of pre-registration healthcare programs and contextualize findings in light of relevant educational theory. A systematic search of PubMed, Scopus, Medline/Ovid, British Nursing Index, and the Cochrane Library databases was undertaken in February 2020. Data extraction and quality evaluation were undertaken by two authors. Fifteen reviews were included. In addition to identifying barriers and enablers to implementation, three interdependent themes regarding SBE best practice were found: curriculum level integration and planning (curriculum level integration, the opportunity for deliberate repeated practice, distribution, and sequencing); simulation design and delivery (clearly defined learning outcomes and benchmarks, pre-brief, multiple learning strategies, interactivity and individualized learning, feedback, and debrief); and resources (facilitator competency, controlled environments). These themes broadly align with the social constructivist theory of experiential learning whereby structured opportunities to learn via concrete experience, reflective observation, abstract conceptualization, and active experimentation are provided through effective planning, design, and delivery of SBE. Interdependencies suggest that integration of SBE at curriculum-level enables planning and implementation of best practice principles which are associated with effective learning, which also inform and facilitate the availability of adequate simulation resources.

The Student Navigator Project (SNaP): Preparing Students Through Longitudinal Learning

INTRODUCTION

Early medical school education has historically focused on teaching basic medical sciences. More recently, medical schools are encouraged to incorporate health systems science (HSS) into early curricula. Addressing all of these components in an overcrowded curriculum remains challenging.

METHODS

We report on the Student Navigator Project (SNaP), a pre-clinical experience where students engage longitudinally with medically and socially complex patients. SNaP is built on a foundation of trust, responsibility, and ownership in the student-patient relationship. Early learners take an active role in navigating, advocating, and coaching for their patients. In addition, students are integrated as medical assistants into a primary care clinic; complete a mentored, team-based quality improvement project; and engage in evidence-based medicine, teaching, and handoff activities.

RESULTS

As a result of these activities, students learn firsthand about HSS, contribute meaningfully to their patients' care, and are immersed in a systems-based practice approach early in their medical school education. Preliminary outcomes (2016-2019) show satisfaction with the program and knowledge of program focus areas.

CONCLUSIONS

The authors are engaged in improvement cycles to modify program structure and curriculum in order to promote dissemination in diverse clinical settings. Ultimately, we plan to measure longer-term outcomes, including clerkship and residency preparation, career choice, and practice setting.

A Comparison of Patient Safety Competencies between Clinical and Classroom Settings among Nursing Students

Background: As nurses play an important role in the implementation of patient safety in hospitals, competencies of patient safety should be developed and enhanced among nursing students. Self-assessment is a method that can be used to assess patient safety and its dimensions to help the students prepare themselves before entering the work life.Purpose: This study aimed to investigate differences in patient safety competencies between classroom and clinical settings among nursing students using a self-assessment method.Methods: A descriptive study using the Health Professional Education in Patient Safety Survey (H-PEPSS) questionnaire was conducted among 181 nursing students in a public university in Indonesia. Paired t-test, ANOVA, and independent t-test were performed to determine the comparison in the values of patient safety dimensions across classroom, clinical learning, and year of nursing course.Results: Nursing students showed a higher mean value in the classroom setting than the clinical setting. Out of the seven dimensions of patient safety competencies, “clinical safety” (M=4.36) and “communicate effectively” (M=4.29) obtained the highest score in classroom setting, while “adverse events” showed the lowest (M=4.03). In the clinical setting, “clinical safety” (M=4.19) and “communicate effectively” (M=4.12) obtained the highest score, while “working in teams” (M=3.82) was the lowest. The third-year students showed a better score than the fourth year in most dimensions.Conclusion: In this study, the patient safety competencies among nursing students were higher in the classroom setting than in the clinical setting. It is recommended to investigate the factors that can increase the achievement of patient safety competence among nursing student in the clinical setting.

Effects of a single interprofessional simulation session on medical and nursing students' attitudes toward interprofessional learning and professional identity: a questionnaire study

BACKGROUND

Participation in simulation-based interprofessional education (sim-IPE) may affect students' attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the 'fit' of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK.

METHOD

Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured. Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures.

RESULTS

A total of 194 medical and 266 nursing students completed questionnaires. A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site. Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students.

CONCLUSIONS

Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace. Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect.

Experiences of Arab male nursing students during high fidelity maternity simulation training

BACKGROUND

In Arab countries, many nursing schools rely heavily on simulation-based activities to provide experiential learning to male students with regard to maternal and child care; however, no study has been conducted to explore their experiences with such simulation training.

AIM

To describe the experiences of male nursing students who were exposed to high-fidelity simulation training related to maternity and child care.

METHODS

Husserl's approach to phenomenology guided this study, through the use of a structured interview with 15 Arab male nursing students. A thematic analysis technique served as a framework for the data analysis.

FINDINGS

Thematic analysis revealed four essential themes: gained competency; compensation for missed clinical experience; overcoming of cultural or religious barriers; and challenges related to the use of simulation technologies.

CONCLUSIONS

High-fidelity simulation can be a viable option to clinical training for enhancing Arab male nursing student competencies when providing maternal and child nursing care, which are often not available in the clinical area or are considered to be off limits due to cultural or religious reasons.

High-fidelity simulation and nursing students' anxiety and self-confidence: A systematic review

BACKGROUND

As a complementary teaching pedagogy, high-fidelity simulation remains as an effective form of simulation modality. Empirical evidence has additionally shown high-fidelity simulation (HFS) to be an effective contributor to students' learning outcomes.

PURPOSE

This paper critically appraised existing scientific articles that covered the influence of utilizing HFS on the effects of nursing students' anxiety and self-confidence during undergraduate nursing education.

METHODS

This was a systematic review of scientific articles conducted from 2007 to 2017 on the topic of the influence of using HFS on students' self-confidence and anxiety. The literature of six electronic databases (Proquest, SCOPUS, MEDLINE, PubMed Central, CINAHL, and PsychINFO) was reviewed.

RESULTS

Following the literature search, 35 articles were selected. This review provides updated evidence on the efficacy of HFS in reducing anxiety and enhancing self-confidence among nursing students when performing nursing duties or managing patients. Moreover, this review highlights the need for more research that examines the impact of HFS on students' anxiety.

CONCLUSION

As this form of simulation is found to be effective in the enhancement of nursing student self-confidence and the reduction of their anxiety when caring for patients and/or employing nursing skills, the inclusion of simulation-based activities in all clinical nursing courses is vital.