Learning by viewing versus learning by doing: A comparative study of observer and participant experiences during an interprofessional simulation training

Interprofessional education for healthcare professionals. A BEME realist review of what works, why, for whom and in what circumstances in undergraduate health sciences education: BEME Guide No. 83

AIM

To provide an evidence-informed program theory (PT) for Interprofessional Education (IPE) that adds to the knowledge base of how IPE in undergraduate health sciences education works.

METHODS

We undertook a realist review of the literature and synthesis of the evidence combined with stakeholder experience. Our initial program theory (IPT), built around development, delivery and evaluation of IPE interventions, was tested and refined following an in-depth search of the literature and consultation with stakeholders. The literature (2010-2022) was selected based on the realist criteria of relevance and rigor, as well as on conceptual richness of the studies.

RESULTS

Our PT is built upon 124 CMOs (Context of IPE interventions, Mechanisms that fired within that context, and IPE Outcomes), from 58 studies. Our PT comprises an array of elements found in the Context, including traits and behavioral displays of students and facilitators, and discusses four Mechanisms (feeling responsible, feeling enthusiastic/excited, feeling safe to take risks, and feeling ready), which are likely to lead to outcomes related to the Interprofessional Education Collaborative (sub)competencies.

DISCUSSION

Results were linked to learning theories to further build our understanding. The PT can serve as a guide for the development, delivery, and evaluation of IPE interventions.

An observer tool to enhance learning of incoming anesthesia residents' skills during simulation training of central venous catheter insertion: a randomized controlled trial

BACKGROUND

Central venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for much of the session. To improve learning during observation periods, the use of an observer tool (OT) has been advocated but its educational effectiveness is not well defined.

METHODS

Incoming anesthesia residents were randomized to use an OT (i.e. procedural skill-based checklist) (OT+) or not (OT-) when observing other residents during a simulation bootcamp. The primary outcome was a composite score (total 60 points) evaluating CVC procedural skills rated immediately after the training. This score covers theoretical knowledge explored by multiple choice questions (MCQs) (/20), perceived improvement in knowledge and skills (/20), perceived impact on future professional life (/10) and satisfaction (/10). Measurements were repeated 1 month later. Residents in each group recorded the number of CVCs placed and their clinical outcomes (attempts, complications) during the first month of their clinical rotation using a logbook.

RESULTS

Immediately after training, the composite score was similar between the two groups: 45.3 ± 4.2 (OT+, n = 49) and 44.4 ± 4.8 (OT-, n = 42) (p = 0.323). Analysis of sub-items also showed no difference. Results at 1 month were not different between groups. Analysis of the logbook showed no difference between groups. No serious complications were reported.

CONCLUSIONS

The use of a procedural task-based OT by incoming anesthesia residents and used during CVC insertion simulation training was not associated with better learning outcomes, neither immediately after the session nor when re-evaluated 1 month later. The training at least once on simulator of all residents could limit the impact of OT. Further studies are necessary to define the place of OT in simulation training.

Collaboration Scripts or Checklists to Engage Novice Observers in Immersive Simulation?

INTRODUCTION

In simulation, students often observe their peers perform a task. It is still unclear how different types of instructional guidance can turn the observational phase into an active learning experience for novices. This mixed-method study aims to understand similarities and differences between use of collaboration scripts and checklists by observers in terms of cognitive load and perception of learning.

METHODS

Second-year pharmacy students ( N = 162) were randomly assigned to 1 of 4 conditions when observing a simulation: collaboration scripts (heuristic to analyze in dyads while observing), checklists, both, or no guidance. We measured observers' intrinsic and extraneous cognitive load and self-perceived learning and conducted focus group interviews.

RESULTS

Intrinsic cognitive load was significantly lower for checklists (M = 3.6/10) than for scripts (M = 4.7/10) or scripts and checklists combined (M = 4.7/10). Extraneous cognitive load was significantly lower for checklists (M = 1.5/10) than for scripts combined with checklists (M = 2.6/10) or no guidance (M = 1.8/10). There was no statistical difference between conditions for self-perceived learning. Coding of focus group interviews revealed 6 themes on observers' perception of learning under different conditions of instructional guidance. Students explained that collaboration scripts felt more complex, whereas checklists were perceived as a simple fact-checking exercise. Observing the simulation, regardless of guidance, was a meaningful learning experience.

CONCLUSIONS

With or without guidance, observers are actively engaged with the simulation, but their effort differed depending on instructions. When choosing between checklists or collaboration scripts, educators should be guided by the type of simulation task.

'Learning by doing', a model for improving the promotion of healthy lifestyles by student nurses

BACKGROUND

'Learning by doing' is a learning model based on performing actions and gaining experience. The 'nursing process' is a systematic, rational method for providing nursing care. During their university education, nursing students need to acquire the ability to promote healthy lifestyles.

OBJECTIVE

To determine the effectiveness of a learning strategy based on learning by doing and grounded in the use of the nursing process, on the lifestyle of nursing students.

METHODS

This quasi-experimental intervention (before-after), performed over 2011-2022, involved 2300 nursing students at a university nursing school in Spain. The risk factors for chronic diseases-being a smoker, being overweight, or having high blood pressure-to which each student was exposed were recorded. Those positive for at least one risk factor selected companion students as 'support nursing students' who became responsible for designing an individualised care plan to reduce the risk(s) faced. To ensure the correct use of the nursing process, teachers approved and monitored the implementation of the care plans. Whether risk-reduction objectives were met was determined three months later.

RESULTS

The students with risk factors largely improved their lifestyles (targets for reducing smoking/body weight were met) with the help of their supporting peers.

CONCLUSIONS

The learning by doing method demonstrated its effectiveness, improving the lifestyle of at-risk students via the use of the nursing process.

Medical Students' Learning Process During Simulated Patient Consultations in Psychiatry: A Grounded Theory Study

INTRODUCTION

Recent changes in psychiatric care and teaching, which limit patient contact for medical students, can be partially overcome by simulation-based education in psychiatry. The authors explored the learning processes of medical students during meetings with simulated patients to inform efforts to improve this teaching.

METHODS

After recruiting 81 undergraduate medical students from 3 universities to participate in 6 simulation sessions in psychiatry, the authors purposively sampled 21 students to participate in face-to-face individual semistructured interviews analyzed with constructivist grounded theory. Integration of this analysis with those of the simulation consultation videotapes and the debriefing audiotapes improved the triangulation process.

RESULTS

Three organizational themes were identified: developing and structuring representations of psychiatry; integrating subjectivity into learning; and refining and developing psychiatric praxis. Given the broad and in-depth learning that occurs, simulation in psychiatry should respect content validity of SP portrayals to ensure appropriate learning. However, psychological fidelity seems to provide adequate realism while retaining feasibility. Psychiatric simulation also requires the encouragement of student self-confidence and well-being. Within a reflective framework, simulation triggers cognitive reframing, which can alleviate fears and prejudice toward people with mental disorders.

CONCLUSIONS

The holistic interactive learning process involved in simulation can address the complexity of the personal and interpersonal features needed in psychiatry.

A Literature Study of Medical Simulations for Non-Technical Skills Training in Emergency Medicine: Twenty Years of Progress, an Integrated Research Framework, and Future Research Avenues

Medical simulations have led to extensive developments in emergency medicine. Apart from the growing number of applications and research efforts in patient safety, few studies have focused on modalities, research methods, and professions via a synthesis of simulation studies with a focus on non-technical skills training. Intersections between medical simulation, non-technical skills training, and emergency medicine merit a synthesis of progress over the first two decades of the 21st century. Drawing on research from the Web of Science Core Collection's Science Citation Index Expanded and Social Science Citation Index editions, results showed that medical simulations were found to be effective, practical, and highly motivating. More importantly, simulation-based education should be a teaching approach, and many simulations are utilised to substitute high-risk, rare, and complex circumstances in technical or situational simulations. (1) Publications were grouped by specific categories of non-technical skills, teamwork, communication, diagnosis, resuscitation, airway management, anaesthesia, simulation, and medical education. (2) Although mixed-method and quantitative approaches were prominent during the time period, further exploration of qualitative data would greatly contribute to the interpretation of experience. (3) High-fidelity dummy was the most suitable instrument, but the tendency of simulators without explicitly stating the vendor selection calls for a standardised training process. The literature study concludes with a ring model as the integrated framework of presently known best practices and a broad range of underexplored research areas to be investigated in detail.

An Unfolding Tabletop Simulation Training Exercise on Disaster Planning for Nursing Students

BACKGROUND

Disaster planning is an essential component for nursing students to learn.

PROBLEM

Clinical experiences of disasters are typically unavailable for nursing students. Increasing frequency of disaster events around the globe has made disaster planning knowledge and skills a critical component in nursing education and professional practice.

APPROACH

An unfolding tabletop disaster planning exercise was created as a simulation training strategy meant to strengthen essential disaster response skills. The exercise involves 5 realistic scenarios related to a mass casualty event, taking students from the disaster site to the hospital-based disaster response.

OUTCOMES

Implementation of a tabletop disaster planning simulation in one nursing program replaced the traditional lecture-based disaster content.

CONCLUSION

An unfolding tabletop disaster planning simulation is a comprehensive, interactive, sustainable, and low-cost teaching strategy that draws on nursing students' fundamental knowledge. Students had the opportunity to practice clinical skills required during a disaster, such as communication, prioritization, teamwork, and delegation.

Satisfaction and self-confidence of nursing students as participants and observers in realistic simulations

OBJECTIVE

To analyze the satisfaction and self-confidence of Nursing students regarding the learning process, in the roles of participants and observers, in realistic simulation scenarios.

METHOD

Observational study with 44 nursing college students in the south of Brazil. Data collection occurred from September to November 2018, through the application of the Learning Satisfaction and Self-Confidence Scale to realistic simulation scenarios. Data were analyzed using descriptive statistics and generalized estimating equations complemented by Bonferroni.

RESULTS

The level of satisfaction was 4.78 (±0.35) and self-confidence in learning was 4.46 (±0.39). Students in the 8th and 9th semesters had the highest means of self-confidence factor (p<0.001) when compared to the others.

CONCLUSION

It was concluded that there was no statistically significant difference in the satisfaction and self-confidence in learning of nursing students with different roles in the simulation scenario.

Evaluation of online interprofessional simulation workshops for obstetric and neonatal emergencies

OBJECTIVES

To explore student perceptions of learning and interprofessional aspects of obstetric and neonatal emergencies through online simulation-based workshops.

METHODS

This qualitative study was conducted at Monash University, Australia. Data were obtained from six separate online Obstetric Neonatal Emergency Simulation workshops held between May 2020 and August 2021. A total of 385 students attended and were invited to participate in the study by completing an online survey two-three weeks later. Of the attendees, 144 students completed the survey (95 medical, 45 midwifery), equating to a response rate of 37%. Survey responses were downloaded from online survey platform and separated into medical and midwifery responses. Thematic analysis of data was performed using a coding framework, resulting in development of themes and subthemes.

RESULTS

Main themes were adaptability, connectivism, preparedness for practice, experiential learning, learning through modelling and dynamics of online interaction. Students reported that online workshop was a useful alternative method to experience simulation-based learning, increase their readiness for clinical practice and foster positive interprofessional relationships. Consistent with existing literature evaluating similar in-person programs, midwifery students were most interested in interprofessional interaction (predominant theme: dynamics of online interaction), whilst medical students were more concerned with developing clinical skills (predominant themes: learning through modelling, experiential learning).

CONCLUSIONS

Online learning may be a useful and convenient way of delivering interprofessional simulation-based education during the pandemic, in remote areas and as an adjunct to in-person teaching. Future studies should evaluate the impact of online learning with a mixed methods study and in comparison, to in-person programs.

A Mixed-Methods Realist Analysis of an Interdisciplinary Simulation Intervention for Psychiatry Residents

OBJECTIVES

Simulation research in postgraduate psychiatry remains limited, with minimal studies on interdisciplinary involvement and mechanisms of change. To address these gaps, the authors implemented a mixed-methods realist analysis of an interdisciplinary simulation intervention administered to psychiatry residents.

METHODS

The University of Calgary implemented a simulation intervention for psychiatry residents. Eight junior residents participated in or observed 4 scenarios and eighteen senior residents participated in or observed 8 scenarios. Scenarios lasted 15 minutes with a pre-simulation orientation and post-scenario debrief. Most scenarios involved interdisciplinary staff. Scenarios included agitated and suicidal patients; treatment-related emergencies; and challenging conversations. All residents completed pre- and post-simulation surveys reporting confidence levels. Changes in confidence were analyzed using paired t tests and differences between junior and senior residents' confidence using ANOVA. Eleven residents participated in 2 focus groups. Transcripts were analyzed using a constant comparative model to identify contexts, mechanisms, outcomes, and the relationship between these realist categories. Key themes were extracted using generic theme analysis.

RESULTS

Aggregated survey data demonstrated statistically significant improvements in self-reported confidence for 7 of 8 proposed scenarios, with variations in confidence outcomes between junior and senior residents. Four themes emerged: (1) How Simulations Facilitate Learning, (2) The Role of Pre-simulation Instructions, (3) Factors Facilitating Confidence, (4) Positive Effects of Interdisciplinary Involvement.

CONCLUSIONS

This study identifies possible mechanisms for residents' self-reported improvements in learning and confidence, which may help programs tailor interventions. Furthermore, this study suggests there may be benefits to interdisciplinary simulations, with self-reported outcomes of improved collaboration and safety planning.

Use of an Observer Tool to Enhance Observers' Learning of Anesthesia Residents During High-Fidelity Simulation: A Randomized Controlled Trial

INTRODUCTION

The growing number of learners implies that all of them cannot play an active role during high-fidelity scenarios. Studies suggest a positive educational value when learners are observers only, but it remains uncertain whether learning outcomes might be improved by using an observer tool (OT).

METHODS

Eighty-nine anesthesia residents were randomized to use an OT (n = 44, OT+; based on a cognitive aid) or not (n = 45, OT-) when not role-playing. The main outcome parameter was the learning outcomes assessed by comparing the change (before-after) in the response score to a questionnaire dedicated to medical knowledge obtained in the OT+ and OT- groups. The impact of using the OT was also assessed by measuring the perceived stress level and the change of the Anesthetists' Non-Technical Skill items values.

RESULTS

At the end of the session, the mean medical knowledge score (mean ± SD) was higher in the OT+ group than in the OT- group (11.4 ± 2.7 vs. 9.6 ± 2.4, respectively, P = 0.0008). The mean Anesthetists' Non-Technical Skill score and level of stress perceived did not differ between groups. Trainees rated similarly the learning value and satisfaction related to the simulation course.

CONCLUSIONS

This study suggests that observing high-fidelity simulation scenarios using an OT based on a cognitive aid increases the medical knowledge gain when compared with that seen in passive observers. This study suggests that the use of an OT improves the educational value of simulation.

Satisfação e autoconfiança de estudantes de enfermagem como atuantes e observadores em simulação realística

RESUMO Objetivo: Analisar a satisfação e a autoconfiança de estudantes de Enfermagem com a aprendizagem, nos papéis de atuantes e observadores, em cenários de simulação realística. Método: Estudo observacional com 44 estudantes de Enfermagem de instituições de ensino superior do sul do país. A coleta de dados foi no período de setembro a novembro de 2018, através da Escala de Satisfação e Autoconfiança com a Aprendizagem após participação em cenários de simulação realística. Os dados foram analisados através da estatística descritiva e do modelo de Equações de Estimativas Generalizadas complementado por Bonferroni. Resultados: O nível de satisfação foi de 4,78 (± 0,35) e o de autoconfiança com a aprendizagem, de 4,46 (± 0,39). Os alunos dos 8º e 9º semestres foram os que apresentaram maiores médias em relação aos demais no fator da autoconfiança (p < 0,001). Conclusão: Conclui-se que não houve diferença estatisticamente significativa na satisfação e na autoconfiança com a aprendizagem de estudantes de Enfermagem com papéis diferentes no cenário de simulação.

Getting Better Together: The Two-Team Training Approach in Simulation-Based Education

Most clinical cases involve more than one nurse and one profession in the patient care plan, and so it can be stated that health care is very often a team event. In this article, I describe a two-team training approach that is very effective for maximizing learning and preparing high-performing teams in several team-based courses. This strategy exemplifies the power of vicarious learning and learning through imitation. Benefits of the two-team training approach in simulation-based education may include: (1) improved use of training time; (2) increased training volume; (3) recognition, correction, and immediate application of desired behaviors; (4) an improved simulation do-over process; (5) improvement in self-efficacy; and (6) applicable use of research and evidence-based educational practices. The two-team approach is an educational strategy that is supported by research and sound educational learning theories and should be considered for inclusion in organizational continuing education training plans. [J Contin Educ Nurs. 2021;52(9):417-422.].

Simulation effectiveness tool modified (SET-M): adaptation and validation for Brazil

Objective:

to adapt the Simulation Effectiveness Tool - Modified (SET-M) to Portuguese and to verify validity and reliability indexes.

Method:

methodological study using ISPOR, Confirmatory Factor Analysis, correlation between the adapted instrument/Simulation Design Scale - Student Version/Individual Practice Assessment and reliability (test-retest and internal consistency indexes). Convenience sample with a total of 435 Nursing undergraduate and graduate students.

Results:

Simulation Effectiveness Tool - Modified Brazilian Version obtained an average score between 2.36 to 2.94. The Confirmatory Factor Analysis had a factor load > 0.30 for 17 of the 19 items. Cronbach’s alpha ranged between 0.729 and 0.874. McDonald’s omega was 0.782. There was no correlation between Simulation Effectiveness Tool - Modified Brazilian Version and the Simulation Design or Individual Practical Assessment. There was a positive correlation between the Simulation Effectiveness Tool - Modified Brazilian Version and the participants’ age. The scores of the volunteers in the simulations were significantly higher than those of the observers in three domains.

Conclusion:

the SET-M Brazilian Version, maintaining the 19 items and four domains of the original scale, was made available for use in Brazil to evaluate the effectiveness of the simulation, recommending studies with different samples.

Pharmacy technicians, supporting our past, shaping our future: Implementing an ASHP-ACPE-accredited pharmacy technician training program in an academic medical center

PURPOSE

Pharmacy technician training and education vary depending on practice site and state law. Although technician certification provides a national standard for credentialing, not all states require it, making certification a voluntary process for technicians or the organizations employing them. As the role of the pharmacist has evolved, the need for highly trained pharmacy technicians has grown. The pharmacy technician's expanded role in specialized areas of pharmacy practice has created new opportunities that require advanced training.

SUMMARY

Research is lacking on return on investment for workforce development programs, making it difficult to advocate for pharmacy technician training programs. Therefore, it is important to create internal metrics that link one's program to business performance. This begins with conducting a job market analysis for the geographic area. It is imperative to identify the current occupational outlook for pharmacy technicians, identifying areas with potential for growth as well as where there are shortages or high turnover. Successful development of an American Society of Health-System Pharmacists (ASHP) and Accreditation Council for Pharmacy Education (ACPE)-accredited pharmacy technician program requires a long-term strategy to address key market issues as well as social and economic barriers and financial data to secure funding.

CONCLUSION

This case study details Yale New Haven Hospital's journey from proof of concept to implementation of an ASHP-ACPE-accredited pharmacy technician training program.

Clinical inter-professional education activities: Students' perceptions of their experiences

Background and purpose

Students from different health disciplines should learn together during certain periods of their education to acquire skills necessary for solving the health problems. The Faculty of Health Sciences of University of the Witwatersrand created inter-professional education (IPE) activities for students to assess clinical IPE groups' perceptions of IPE experiences and to identify lessons learnt during IPE sessions.

Methods

This was a qualitative study with review of the students' post IPE feedback forms. The students were granted 'protected time' of three full days over a period of two months to participate in IPE activities.

Results

Students felt that knowledge about health team members was gained and that IPE groups should have more than one person from each field with the same level of clinical exposure. The students indicated the need to have regular IPE activities and if possible to incorporate this into clinical practice for them to experience it in daily clinical practice.

Conclusion

Participating in the IPE activity made students gain appreciation and respect for other health professionals' roles and scope. When student groups are big, patient observations can be done as this does not compromise IPE learning outcomes. Group composition should be kept in mind to cater for the learning needs of all students. If it is not possible to meet the needs of all professions, smaller groups with professions applicable to case can be created.

Student-LED interprofessional sequential simulation improves communication and teamwork

BACKGROUND

Although simulation is a well-established learning method in Finland, sequential simulations are still uncommon. The objective of this project was to pilot interprofessional, sequential simulation demonstrating acute clinical pathways. The learning objectives were communication and collaboration.

METHODS

Two groups consisting of nursing and emergency care students planned the simulation exercises. Other participants in the simulation were medical students, biomedical science students and radiography students.

RESULTS

Participants considered the sequential simulation were a good learning method particularly for skills in communication, patient encounters and working in an interprofessional setting.

CONCLUSIONS

An interprofessional, sequential simulation of a clinical pathway is a good method to practice non-technical skills. Sequential simulation also helps students understand the whole health care system.

The impact of interprofessional simulation experiences in occupational and physical therapy education: a qualitative study

Abstract Interprofessional experiences are an essential part of preparing occupational and physical therapy students for clinical practice. Simulation has been used to help students achieve clinical competencies, including interprofessional competencies. The following study aimed to explore the students’ perceptions of an interprofessional simulation experience, identify opportunities for the integration of interprofessional experiences across the curriculum, and document the design elements that positively influenced the outcomes of the interprofessional simulation experience. An exploratory case study design was used to examine the study aims. Focus groups were used to collect qualitative data from 85 graduate-level occupational and physical therapy students. Thematic analysis was completed on the focus group transcripts. Results from the students indicated that they perceived the interprofessional simulation experience to be beneficial to the development of affective skills and role identity. The students identified a desire for increased exposure to interprofessional education experiences throughout the curriculum. The design and implementation of the interprofessional simulation were positively received by students due to the emphasis on creating a realistic experience and despite initial student anxiety related to the experience. Interprofessional simulation is a valuable and appropriate method for engaging students in interprofessional education and developing interprofessional skills based on the results of the current study. Documenting the process of designing and implementing an interprofessional simulation may assist other programs in developing interprofessional simulation opportunities for healthcare students.

Optimizing Multidisciplinary Simulation in Medical School for Larger Groups: Role Assignment by Lottery and Guided Learning

PURPOSE

Medical school simulations are often designed for a limited number of students to maximize engagement and learning. To ensure that all first-year medical students who wished to join had an opportunity to participate, we designed a novel method for larger groups.

PATIENTS AND METHODS

We devised a low technology "Orchestra Leader's" chart approach to prominently display students' roles, chosen by lottery. During simulation, the chart was mounted on an intravenous pole and served as a group organizational tool. A course instructor prompted students using the chart to accomplish the course objectives in a logical order. Real-life cardiologists and gastroenterologists provided the students with expert subspecialty consultation. We analyzed 125 anonymous student evaluation ratings for 3 years (2017-2019) with a range of 8 to 19 students per laboratory session.

RESULTS

Our 2017-2019 larger group sessions were all rated as excellent (1.26, Mean, SD ±.510) on the Likert scale where 1.0 is excellent and 5.0 is poor. There were no statistically significant differences in overall ratings among the 2017, 2018 and 2019 sessions. The subspecialists were uniformly rated as excellent. Verbatim free-text responses demonstrated resounding student appreciation for the role assignment by lottery method.

CONCLUSION

We designed a novel, "Orchestra Leader's" chart approach for accommodating larger groups in a multidisciplinary simulation laboratory using role assignment by lottery, roles depicted on an organizational chart, and expert instructor prompting. Our consistently excellent ratings suggest that our methods are useful for achieving well-rated larger group simulation laboratories.

Pedagogical practices that influence professional identity formation in baccalaureate nursing education: A scoping review

OBJECTIVES

The purpose of this review was to identify pedagogical practices that contribute to professional identity formation in undergraduate nursing education and to map the components of professional identity described within these practices.

DESIGN

A scoping review using a six-stage methodological framework was used to capture a range of evidence describing how professional identity has been conceptualized and integrated into nursing curriculum.

DATA SOURCES

Databases searched included: Ovid MEDLINE: Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE® Daily and Ovid MEDLINE® 1946-Present, EBSCO CINAHL (1981 to present), OVID PsycINFO (1806 to Present), ProQuest ERIC, ASSIA, and Sociological Abstracts. Additional studies were identified by scanning the reference lists of relevant articles.

REVIEW METHODS

The study team collaboratively designed the data charting table and two coauthors independently screened the studies using Covidence software. Qualitative content analysis was used to categorize learning outcomes into five components of professional identity that were associated with pedagogical practices identified in the studies.

RESULTS

A total of 114 peer-reviewed journal articles were initially charted. Articles were categorized as intervention studies (46, 40%), perspective studies (40, 35%), theoretical papers (17, 15%), or reviews (11, 10%). To ensure feasibility in collating and reporting the results, the review focused on the 46 empirical intervention studies that described associations between pedagogical practices and professional identity formation learning outcomes for students.

CONCLUSIONS

This scoping review illustrates the range of contexts in which nursing students learn, the multidimensional nature of identity formation, as well as the breadth of pedagogical practices and learning outcomes that guide course design. The results can be used to inform future curriculum planning and to identify focused research questions to extend our understanding of evidence-based teaching practices supporting professional identity formation.

Experiential learning without prior vicarious learning: an insight from the primary dental care setting

The vicarious learning method (by observation) is used to help learners emulate their teachers' behaviours. The experiential learning method (by experience) is traditionally used thereafter, so that learners can apply these behaviours to a given situation. Both methods are widely utilised within clinical skills training. A clinical teacher may well face the question of whether a learner can complete a certain clinical task without having seen it performed before. Therefore, clinical teachers will need to determine which method, vicarious or experiential, is most effective for their learners. To help explore this, the author reflects on two examples from dental teaching practice, followed by discussion of the need to also observe soft skills; provide meaningful feedback; be a good role model; facilitate deep learning; know our learners, and implement learner-centred learning. Collectively, this reveals that although experiential learning may be possible and beneficial by itself, further research is required to fully support this.

Dynamic Multi-Swarm Differential Learning Quantum Bird Swarm Algorithm and Its Application in Random Forest Classification Model

Bird swarm algorithm is one of the swarm intelligence algorithms proposed recently. However, the original bird swarm algorithm has some drawbacks, such as easy to fall into local optimum and slow convergence speed. To overcome these short-comings, a dynamic multi-swarm differential learning quantum bird swarm algorithm which combines three hybrid strategies was established. First, establishing a dynamic multi-swarm bird swarm algorithm and the differential evolution strategy was adopted to enhance the randomness of the foraging behavior's movement, which can make the bird swarm algorithm have a stronger global exploration capability. Next, quantum behavior was introduced into the bird swarm algorithm for more efficient search solution space. Then, the improved bird swarm algorithm is used to optimize the number of decision trees and the number of predictor variables on the random forest classification model. In the experiment, the 18 benchmark functions, 30 CEC2014 functions, and the 8 UCI datasets are tested to show that the improved algorithm and model are very competitive and outperform the other algorithms and models. Finally, the effective random forest classification model was applied to actual oil logging prediction. As the experimental results show, the three strategies can significantly boost the performance of the bird swarm algorithm and the proposed learning scheme can guarantee a more stable random forest classification model with higher accuracy and efficiency compared to others.

Implementation, Outputs, and Cost of a National Operational Research Training in Rwanda

Background

Training and mentorship in research skills are essential to developing a critical mass of researchers in low- and middle-income countries (LMICs). However, reporting on the details of such training programs, especially regarding the cost of the training, is limited.

Objectives

This paper describes a year-long operational research training and mentorship course in Rwanda, implemented between 2013 and 2017.

Approach

We describe motivations for the design of the Intermediate Operational Research Training Course (IORT) across four iterations. We also report outputs, evaluate trainee experiences, and estimate training and mentorship costs.

Findings

Of the 132 applicants to the course, 55 (41.7%) were selected, and 53 (96.4%) completed the training. The ratio of female-to-male trainees in the course increased from 1:8 in 2013 to 1:3 in 2017. Trainees developed and co-first-authored 28 research manuscripts, 96.4% (n = 27) of which are published in peer-reviewed journals. For the 15 trainees who completed the post-course evaluation, 93.3% and 86.7% reported improvement in their research and analytical skills, respectively. The median cost per trainee to complete the course was US$908 (Range: US$739-US$1,253) and per research project was US$2,708 (US$1,748-US$6,741). The median annual training delivery and mentorship cost was US$47,170 (US$30,563-US$63,849) for a course with a Rwanda-based senior mentor, junior mentor, and training coordinator. The total essential cost for a year-long IORT course with 16 trainees co-leading eight research projects and mentored by two senior and four junior mentors was US$101,254 (US$73,486-US$157,569).

Conclusion

We attribute the high course completion rates, publication rates, and skills acquisition to the learning-by-doing approach and intensive hands-on mentorship provided in the course. IORT was costly and funded through institutional resources and international partnerships. We encourage funders to prioritize comprehensive research capacity-building initiatives that provide intensive mentorship as these are likely to improve the pool of skilled researchers in LMICs.

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.

Creation and Implementation of a Large-Scale Geriatric Interprofessional Education Experience

The care of the older adult requires an interprofessional approach to solve complex medical and social problems, but this approach is difficult to teach in our educational silos. We developed an interprofessional educational session in response to national requests for innovative practice models that use collaborative interprofessional teams. We chose geriatric fall prevention as our area of focus as our development of the educational session coincided with the development of an interprofessional Fall Risk Reduction Clinic. Our aim of this study was to evaluate the number and type of students who attended a pilot and 10 subsequent educational sessions. We also documented the changes that occurred due to a Plan-Do-Study-Act (PDSA) rapid-cycle improvement model to modify our educational session. The educational session evolved into an online presession self-study didactic and in-person educational session with a poster/skill section, an interprofessional team simulation, and simulated patient experience. The simulated patient experience included an interprofessional fall evaluation, team meeting, and presentation to an expert panel. The pilot session had 83 students from the three sponsoring institutions (hospital system, university, and medical university). Students were from undergraduate nursing, nurse practitioner graduate program, pharmacy, medicine, social work, physical therapy, nutrition, and pastoral care. Since the pilot, 719 students have participated in various manifestations of the online didactic plus in-person training sessions. Ten separate educational sessions have been given at three different institutions. Survey data with demographic information were available on 524 participants. Students came from ten different schools and represented thirteen different health care disciplines. A large-scale interprofessional educational session is possible with rapid-cycle improvement, inclusion of educators from a variety of learning institutions, and flexibility with curriculum to accommodate learners in various stages of training.

Persuasion of tacit knowledge in teaching information technology and information systems

Purpose

The purpose of this paper is to examine information technology and information systems (IT/IS) technology teaching and learning (T&L) as affected by three key factors of tacit knowledge (TK). These factors are the de-contextualization, the faculty and students’ mental model gap and the intrinsic inability of faculty to teach what they know (i.e. the know-how-know what gap).

Design/methodology/approach

The approach is based on intensive literature review and synthesis of Nonaka’s socialization, externalization, combination and internalization model and other relevant knowledge management (KM) principles applied to understand the effects of mobilization and nurturing of TK in pedagogical activities and strategies.

Findings

This paper demonstrated a holistic view of the role of TK in teaching IT/IS through deep learning activities. It differentiates between faculty and student mental models and the ability of the faculty to convey real-world know-how to students.

Research limitations/implications

This study is by no means comprehensive in exploring the TK contextual dimensions of IT/IS T&L milieus. However, some of the assumptions and factors in this paper are not pertinent to some pedagogical environments.

Practical implications

The activities in this paper introduced new propositions on IT/IS teaching by focusing on TK concepts in light of its challenges. The study could be used by institutes to place emphasis on accommodating TK within effective IT/IS T&L activities.

Originality/value

Drawing on the KM literature and experience, this paper offers new insight into how TK can be innovatively incorporated into a pedagogical landscape.

Teaching Crisis Resource Management Skills to Nurses Using Simulation

BACKGROUND

Education programs teaching crisis resource management (CRM) skills (problem solving, situational awareness, resource utilization, communication, and leadership) have been shown to positively affect learner competence in handling crisis events. As part of an education program, a high-fidelity simulation program was used as a learning intervention to teach these skills to practicing nurses.

METHOD

In this repeated-measures observational study, 11 RNs were evaluated at four time points, measuring the effect of an education program on observed performance of CRM skills. Performance was measured using the Ottawa Global Rating Scale and a checklist tool.

RESULTS

Statistically significant changes in mean scores occurred between times one and two, and nonstatistically significant improvement occurred in means overall.

CONCLUSION

This study adds evidence of the effectiveness of high-fidelity simulation education and highlights the need for further research. [J Contin Educ Nurs. 2020;51(6):257-266.].

The state of ethics education at medical schools in Turkey: taking stock and looking forward

BACKGROUND

Ethics teaching is globally considered an essential part of medical education fostering professionalism. It does not only provide knowledge for good clinical conduct, but also trains medical students as virtuous practitioners. Although Turkey has had a considerable experience in ethics education of healthcare professionals, the general state of ethics curricula at medical schools in Turkey is unknown.

METHODS

The purpose of this study was to collect comprehensive data about the ethics education programs at medical schools in Turkey. To this aim, we designed a cross-sectional descriptive questionnaire survey which focuses on the content, teaching years, teaching, assessment and evaluation methodologies, workforce and infrastructure. We delivered the questionnaire to all medical schools in Turkey. Seventy-nine medical schools participated in this study (response rate: 78%).

RESULTS

Although most institutions had an undergraduate ethics curriculum (91.1%), the findings suggest deficiency of teaching personnel (34.2% had no instructors). Furthermore, the distribution and composition of the workforce was imbalanced. The content varies largely among institutions. Medical schools with an ethics department were more likely to diversify teaching topics. However, ethics education was largely based on the four-principle approach. The content was usually conveyed to students theoretically. Around 90% of schools had classroom lectures. It is the only method used at one-third of them. Clinical ethics education was mostly lacking. Multiple-choice tests were widely used to assess and evaluate student attainments (86.1%).

CONCLUSIONS

Staff qualified to teach ethics and ethics education integrated into the six-year medical curriculum given by a multidisciplinary team are urgent necessities. Considering teaching, assessment and evaluation methodologies used, most medical schools seem to fall short of fostering students to develop ethical attitudes. Endeavors aiming for modern topics should be encouraged. As the organization ethics education change continuously, we think that a platform for monitoring ethics education at medical schools in Turkey should be established. Such a body would help ethics instructors to network and find solutions to current problems and build shared wisdom.

Simulación de la capacitación en emergencias para estudiantes de enfermería

Introducción: La capacitación de los estudiantes de enfermería en maniobras de reanimación cardiopulmonar (RCP) es esencial para un desempeño seguro y de calidad en diferentes escenarios de desempeño de enfermería. La integración a los escenarios de práctica clínica, desde los primeros años del programa, proporciona una mayor seguridad para actuar en situaciones de emergencia. El objetivo era evaluar los conocimientos de los estudiantes de enfermería recién graduados antes y después de realizar una capacitación sobre soporte vital básico (SVB) mediante simulación. Materiales y métodos: Se trata de un estudio cuasiexperimental llevado a cabo en 2015 en una institución pública de educación superior en el sureste de Brasil. Los estudiantes respondieron una prueba previa y, justo después de la intervención, respondieron otra prueba posterior. Para el análisis, se utilizaron las pruebas emparejadas de McNemar y Wilcoxon. Resultados: Se identificó que inmediatamente después de tomar el curso, los estudiantes mostraron tener conocimientos satisfactorios  (≥ 80%) en varios temas. Sin embargo, las preguntas de la prueba relacionadas con los eslabones de la cadena de supervivencia (-18.7%; p = 0.004) y con la secuencia de la maniobra de apertura de vía aérea (-16.0%; p = 0.091) mostraron una reducción del número de respuestas correctas después de la intervención. Discusión: El uso de estrategias combinadas, incluida la simulación de fidelidad media para la enseñanza de SVB, ha facilitado la comprensión del contenido de SVB. Conclusiones: El uso de la simulación mostró una evolución positiva del conocimiento sobre los temas relacionados con la profundidad de la compresión torácica, la secuencia de la RCP y la relación compresión-ventilación por minuto en la RCP. Como citar este articulo: Costa, Christefany Régia Braz; Melo, Elizabete Santos; Reis, Renata Karina. Simulação no ensino de emergência para estudantes de enfermagem. Revista Cuidarte. 2020; 11(2): e853. http://dx.doi.org/10.15649/cuidarte.853

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.

Impact of Pharmacy Student Observation Versus Active Participation in an Interprofessional Simulation

Objective. To compare the change in pharmacy students' self-reported competence toward interprofessional collaboration between those that were active participants in or observers of an interprofessional simulation. Methods. Second- and third-year (P2 and P3) pharmacy students and senior nursing students participated in an interprofessional simulation. Third-year pharmacy students and senior nursing students were divided into teams of four (two from each profession) and were active participants. Second-year pharmacy students were observers. All pharmacy students were asked to complete a brief demographic survey and the Interprofessional Collaborative Competency Attainment Survey (ICCAS) after the simulation. Mean retrospective pretest and posttest ICCAS scores for each group of learners were compared using paired sample t tests. To examine the difference in the change in mean total ICCAS score between observers and active participants, repeated measures analysis of variance was completed. Results. One hundred thirty (95%) P2 pharmacy students and 121 (92%) P3 pharmacy students participated in the interprofessional simulation experience as observers and active participants, respectively, and completed the ICCAS for an overall response rate of 94%. The active participants' mean ICCAS scores were significantly higher than those of the observers on both the retrospective pretest (M=4.9, SD=1.0 vs M=5.2, SD=1.0) and the posttest (M=5.9, SD=0.7 vs M=6.2, SD=0.7). The mean change in scores from retrospective pretest to posttest was not significantly different between observer and active participant pharmacy students. Conclusion. Both observation and active participation in an interprofessional simulation experience may increase pharmacy students' self-reported competence in interprofessional collaboration.

Evaluation of a tracheostomy education programme for speech-language therapists

BACKGROUND

Tracheostomy management is considered an area of advanced practice for speech-language therapists (SLTs) internationally. Infrequent exposure and limited access to specialist SLTs are barriers to competency development.

AIMS

To evaluate the benefits of postgraduate tracheostomy education programme for SLTs working with children and adults.

METHODS & PROCEDURES

A total of 35 SLTs participated in the programme, which included a 1-day tracheostomy simulation-based workshop. Before the workshop, SLTs took an online knowledge quiz and then completed a theory package. The workshop consisted of part-task skill learning and simulated scenarios. Scenarios were video recorded for delayed independent appraisal of participant performance. Manual skills were judged as (1) completed successfully, (2) completed inadequately/needed assistance or (3) lost opportunity. Core non-medical skills required when managing a crisis situation and overall performance were scored using an adapted Ottawa Global Rating Scale (GRS). Feedback from participants was collected and self-perceived confidence rated prior, immediately post and 4 months post-workshop.

OUTCOMES & RESULTS

SLTs successfully performed 94% of manual tasks. Most SLTs (29 of 35) scored > 5 of 7 on all elements of the adapted Ottawa GRS. Workshop feedback was positive with significant increases in confidence ratings post-workshop and maintained at 4 months.

CONCLUSIONS & IMPLICATIONS

Postgraduate tracheostomy education, using a flipped-classroom approach and low- and high-fidelity simulation, is an effective way to increase knowledge, confidence and manual skill performance in SLTs across patient populations. Simulation is a well-received method of learning.

Optimizing the observer experience in an interprofessional home health simulation: a quasi-experimental study

The purpose of this quasi-experimental study was to explore the influence of an interprofessional simulation experience on student perceptions of interprofessional collaboration, as well as to explore the influence of the participant and observer roles on these beliefs. A two-session simulation experience was developed to engage professional students in the collaborative care of a patient admitted to a home health agency. To provide the simulation experience in a time efficient manner within the curriculum, students participated in two interprofessional teams of nursing and physical therapy students. Each team actively participated in the collaborative care of the patient in one session. In the alternate session, the interprofessional team observed the care of the patient, documented behaviors ideal for interprofessional teamwork, and provided feedback regarding the interprofessional collaboration and communication observed during debriefing. Observers in this study consistently improved their self-perceived comfort in working with others irrespective of the order in which they participated in the simulation scenario. The use of observers in simulation may provide opportunities for programs to integrate large scale simulation experiences in a time efficient manner to further engage students in active learning as a component of interprofessional education.

Teaching Basic Nursing Care: Nurse Preceptors' Perceptions about Changing the Teaching Context from the Clinical Setting to a School Simulation Lab

Research demonstrates that basic nursing care receives less attention in clinical settings and has become visually less prominent in nursing education curriculums. While much is known about the importance of preceptorship in clinical settings, little is known about how preceptors teach basic nursing care to students in a school simulation lab. This study explores the preceptors' perceptions of teaching basic nursing care to nursing students in the school simulation lab compared to clinical settings. Data were collected through focus group interviews and participant observation and analyzed by using qualitative content analysis. Three main categories emerged: (i) Perceived advantages and disadvantages, (ii) Positive attitudes - remembering being a student, and (iii) Knowing what to do and showing how to do it. Awareness of the importance of having knowledge about basic nursing care may contribute to counterbalancing the devaluation of basic nursing care among nursing students.

Examining the effects of an obstetrics interprofessional programme on reductions to reportable events and their related costs

There are many ways to account for the return on investment (ROI) in healthcare: improved communication, teamwork, culture, patient satisfaction, staff satisfaction, and clinical outcomes are but a few. Some of these are easier to quantify and associate to an intervention than others. What if the outcomes listed were not just independent results, but beget one another? In 2001, the Society of Obstetricians and Gynaecologists of Canada created the Managing Obstetrical Risk Efficiently (MOREOB) programme, to improve healthcare culture and patient outcomes in obstetrics by leveraging front-line ownership. Our study provides evidence that MOREOB lowers the frequency and cost of reportable events in maternity units. We sought to review the impact of this intervention on the frequency and cost of reportable events at the insurer level of a clinically focused, three-year interprofessional culture change intervention applied to the maternity unit. We compared the impact of reportable events both in the obstetrical and in the non-obstetrical areas of the same hospitals during the same time periods. We analysed these data using an interrupted time series (ITS) design, among 34 Ontario Canada hospitals. The ITS design assessed changes in the frequency and cost of reportable events before and after the implementation of the intervention. The method was ideally suited as the various maternity units had differing programme commencement and completion dates. The frequency of reportable events showed little change during the three-year intervention. As culture change grew, the changes in behaviour and processes that impact patient outcomes took longer to accrue. A large reduction in the frequency of reportable events occurred in the following three-year (14% reduction) and six-year (25% reduction) tranches. Our results show statistically significant reductions in the frequency and costs associated with reportable events at the level of an insurer. The results also give insight as to the investment of time required to achieve a level of sustainability.

The Impact of a New Pedagogical Intervention on Nursing Students' Knowledge Acquisition in Simulation-Based Learning: A Quasi-Experimental Study

Simulation-based learning is an effective technique for teaching nursing students' skills and knowledge related to patient deterioration. This study examined students' acquisition of theoretical knowledge about symptoms, pathophysiology, and nursing actions after implementing an educational intervention during simulation-based learning. A quasi-experimental study compared theoretical knowledge among two groups of students before and after implementation of the intervention. The intervention introduced the following new components to the existing technique: a knowledge test prior to the simulation, video-recording of the performance, and introduction of a structured observation form used by students and facilitator during observation and debriefing. The intervention group had significantly higher scores on a knowledge test conducted after the simulations in comparison to the scores in the control group. In both groups scores were highest on knowledge of symptoms and lowest on knowledge of pathophysiology; the intervention group had significantly higher scores than the control group on both topics. Students' theoretical knowledge of patient deterioration may be enhanced by improving the students' prerequisites for learning and by strengthening debriefing after simulation.

Developing confidence in basic prescribing skills during medical school: a longitudinal questionnaire study investigating the effects of a modified clinical pharmacology course

PURPOSE

To investigate if increased focus on pharmacotherapy during medical school can increase students' confidence in basic prescribing skills, that is, performing medication reviews and writing medication discharge summaries.

METHODS

In 2016, the clinical pharmacology course in medical school in Gothenburg, Sweden, was modified to facilitate the students' acquisition of prescribing skills, with (i) clarified learning outcomes; (ii) supply of a list of common drugs for self-completion; (iii) instructions to practice medication reviews/discharge summaries during the ward-based education; and (iv) a concluding compulsory seminar where the students were to present prescribing-related experiences from their ward-based attendance. Questionnaires were administered to students participating in the course before (2016; n = 101) and after (2017; n = 137) implementation of the modifications. Students were asked to grade their agreement from 1 (totally disagree) to 5 (totally agree) on statements related to their perceived confidence in basic prescribing skills.

RESULTS

In all, 195 students returned the questionnaire (response rate 82%; median age 24 years; 68% female). Confidence was rated higher after the modifications were implemented, both regarding medication reviews and medication discharge summaries, after vs. before 3.6 ± 1.2 vs. 3.2 ± 1.0 (P = 0.024), and 4.3 ± 0.9 vs. 3.9 ± 1.1 (P = 0.008), respectively. The adjusted odds for being confident in performing these tasks were 1.49/1.36 times greater after the course modifications (P = 0.047/0.019). Perceived confidence in performing medication reviews/summary reports was positively correlated with numbers performed (P < 0.0001).

CONCLUSIONS

Modifications of the clinical pharmacology course during medical school, focusing on students' training in pharmacotherapy, was associated with increased confidence of this core skill for a physician.

Adapting operational research training to the Rwandan context: the Intermediate Operational Research Training programme

Background: Promoting national health research agendas in low- and middle-income countries (LMICs) requires adequate numbers of individuals with skills to initiate and conduct research. Recently, non-governmental organizations (NGOs) have joined research capacity building efforts to increase research leadership by LMIC nationals. Partners In Health, an international NGO operating in Rwanda, implemented its first Intermediate Operational Research Training (IORT) course to cultivate Rwandan research talent and generate evidence to improve health care delivery.

Objective: This paper describes the implementation of IORT to share experiences with other organizations interested in developing similar training programmes.

Methods: The Intermediate Operational Research Training utilized a deliverable-driven training model, using learning-by-doing pedagogy with intensive hands-on mentorship to build research skills from protocol development to scientific publication. The course had short (two-day) but frequent training sessions (seven sessions over eight months). Trainees were clinical and programme staff working at the district level who were paired to jointly lead a research project.

Results: Of 10 trainees admitted to the course from a pool of 24 applicants, nine trainees completed the course with five research projects published in peer-reviewed journals. Strengths of the course included supportive national and institutional research capacity guidelines, building from a successful training model, and trainee commitment. Challenges included delays in ethical review, high mentorship workload of up to 250 hours of practicum mentorship, lack of access to literature in subscription journals and high costs of open access publication.

Conclusions: The IORT course was an effective way to support the district-based government and NGO staff in gaining research skills, as well as answering research questions relevant to health service delivery at district hospitals. Other NGOs should build on successful programmes while adapting course elements to address context-specific challenges. Mentorship for LMIC trainees is critical for effectiveness of research capacity building initiatives.

Simulated interprofessional learning activities for rural health care services: perceptions of health care students

Background

The literature on interprofessional learning (IPL) has limited empirical evidence on the impact of simulated IPL sessions in promoting collaborative health care services in rural settings. This study aims to explore health care students’ perception of the relevance of simulated IPL for rural health care services.

Methods

Three focus group interviews were held with pre-registration medical, pharmacy, and allied health students (n=22). Students worked together to manage complex simulation scenarios in small interprofessional teams. Focus group sessions were held at the end of simulation activities to explore students’ views on the relevance of simulated IPL activities. Thematic analysis was undertaken on the qualitative data obtained from the focus groups.

Results

Participants embraced both the interprofessional and the simulation components enthusiastically and perceived these to be useful for their future as rural health care practitioners. Four major themes emerged from the qualitative analysis: appreciation of the role of other health disciplines, collaborative approach to patient care, competency and skills for future health care practice, and relevance for future rural and remote health care practice. Students acknowledged the simulated IPL sessions for improving their understanding of multidisciplinary practice in rural practice and facilitating the appreciation for collaborative practice and expertise.

Conclusion

Based on the findings of this study, simulated IPL activities seem to be a potential intervention for developing collaborative practice among pre-registration health profession students. However, further evidence is required to assess if positive responses to simulated IPL activities are sustained in practice and translate into improving patient outcome.