A preliminary simulation-based qualitative study of healthcare students’ experiences of interprofessional primary care scenarios

Using Simulation to Improve Communication Skills

Ineffective communication is implicated in 80% of medical errors, costing the United States approximately $12 billion annually. Teaching communication skills is a component of nursing curricula linked to improved patient outcomes. Simulation-based experience (SBE) is a strategy for healthcare professionals to learn communication skills. Providing nurses with the ability to practice nurse-nurse, nurse-physician, nurse-patient, and team communication skills in a psychologically safe learning environment provides an opportunity for skill development and meaningful self-reflection. The multiple modalities for SBE support needed communication techniques for skill development and acquisition to improve patient outcomes.

A qualitative study of the value of simulation-based training for nursing students in primary care

BACKGROUND

Clinical placement is an essential component of nursing education, providing students with the opportunity to apply theoretical knowledge to practice. However, challenges such as lack of supervision and passive involvement in tasks can hinder the learning experience. Supplementing clinical placement with simulation-based training (SBT) has been explored as a potential solution, though this approach has been underexplored within primary care. This study aimed to explore the educational value of a supplemental SBT course for nursing students during primary care placement, as well as the adaption of this approach to a primary care setting.

METHODS

A qualitative descriptive study was conducted at a medical education and simulation academy in Denmark. Sixth-semester nursing students on placement in primary care were invited to participate. The intervention consisted of a three-day simulation course covering core nursing competencies and common clinical conditions encountered within primary care. Simulation adopted a standardised patient approach. Data was collected using focus group interviews, which was analysed using inductive thematic analysis.

RESULTS

Thirty-one nursing students participated in the study. Seven themes emerged from the analysis, including perceptions, educational value, simulation adjustments to primary care, educators' competencies, learning needs within primary care, challenges of clinical placement and career guidance. Generally, participants perceived the intervention positively, appreciating its relevance to their clinical placement and its educational impact in this context. Participants also provided insights into the adaptation of SBT to a primary care setting, as well as nursing students' learning needs within this context.

CONCLUSION

The findings indicate that the intervention had a positive impact on participant competencies within this context and enhanced their clinical practice within primary care. Furthermore, the results inform educators on how to effectively employ primary care-related SBT. Overall, this study supports the need for an increased application of SBT within primary care.

TRIAL REGISTRATION

Not relevant.

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.

Reflections on the design and application of 'Surveypura': a simulation-based pedagogical tool for quantitative research methods in public health and social sciences

It has been reported from various contexts that learning quantitative methods for public health and social research is challenging for students. Based on our observations of these challenges, we designed a simulation-based pedagogical tool called Surveypura to support classroom-based learning of quantitative research methods. The tool includes a large illustration of a fictional village with 155 houses, alongside data for each of the households. The features of the houses, household characteristics, and the village have been carefully designed to give the visual feel of an actual village and better assist the pedagogical process. The tool was used by five facilitators with their masters' students at our university in courses on social research and epidemiology. Our observations of the sessions and interactions with facilitators and students suggested that the tool supported more engaged learning of quantitative research methods in a non-intimidating manner. We believe that Surveypura can be a useful simulation-based pedagogical tool to teach quantitative research methods in epidemiology and social sciences even in other contexts.

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

REGISTRATION NUMBER

CRD42022325514 (PROSPERO).