Prelicensure Simulation-Enhanced Interprofessional Education: A Critical Review of the Research Literature

Mapping the Terrain of Faculty Development for Simulation: A Scoping Review

ABSTRACT

Understanding what interventions and approaches are currently being used to improve the knowledge, skills, and effectiveness of instructors in simulation-based education is an integral step for carving out the future of simulation. The current study is a scoping review on the topic, to uncover what is known about faculty development for simulation-based education.We screened 3259 abstracts and included 35 studies in this scoping review. Our findings reveal a clear image that the landscape of faculty development in simulation is widely diverse, revealing an array of foundations, terrains, and peaks even within the same zone of focus. As the field of faculty development in simulation continues to mature, we would hope that greater continuity and cohesiveness across the literature would continue to grow as well. Recommendations provided here may help provide the pathway toward that aim.

Health Care Simulation in Person and at a Distance: A Systematic Review

ABSTRACT

Distance simulation is a method of health care training in which the learners and facilitators are in different physical locations. Although methods of distance simulation have existed in health care for decades, this approach to education became much more prevalent during the COVID-19 pandemic. This systematic review studies a subset of distance simulation that includes combined in-person and distance simulation elements, identified here as "mixed- distance simulation." A review of the distance simulation literature identified 10,929 articles. Screened by inclusion and exclusion criteria, 34 articles were ultimately included in this review. The findings of this review present positive and negative aspects of mixed-distance simulation formats, a description of the most frequent configurations related to delivery, terminology challenges, as well as future directions including the need for faculty development, methodological rigor, and reporting details.

The effect of interprofessional simulations on pharmacy and physician assistant students' learning of advanced cardiac life support concepts

BACKGROUND

The Interprofessional Education Collaborative (IPEC) defined core competencies for IPE in 2011, and use of simulation in interprofessional education (IPE) continues to be developed in prelicensure health education programs.

INTERPROFESSIONAL EDUCATION ACTIVITY

In this prospective, observational study, interprofessional student teams addressed reversible causes of cardiac arrest in weekly simulations during an Emergency Medicine course. Each simulation was followed by sequential team debriefs, first regarding the IPEC core competencies of interprofessional communication, teamwork, and roles and responsibilities, and second regarding the patient-related content of the case.

DISCUSSION

Twenty-eight pharmacy students and 60 physician assistant students completed the course. A didactic knowledge exam was administered before, immediately after, and 150 days after the course. Both disciplines' exam scores significantly increased from baseline to the end of the course and from baseline to the 150-day follow-up. Students also completed the validated Interprofessional Perceptions Survey before and after the course. Both disciplines demonstrated significant increases in Team Value, Efficiency and Interprofessional Accommodation components.

IMPLICATIONS

Participation in this simulation-based course resulted in 150-day retention of advanced cardiovascular life support knowledge and improved interprofessional perceptions in both pharmacy and physician assistant students.

Factors of Engagement in Synchronous Online Learning Conversations and Distance Debriefing: A Realist Synthesis Review

SUMMARY STATEMENT

The COVID-19 pandemic propelled remote simulation and online distance debriefings. Like in-person debriefings, faculty seek to facilitate effective reflective discourse. The online learning environment, however, presents challenges to learner engagement that differ considerably from in-person debriefing, yet little research exists in this area. In an effort to identify factors that influence debriefing engagement in the online environment, we conceptualized distance debriefings as complex social interactions and performed a realist review of the literature for evidence in the fields of online learning, healthcare simulation, instructional design, and other teaching and learning fields to see whether we might discern factors that influence engagement in online learning conversations that might inform online distance debriefing best practices. Eighteen articles were found through our search of 5 online databases (MEDLINE, CINAHL, ERIC, Google Scholar). We conducted iterative purposeful searching and continued to do so throughout the review to try to identify any additional studies that would contribute to our understanding. A thematic analysis of the findings of our included articles revealed indicators categorized using the community of inquiry framework, enabling us to understand and explain them in the context of online learning and propose their application to distance debriefing engagement. We also propose a new dimension to the framework: internal and external factors of engagement. Our findings demonstrate that online learning can positively influence engagement of learners if essential factors are implemented. These factors may inform recommendations for best practices toward learner engagement during healthcare simulation distance debriefing.

Simulation-Based Education in Physical Therapist Professional Education: A Scoping Review

OBJECTIVES

The purposes of this study were to (1) describe and summarize the use of simulation-based education (SBE) with student physical therapists in the international literature and (2) describe the application and integration of standards of best practice (SOBP) for SBE reported in published physical therapy education research.

METHODS

Ovid MEDLINE, CINAHL, Web of Science, and ERIC databases were searched. The search included any published study that involved the use of SBE with student physical therapists. Because this was a scoping review, only descriptive statistics were compiled; no methodological quality assessment was performed.

RESULTS

This scoping review revealed a significant increase in literature describing SBE with student physical therapists in the past 10 years. Simulation was used to address learning objectives across a variety of content areas and clinical settings. Communication skills were the most common objectives for simulation. Limited use of SOBP, published in 2016, was reported, and use of author-generated outcome measures without validation was common.

CONCLUSIONS

Although there has been an increase in literature reporting the use of SBE with student physical therapists across many practice areas and settings, many articles reported limited use and integration of published SOBP and frequently utilized outcome measures that had not been validated.

IMPACT

The findings show that limited use of validated outcome measures and SOBP constrain the capacity for reproducing studies, comparing findings among studies, and completing systematic reviews that could inform and optimize best practices for the use of SBE in physical therapist professional education. Further research on SBE in physical therapy would benefit from investigations that integrated and reported the use of SOBP for standardized patients, simulation design, and delivery and assessment of learning outcomes over time at multiple Kirkpatrick learning levels.

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 Interprofessional Simulation with Telehealth to Enhance Teamwork and Communication in Home Care

Interpersonal communication and teamwork are critical to patient safety. There is evidence supporting the effectiveness of formalized team training strategies such as simulation-based learning experiences to permit opportunities for deliberate practice and skill acquisition. However, there is a paucity of evidence examining the best method for delivery of simulation-based interprofessional education activities (Sim-IPE). The purpose of this project was to explore the effectiveness of using a Sim-IPE with a home-based patient assessment and intervention for students in undergraduate nursing, nurse practitioner, and physical therapy programs with the goal of enhancing interprofessional team communication and team performance. A mixed-methods, observational research design was used to evaluate teamwork and communication following virtual/web-based deliberate practice and a subsequent face-to-face Sim-IPE with telehealth. There were two distinct stages: (1) provision of interprofessional education elements of teamwork and communication via a virtual web-based platform to interprofessional student teams; (2) participation of all 29 student teams in a Sim-IPE activity using a standardized patient in a simulated home-based setting. Teams scored very high on an interprofessional communication and teamwork scale, and students strongly agreed that the prebriefing, scenario, and debriefing assisted in their learning. Students also valued exposure to telehealth and the ability to work with students from other health professions.

Start here- principles of effective undergraduate training

Obstetric and gynaecology undergraduate training is an intense time for learners as they encounter various health conditions related to women's health and also learn about pregnancy care and birth. The experience is directed to familiarise students with basic clinical management of gynaecological conditions, also develop communication and related core examination and procedural skills. Similarly, midwifery training encompasses independent care of low-risk pregnant women and assist in care of high-risk pregnancy in partnership with obstetricians. Although its necessary to acquaint most learners with core clinical skills in obstetrics and gynaecology, learning opportunities on patients can be limited, due to the intrusive nature of women's health examination. Simulation Based Education (SBE) can facilitate learning hands-on clinical examination and procedural skills, using realistic part-task and high-fidelity simulators prior to approaching patients. This can apply to both medical and midwifery undergraduate training, further creating opportunities for professional interaction and shared learning space to facilitate interprofessional education. IPE has been shown to improve professional relationships in practicing clinicians. This learning pedagogy can be applied in the undergraduate setting as well, to decrease risk of conflict and appreciate roles of other interprofessional staff in future clinical practice. In this chapter we highlight some challenges faced by medical and midwifery undergraduates in their learning from a global perspective. We also describe some teaching and learning initiatives that can be applicable across various settings of obstetrics, gynaecology medical undergraduate and midwifery teaching with relevant case studies to facilitate new graduates preparedness for practice.

Gaining interprofessional knowledge and interprofessional competence on a training ward

BACKGROUND

Since 2017, interprofessional training wards have been established in Germany. On these wards, different health professions collaboratively provide patient care supervised by facilitators from the background. We investigated the gains in interprofessional knowledge and interprofessional competence reported after the mandatory placements on Mannheim's Interprofessional Training Ward MIA. We also compared these levels of knowledge and competence at the end of the placement with control groups.

METHODS

In a quasi-randomized controlled study, we used a questionnaire to collect self-reported data on the interprofessional learning outcome. We used t-tests to compare (a) pretest and posttest data in the experimental group and (b) the levels of interprofessional knowledge and competence between the experimental and control groups.

RESULTS

The results confirmed that the MIA participants perceived a significant increase in interprofessional knowledge and competence during the placement on the training ward. MIA participants also reported significantly higher levels of interprofessional knowledge and competence than the control groups.

CONCLUSIONS

Placements on an interprofessional training ward make it possible to experience and practise interprofessional collaboration in real patient care. They help to prepare all future health professionals to assume their professional role in an interprofessional team to provide the best possible patient care.

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.

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.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

The Use of Theoretical Frameworks Guiding Interprofessional Simulation: An Integrative Review

AIM

The aim of the review was to describe and summarize the use of theoretical premises noted in published studies on the implementation of interprofessional simulation (IPE-Sim).

BACKGROUND

IPE-Sim is an educational methodology being used throughout nursing, allied health, and health science programs of study. Understanding frameworks currently used in IPE-Sim is essential in advancing the knowledge of this type of educational methodology.

METHOD

An integrative literature review on the use of theories and models guiding IPE-Sim was performed.

RESULTS

Ten studies meeting the inclusion criteria were categorized into theoretical frameworks (n = 4) or competency frameworks (n = 6) guiding the development and implementation of IPE-Sim and were included in the review. The literature review revealed a lack of consistent theoretical and competency-based frameworks guiding the development, implementation, assessment, and research of IPE-Sim.

CONCLUSION

The integrative literature review describes specific theoretical and competency frameworks currently used in the literature on IPE-Sim.

Interprofessional simulation in a student community clinic: insights from an educational framework and contact theory

Introduction

Simulation in community care is a relatively understudied area. In this paper, we report a qualitative evaluation of the Simulated Client Interprofessional Education (SCIPE) program in a community clinic for undergraduate health and social care students in a rural setting. We sought to explore the stakeholders’ perceptions and experiences of training for, and conduct of, a simulated client-based activity to support the development of collaborative practice of students. We used an educational framework (presage, process, product–3P) and contact theory to analyse the evaluation data and suggest improvement strategies.

Methods

Data on professional characteristics was collected from facilitators, simulated client and students. Facilitators and simulated clients received training. Written evaluations were collected after training and after the simulated clinics. Purposively sampled facilitators, students and community partner agencies participated in individual semi-structured interviews to gain deeper insights into experiences.

Results

Fourteen clinics involved 5 facilitators, 12 simulated clients and 40 students. Fifteen interviews were conducted. The SCIPE program led to perceived improvements in students’ communication and awareness of interprofessional collaboration. Participation in the program enabled students to experience a holistic approach to client interviewing and development of competency in collaborative goal setting. Further attention to presage and ability of facilitators to build positive contact conditions was identified. Coordination from a central site facilitated exchange and quality assurance for all elements of the program. Scoping of conditions of positive contact enabled a greater understanding of students’ and facilitators’ evaluation of the experience and constraints which would be modifiable for future improvement and sustainability.

Discussion

Although the SCIPE program benefited students, the need for more explicit organisational engagement and support was revealed in interviews. The use of 3P and contact theory was helpful in identifying elements of the program for maintenance and development. Future research could follow students into practice to see if the behaviours are sustained and translated. Strengths included broad stakeholder involvement and immediate feedback. The key limitation was that the activity lacked explicit institutional support, facilitators required further training in briefing and the outcomes largely refer to participants’ perceptions and may not translate to practice.

[Simulation-based interprofessional education for critical care teams: Concept, implementation and assessment]

Interprofessional simulation-based education is effective for learning non-technical critical care skills and strengthening interprofessional team collaboration to optimize quality of care and patient outcome. Implementation of interprofessional simulation sessions in initial and continuing education is facilitated by a team of "champions" from each discipline/profession to ensure educational quality and logistics. Interprofessional simulation training must be integrated into a broader interprofessional curriculum supported by managers, administrators and clinical colleagues from different professional programs. When conducting interprofessional simulation training, it is essential to account for sociological factors (hierarchy, power, authority, interprofessional conflicts, gender, access to information, professional identity) both in scenario design and debriefing. Teamwork assessment tools in interprofessional simulation training may be used to guide debriefing. The interprofessional simulation setting (in-situ or simulation centre) will be chosen according to the learning objectives and the logistics.

Priorities Related to Improving Healthcare Safety Through Simulation

STATEMENT

Improving healthcare safety is a worthwhile and important endeavor. Simulation-based activities can help with such a goal through research and training. In this manner, it can focus on education and training, assessment and metrics, process improvement, and culture change to help move forward both patient safety and quality of care.This article will address the following three main topics: (1) designing simulation-based activities to promote high reliability in healthcare, (2) developing simulation-based activities to foster resilience in healthcare systems, and (3) evaluating the impact of adverse events in healthcare and how simulation-based activities can be used to determine and potentially to prevent their cause. These topics will be treated sequentially, providing synopses of concepts and giving examples of research currently being undertaken. It will then highlight current priorities for simulation-based research in this domain by drawing from insights obtained and a targeted literature review.

Simulation Experiences in Canadian Physiotherapy Programmes: A Description of Current Practices

Purpose: Although health care professional education programmes around the world are increasingly using sophisticated simulation technology, the scope of simulation use in Canadian physiotherapy programmes is currently undefined. The current study explores the definitions of simulation, its current use, and the perceived benefits and barriers in Canadian entry-to-practice physiotherapy programmes. Method: Using a qualitative, descriptive study approach, we contacted Canadian physiotherapy programmes to identify faculty members with simulation experience. Using a semi-structured interview format, we asked participants to discuss their perspectives of simulation in their physiotherapy programmes. Interviews were audio recorded, transcribed, and analyzed for themes. Results: Of 13 eligible Canadian physiotherapy programmes, participants from 8 were interviewed. The interviews revealed three major themes: (1) variability in the definition of fidelity in simulation, (2) variability in simulation use, and (3) the benefits of and barriers to the use of simulation. Conclusions: Variability in the definition of fidelity in simulation among Canadian physiotherapy programmes is consistent with the current literature, highlighting a spectrum of complexity from low fidelity to high fidelity. Physiotherapy programmes are using a variety of simulations, with the aim of creating a bridge from theoretical knowledge to clinical practice. This study describes the starting point for characterizing simulation implementation in Canadian physiotherapy programmes and reflects the diversity that exists across the country.

Effectiveness of an interprofessional patient safety team-based learning simulation experience on healthcare professional trainees

BACKGROUND

Although the American Council of Graduate Medical Education (ACGME) mandates formal education in patient safety, there is a lack of standardized educational practice on how to conduct patient safety training. Traditionally, patient safety is taught utilizing instructional strategies that promote passive learning such as self-directed online learning modules or didactic lectures that result in suboptimal learning and satisfaction.

METHODS

During the summer of 2015, 76 trainees consisting of internal medicine interns and senior-level nursing students participated in an interactive patient safety workshop that used a flipped classroom approach integrating team based learning (TBL) and interprofessional simulated application exercises.

RESULTS

Workshop trainees demonstrated an increase in knowledge specifically related to patient safety core concepts on the Team Readiness Assurance Test (TRAT) compared to the Individual Readiness Assurance Test (IRAT) (p = 0.001). Completion rates on the simulation application exercises checklists were high except for a few critical action items such as hand-washing, identifying barriers to care, and making efforts to clarify code status with patient. The Readiness for Interprofessional Learning Scale (RIPLS) subscale scores for Teamwork and Collaboration and Professional Identity were higher on the post-workshop survey compared to the pre-workshop survey, however only the difference in the Positive Professional Identity subscale was statistically significant (p = 0.03). A majority (90%) of the trainees either agreed that the safety concepts they learned would likely improve the quality of care they provide to future patients.

CONCLUSIONS

This novel approach to safety training expanded teaching outside of the classroom and integrated simulation and engagement in error reduction strategies. Next steps include direct observation of trainees in the clinical setting for team-based competency when it comes to patient safety and recognition of system errors.

Status of Nordic research on simulation-based learning in healthcare: an integrative review

Background

Based on common geography, sociopolitics, epidemiology, and healthcare services, the Nordic countries could benefit from increased collaboration and uniformity in the development of simulation-based learning (SBL). To date, only a limited overview exists on the Nordic research literature on SBL and its progress in healthcare education. Therefore, the aim of this study is to fill that gap and suggest directions for future research.

Methods

An integrative review design was used. A search was conducted for relevant research published during the period spanning from 1966 to June 2016. Thirty-seven studies met the inclusion criteria. All included studies were appraised for quality and were analyzed using thematic analysis.

Results

The Nordic research literature on SBL in healthcare revealed that Finland has published the greatest number of qualitative studies, and only Sweden and Norway have published randomized control trials. The studies included interprofessional or uniprofessional teams of healthcare professionals and students. An assessment of the research design revealed that most studies used a qualitative or a descriptive design. The five themes that emerged from the thematic analysis comprised technical skills, non-technical skills, user experience, educational aspects, and patient safety.

Conclusion

This review has identified the research relating to the progress of SBL in the Nordic countries. Most Nordic research on SBL employs a qualitative or a descriptive design. Shortcomings in simulation research in the Nordic countries include a lack of well-designed randomized control trials or robust evidence that supports simulation as an effective educational method. In addition, there is also a shortage of studies focusing on patient safety, the primary care setting, or a combination of specialized and primary care settings. Suggested directions for future research include strengthening the design and methodology of SBL studies, incorporating a cross-country comparison of studies using simulation in the Nordic countries, and studies combining specialized and primary care settings.

Electronic supplementary material

The online version of this article (10.1186/s41077-018-0071-8) contains supplementary material, which is available to authorized users.

The effect of an interprofessional simulation-based education program on perceptions and stereotypes of nursing and medical students: A quasi-experimental study

BACKGROUND

Interprofessional education is intended to train practitioners to collaboratively address challenges in healthcare delivery, and interprofessional simulation-based education (IPSE) provides realistic, contextual learning experiences in which roles, responsibilities, and professional identity can be learned, developed, and assessed. Reducing negative stereotypes within interprofessional relationships is a prime target for IPSE.

OBJECTIVES

We sought to understand whether perceptions of interprofessional education and provider stereotypes change among nursing and medical students after participating in IPSE. We also sought to determine whether changes differed based on the student's discipline.

DESIGN

This was a quasi-experimental pretest-posttest study.

SETTING

The study took place at a large mid-Atlantic public university with a comprehensive health science campus.

PARTICIPANTS

147 senior Bachelors of Science in Nursing students and 163 fourth-year medical students participated.

METHODS

Students were grouped into interprofessional teams for a two-week period and participated in three two-hour simulations focused on collaboration around acutely ill patients. At the beginning of the first session, they completed a pretest survey with demographic items and measures of their perceptions of interprofessional clinical education, stereotypes about doctors, and stereotypes about nurses. They completed a posttest with the same measures after the third session.

RESULTS

251 students completed both the pretest and posttest surveys. On all three measures, students showed an overall increase in scores after the IPSE experience. In comparing the change by student discipline, medical students showed little change from pretest to posttest on stereotypes of doctors, while nursing students had a significant increase in positive perceptions about doctors. No differences were noted between disciplines on changes in stereotypes of nurses.

CONCLUSIONS

This study demonstrated that a short series of IPSE experiences resulted in improved perceptions of interprofessional practice and changes in stereotypical views of each profession even when the experience was not directly designed to address these issues. Differences observed between nursing and medical students should be explored further.

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.

Dyspnea in a Hospitalized Patient: Using Simulation to Introduce Interprofessional Collaborative Practice Concepts

INTRODUCTION

Improved team communication is essential in preventing errors in patient care. Based on TeamSTEPPS concepts, we developed this simulation case scenario to engage learners from various health care professions in interprofessional teamwork. The case was developed for graduating medical, physician assistant, and nursing students with clinical experience, as well as pharmacy students just beginning clinical rotations.

METHODS

Learners are evenly distributed into groups based on their professional training to provide an opportunity to function as a team. Faculty receive case materials prior to the day they will be volunteering and receive just-in-time training to refresh medical management knowledge and to prepare them for interprofessional facilitation, debriefing, and team skills. Faculty start by introducing interprofessional teamwork skills based on TeamSTEPPS concepts and providing an activity in which teams compete to create the longest paper chain. Next, faculty run a scenario featuring a standardized patient or high-fidelity manikin developing dyspnea in a simulated hospital setting. Learners can use skills from their profession-specific education as well as theoretical knowledge while demonstrating interprofessional communication skills during the simulation.

RESULTS

Overall, 1,475 students have been trained with this resource over the last 5 years. Evaluations completed by learners postsimulation have rated this resource favorably. This resource has equivalent outcomes to two other scenarios also in the workshop series, indicating that using this resource alone will meet the workshop objectives.

DISCUSSION

This simulation experience advances the work of interprofessional education in developing increased self-efficacy in learners to be able to implement team skills and work in an interprofessional team.