Incorporating Simulation Into Your Plan-Do-Study-Act Cycle

Evaluating the Effectiveness of a Virtual Mock Interview for Health Professions Students

BACKGROUND

Virtual mock interviews were offered to students to improve job interviewing skills. This educational quality improvement project aimed to use virtual mock interviews to increase student preparedness and confidence, and reduce anxiety related to professional interviews.

METHOD

Health professions students (n = 19) participated in the mock interviews conducted and recorded through a web-based meeting. Students received the recorded interview to watch before follow-up. Students completed pre- and postquestionnaires that addressed students' preparedness, confidence, and anxiety related to interviewing.

RESULTS

Participants' confidence and preparedness improved significantly in their virtual interviews (p < .001), and their anxiety decreased significantly after the virtual interviews (p < .001). After watching the interviews, students' reported eye contact needed improvement and answers included too many "uhms."

CONCLUSION

Students benefited from the virtual mock interviews. Mock virtual job interviews may have a positive effect on successful job acquisition in health professions. [J Nurs Educ. 2023;62(8):479-482.].

Let us to the TWISST; Plan, Simulate, Study and Act

Translational Work Integrating Simulation and Systems Testing (TWISST) is a novel application of simulation that augments how we discover, understand, and mitigate errors in our system. TWISST is a diagnostic and interventional tool that couples Simulation-based Clinical Systems Testing with simulation-based training (SbT). TWISST tests environments and work systems to identify latent safety threats (LSTs) and process inefficiencies. In SbT, improvements made to the work system are embedded in hard wire system improvements, ensuring optimal integration into clinical workflow.

Methods

Simulation-based Clinical Systems Testing approach includes simulated scenarios, Summarize, Anchor, Facilitate, Explore, Elicit debriefing, and Failure Mode and Effect Analysis. In iterative Plan-Simulate-Study-Act cycles, frontline teams explored work system inefficiencies, identified LSTs, and tested potential solutions. As a result, system improvements were hardwired through SbT. Finally, we present a case study example of the TWISST application in the Pediatric Emergency Department.

Results

TWISST identified 41 latent conditions. LSTs were related to resource/equipment/supplies (n = 18, 44%), patient safety (n = 14, 34%), and policies/procedures (n = 9, 22%). Work system improvements addressed 27 latent conditions. System changes that eliminated waste or modified the environment to support best practices mitigated 16 latent conditions. System improvements that addressed 44% of LSTs cost the department $11,000 per trauma bay.

Conclusions

TWISST is an innovative and novel strategy that effectively diagnoses and remediates LSTs in a working system. This approach couples highly reliable work system improvements and training into 1 framework.