Interprofessional education among student health professionals using human patient simulation

Exploring perception and attitude of nursing students towards interprofessional education in Saudi Arabia

INTRODUCTION

Interprofessional education is a process designed to facilitate knowledge exchange between healthcare professionals with the aim of improving learning, collaboration, and patient care. It helsps students gain a better understanding of communication, teamwork, and each profession's role. This study aims to examine Saudi undergraduate nursing students' attitudes and readiness for engagement in high-fidelity simulation interprofessional education and practice after training nurse educators in HFS.

METHODOLOGY

A descriptive cross-sectional study was conducted among 311 nursing students. The process of sampling was done by convenience and was not probabilistic. Participants were asked to complete a self-administered questionnaire. The survey included demographic information as well as the Readiness for Interprofessional Learning Scale.

RESULTS

There was a positive attitude toward Interprofessional education among nursing students and a reasonable level of readiness. The Readiness for Interprofessional Learning Scale score was significantly associated with academic years (p ≤ 0.05).

CONCLUSION

Nursing students have a positive attitude towards interprofessional education and are willing to engage in high-fidelity simulation activities. The integration of high-fidelity simulation in interprofessional education can significantly benefit nursing students by enhancing their clinical skills, decision-making abilities, and teamwork dynamics in a controlled environment.

Development and Evaluation of Interprofessional High-Fidelity Simulation Course on Medication Therapy Consultation for German Pharmacy and Medical Students-A Randomized Controlled Study

Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To adapt the pharmacy curriculum for collaborative practice between pharmacy and medical students, we developed an immersive interprofessional collaboration course for pharmacy students using adult and pediatric high-fidelity simulators (HFS) to assess and train medication consultation skills. In a randomized controlled trial, we investigated whether interprofessional training between pharmacy and medical students results in differences in pharmacy students' performance of medication therapy consultation compared to the case of mono-professional training of pharmacy students only. Before and after inter/mono-professional training, each pharmacy student performed an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire. Additionally, an attitude survey towards interprofessional learning was completed by pharmacy and medical students at the end of the training. As expected, interprofessional as well as mono-professional training showed a statistically significant increase in medication consultation skills. Of importance, the performance in the interprofessional training group was significantly better than in the mono-professional group, particularly in drug therapy counselling and consultation behaviors. There was a significant difference between the intervention and control groups in self-assessment scores, and all study participants had positive attitudes toward interprofessional collaboration and training. Therefore, interprofessional training using HFS has been shown to appropriately train pharmacy students for collaborative practice and consultation skills.

Impact of Just-in-Time TeamSTEPPS Training on Team Performance in a Pediatric Escape Room Interprofessional Experience

OBJECTIVE

To compare differences in observed and self-reported team dynamics between those who received versus those who did not receive TeamSTEPPS training prior to an interprofessional escape room scenario.

METHODS

Final-year pharmacy (N = 27) and physician assistant (N = 88) students participated in an escape room featuring pediatric dosing, asthma, otitis media, type 1 diabetes, and vaccine fundamentals. In total, 29 teams were randomized to control (14) or intervention arm (15). The control group went to the escape room and then returned to the classroom for a team-building module including TeamSTEPPS training. The intervention group started with the team-building module then went to the escape room. One faculty observer was assigned to each team and utilized the Performance Assessment Communication and Teamwork (PACT) expert-observer form to assess team performance. Post-event, students completed an abbreviated PACT post-assessment and a self-reflection on the prompt "What were the most important takeaways from today's interprofessional education experience?"

RESULTS

On the PACT expert-observer form, significantly higher global scores were noted for the intervention arm on all items except situation monitoring. On the aggregate observer data from all stations, leadership emerged as statistically different between the 2 groups. On the PACT post-assessment, the intervention arm reported significantly more leadership during the simulation. On the self-reflections, 70.9% versus 64% in the control arm recognized the importance of teamwork in managing patients.

CONCLUSIONS

Just-in-time TeamSTEPPS training improved observed and to a lesser extent, self-reported teamwork and communication skills. Incorporating TeamSTEPPS training immediately prior to an interprofessional education experience may enhance team performance.

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

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

The prevalence of gender stereotypes in pharmacy student simulated counseling sessions utilizing standardized patients

INTRODUCTION

Simulation in healthcare has been a widely adopted modality to gain practical experience prior to working directly with patients. While simulation in academic settings affords many opportunities to enhance learning, it may also present an opportunity to identify cultural stereotypes. The objective of this study was to assess the prevalence of gender stereotypes in pharmacy student simulated counseling sessions.

METHODS

Simulated counseling sessions completed across several cohorts of pharmacy students were reviewed. A video database of these counseling sessions was manually reviewed retrospectively to determine if students or trained actors portraying the role of the pharmacist and patient, respectively, assigned providers a gender without prompting. Secondary analysis included time to provider gender assignment and acknowledgement.

RESULTS

A total of 73 unique counseling sessions were reviewed. Gender was preferentially assigned in 65 sessions. Assigned provider gender was male for all 65 cases. In most (45 out of 65) cases, gender was assigned by the actors.

CONCLUSIONS

Predetermined gender stereotypes exist in simulated counseling sessions. Simulation needs to be continually monitored for promoting cultural stereotypes. Integration of cultural competency into counseling simulation scenarios represents an opportunity to better train healthcare professionals to function within a diverse work environment.

Simulation-Based Education Implementation in Pharmacy Curriculum: A Review of the Current Status

Simulation-based education (SBE) is a fundamental teaching method that complements traditional teaching modalities. SBE has improved students' knowledge, understanding, and numerous essential skills within undergraduate pharmacy education, similar to traditional teaching methods. However, SBE has become crucial for developing students' teamwork, decision-making, and communication skills. Even though the Accreditation Council for Pharmacy Education (ACPE) has acknowledged the benefit of SBE in interprofessional education (IPE) and the introductory pharmacy practice experience (IPPE). This article provides evidence that SBE can be effective beyond that. This narrative review is focused on the literature related to SBE modalities and the assessment methods of student learning outcomes in the undergraduate pharmacy curriculum. The review illustrates that SBE is an effective teaching method that could be utilized within the pharmacy curriculum. The review also could help pharmacy educators decide on the best modality and placement of integrating patient simulation within the pharmacy curriculum. Combining multiple simulation techniques may be the best way to achieve the desired student learning outcomes.

Digital Tools in Behavior Change Support Education in Health and Other Students: A Systematic Review

Due to the increased prevalence of chronic diseases, behavior changes are integral to self-management. Healthcare and other professionals are expected to support these behavior changes, and therefore, undergraduate students should receive up-to-date and evidence-based training in this respect. Our work aims to review the outcomes of digital tools in behavior change support education. A secondary aim was to examine existing instruments to assess the effectiveness of these tools. A PIO (population/problem, intervention, outcome) research question led our literature search. The population was limited to students in nursing, sports sciences, and pharmacy; the interventions were limited to digital teaching tools; and the outcomes consisted of knowledge, motivation, and competencies. A systematic literature review was performed in the PubMed, CINAHL, MEDLINE, Web of Science, SAGE, Scopus, and Cochrane Library databases and by backward citation searching. We used PRISMA guidelines 2020 to depict the search process for relevant literature. Two authors evaluated included studies using the Mixed Methods Appraisal Tool (MMAT) independently. Using inclusion and exclusion criteria, we included 15 studies in the final analysis: six quantitative descriptive studies, two randomized studies, six mixed methods studies, and one qualitative study. According to the MMAT, all studies were suitable for further analysis in terms of quality. The studies resorted to various digital tools to improve students’ knowledge of behavior change techniques in individuals with chronic disease, leading to greater self-confidence, better cooperation, and practical experience and skills. The most common limitations that have been perceived for using these tools are time and space constraints.

Enhancing communication skills among residents in India: An interprofessional education approach

BACKGROUND

Interprofessional education (IPE) provides opportunities to postgraduates to develop communication skills which are vital for interactions with patients, their relatives, colleagues, paramedical and nursing staff. There is a need to develop an innovative IPE based module on communication skills for postgraduates stressing upon the existing lacunae and requirements detected by a validated assessment tool. We assessed the residents' appraisal of communication skills by a validated questionnaire to identify key areas to improve their communication skills and to determine perceptions of all the stakeholders i.e. faculty, nursing staff and paramedical staff.

METHODS

A descriptive correlational design using an online self-administered questionnaire on a sample of a total of 200 participants comprising residents, paramedical staff, nursing staff and faculty of tertiary care hospital. Study was approved by the Institutional Ethical Committee. Data was analysed by SPSS Version 22.0 used. (p value < 0.05 significant).

RESULTS

The participants included 113 residents, 17 paramedical staff, 33 Nursing staff and 37 faculty members. The present study found a significant difference of scores of means between the residents, faculty, paramedical staff and nursing staff p value < 0.05 except for alter centrism, interaction management and environmental control. The mean scores were also significantly different between the first, second and third year residents.

CONCLUSION

This study validates the need to enhance the communication skills of residents. The scores obtained will help us design and refine IPE module for the benefit of the residents.

Fostering Undergraduate Medicine, Nursing, and Pharmacy Students' Readiness for Interprofessional Learning Using High Fidelity Simulation

Background

Interprofessional education is directly linked to high-quality patient care, however, it remains unclear whether senior undergraduate medicine, nursing, and pharmacy students are ready for interprofessional education using high fidelity human patient simulators.

Purpose

The purpose of this study was to explore student’s readiness for interprofessional learning and determine whether participation in high fidelity interprofessional education resulted in higher levels of readiness for interprofessional learning.

Methods

An interventional program starting with a pre-test before the program and a post-test after the program ends were designed with 24 students. The students were assigned to seven interprofessional teams. Each team participated in a high fidelity interprofessional education module designed to teach the clinical management of an adult patient experiencing acute anaphylaxis. The Readiness for Interprofessional Learning Scale (RIPLS) was used as the pre and post-test instrument.

Results

Prior to participation, students reported a high level of readiness for interprofessional learning, but that readiness significantly improved after participation, including more positive attitudes towards teamwork, enhanced communication skills, and improved respect and trust for team members.

Conclusions

The findings from this study show a higher level of readiness for high fidelity interprofessional learning using human patient simulators among senior undergraduate medicine, nursing, and pharmacy students. These findings support the integration of high fidelity interprofessional education into undergraduate medicine, nursing, and pharmacy undergraduate education programs.

Perception of interprofessional education and educational needs of students in South Korea: A comparative study

Due to the recent emphasis on the importance of interprofessional education (IPE) in healthcare fields, interest in IPE introduction is increasing in South Korea. The purpose of this study was to examine the differences in perceptions of medical, nursing, and pharmacy students regarding IPE. Also, the study aimed at identifying the priority rankings of educational needs by analyzing the differences between students’ perceptions of the importance level and the present level for each interprofessional competency. A cross-sectional study was carried out using a survey. A total of 1,500 questionnaires were distributed, of which 1,084 were returned (response rate, 72.3%). The participants were 559 medical, 393 nursing, and 96 pharmacy students. The questionnaire comprised items on the students’ perception of IPE and their interprofessional competency. The questionnaire comprised 12 items on their IPE perception and 9 items on their interprofessional competency. These items were developed by examining the content validity by medical educational specialists and conducting a factor analysis for verification. Data were analyzed using the t-test and ANOVA, and Borich’s formula was used to calculate the rank of educational needs.89.6% did not know the meaning of IPE. The difference in students’ perception of IPE was not significant by grade. Further, the level of IPE perception was higher for female than male students and for students who knew the meaning of IPE than those who did not. The nursing students’ perception of the importance, preference, and effectiveness of IPE was the highest, whereas medical students’ perception was the lowest. All students perceived their present level to be lower than the importance level for each interprofessional competency. Interprofessional communication skills (6.791) were highly necessary for students. These results will serve as baseline information for developing IPE programs in South Korea.

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

OBJECTIVE

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

DESIGN

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

DATA SOURCES

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

REVIEW METHODS

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

RESULTS

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

CONCLUSION

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

Nurse Practitioner and Medical Students' Perceptions of Teamwork Before and After a Standardized Patient Pilot Simulation

Attitudes toward interprofessional education are positive overall, but inferences about its key elements are hard to draw. Studies with qualitative strands examining interprofessional education's key elements (communication, collaboration/teamwork, learning in practice, and understanding of roles) are especially needed. This mixed quantitative/qualitative standardized patient simulation involved 10 family nurse practitioner and 10 medical students. Both cohorts expressed improved teamwork confidence but were concerned about the complexity of teamwork and pressures on communication. At the complexity/communication nexus, nurse practitioner students thought interprofessional trust and equality were key; medical students saw the importance of strategizing multiple professional perspectives.

Large-group, asynchronous, interprofessional simulation: Identifying roles and improving communication with student pharmacists and student nurses

BACKGROUND

Accreditation standards for health professions training programs continue to require interprofessional education (IPE) activities. Therefore, it is important for faculty collaboration to satisfy these requirements and provide meaningful, mutually beneficial opportunities for students to participate and learn. The medication use process is an integral component of nursing and pharmacy education. When feasible, asynchronous IPE activities that promote medication administration safety and facilitate equal contribution from involved students should be introduced into respective curricula.

INTERPROFESSIONAL EDUCATIONAL ACTIVITY

This study employed a retrospective, pretest-posttest design to measure confidence, satisfaction, and communication. The asynchronous simulation included first-year (junior) student nurses (n = 126) and first year (P1) student pharmacists (n = 152). The simulation focused on the role-related knowledge, skills, and attitudes required to accurately call-in, retrieve, and fill a prescription. Details regarding design, setting, participants, facilitation of the simulation, and barriers overcome are described.

DISCUSSION

Descriptive statistics are provided for satisfaction and confidence, with changes in confidence analyzed using binomial probability confidence intervals. This IPE simulation was an efficient and effective model for introducing students to the specific activity of communicating prescriptions among key members of the interprofessional team.

IMPLICATIONS

Students reported increased confidence and satisfaction with this activity, which supports future iterations of the asynchronous simulation.

The effectiveness of interprofessional education programs for medical, nursing, and pharmacy students

PURPOSE

This study is to develop an interprofessional education (IPE) program for medical, nursing, and pharmacy students and to analyze the effectiveness.

METHODS

Subjects consisted of 116 students (41 medical, 46 nursing, and 29 pharmacy students) enrolled in their final year. Subjects were randomly assigned to either the intervention group or the control group, with 58 in each group. A pretest-posttest control group design was used. The program was operated for a single day, and consisted of small-group activities and role-play. We utilized the following tools: Perceptions towards Interprofessional Education (PIPE), Self-Efficacy for Interprofessional Experiential Learning (SEIEL), and Perception towards Interprofessional Competency (PIC). We used t-test and analysis of covariance for analysis.

RESULTS

The PIPE tool revealed that the scores of the intervention group were significantly higher than those of the control group (p=0.000). The result was the same when the scores were categorized into the groups medical students (p=0.001), nursing students (p=0.000), and pharmacy students (p=0.005). The SEIEL study also indicated the intervention group scored significantly higher than the control group (p=0.000). However, pharmacy students did not reveal significant (p=0.983). The intervention group scored significantly higher than the control group in the PIC. A concluding survey of the intervention group indicated that most students were satisfied with the IPE program.

CONCLUSION

We hope this study will provide useful information for designing and improving IPE programs in other universities.

Interprofessional Service Learning in Medical Education: a Year-Over-Year Assessment of Student Feedback

Community service learning has been extolled as an effective vehicle for interprofessional education based upon studies assessing the short-term impact of these experiences on positive team behaviors and communication skills. Through this study, the authors explore year-over-year student impressions of an interprofessional service learning program to determine whether the short-term successes detailed in prior studies are sustainable over time. Course evaluations were collected from 168 first-year medical students (M1) at Virginia Tech Carilion School of Medicine (VTCSOM) over a 4-year period beginning in 2013 and ending in 2017. All 238 current and former VTCSOM students were also prospectively surveyed and 87 (37%) responses were received. Study results indicate that first-year medical students consistently find interprofessional service learning opportunities to be valuable with regard to improving understanding of the roles of other health professionals, as well as helping to generate positive team behaviors. However, as students progress through their medical education and beyond, they may perceive the skills learned and obstacles encountered through these opportunities to be less generalizable to a clinical setting. These findings add to a growing body of evidence supporting the efficacy of service learning in interprofessional education. However, they also suggest that a potential divide may exist between the intended goals of these experiences at an administrative level and the team-based behaviors and communication skills that clinical students and practicing physicians use to navigate interprofessional conflict in the workplace.

Interprofessional objective structured clinical examination with physician assistant and pharmacy students - A qualitative and quantitative study

BACKGROUND

To assess the impact of an interprofessional objective structured clinical examination (iOSCE) on attitudes/perceptions regarding interprofessional practice (IPP) and to determine if patient (simulated) outcomes improved with interprofessional collaboration (pharmacy and physician assistant (PA) students).

INTERPROFESSIONAL EDUCATION ACTIVITY

A team of interprofessional faculty designed an iOSCE case and grading checklist containing key interventions. Students individually reviewed the case and were asked to document potential changes to the admission orders. Then they were given the opportunity to collaborate in an interprofessional team to discuss the case and orders. Finally, the team presented their recommendations to an interprofessional faculty panel. Individual and team scores were compared to determine the impact of interprofessional collaboration. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered pre- and post-iOSCE to assess changes in opinions about interprofessional learning.

DISCUSSION

Individual and team iOSCE scores for 187 students were evaluated (86 PA and 101 pharmacy). A 21% absolute increase in the number of key interventions was found when comparing average individual scores to average team scores (2.11/5 vs. 3.18/5, p < 0.001). While in aggregate the students had a positive attitude towards IPE pre-iOSCE, RIPLS responses were strengthened post-iOSCE.

IMPLICATIONS

Through iOSCEs, it appears students can learn from and with one another to improve patient care and gain perspective on the roles/skills of interprofessional colleagues.

Measuring health care students' attitudes toward interprofessional learning, perceptions of effectiveness as an interprofessional team member, and competence in managing adult cardiac arrest

BACKGROUND AND PURPOSE

Interprofessional education can be used to prepare healthcare graduates for teamwork. Simulations, when used with interprofessional education, create realistic clinical situations that promote teamwork. Faculty assessed changes in pharmacy and nursing students' competence in treating adult cardiac arrest and perceived readiness for interprofessional learning and teamwork.

EDUCATIONAL ACTIVITY AND SETTING

Eighty-three pharmacy students and 57 nursing students participated in a high fidelity simulation focused on adult cardiac arrest as an expectation of their respective courses. This study took place at a single campus College of Health Professions located at a public land grant institution.

FINDINGS

The Readiness for Health Care Students for Interprofessional Learning Scale (RIPLS) and Team Skills Scale (TSS) were used to develop a survey administered prepost simulation. A paired t-test indicated statistically significant increases of mean values prepost (p < 0.001) for: teamwork and collaboration, professional identity, team skills, and competence. An independent sample t-test found no differences by gender or degree.

DISCUSSION

This research supports using simulation in interprofessional education to increase competence and promote changes in attitudes toward interprofessional learning and teamwork.

SUMMARY

An interprofessional simulation increased student's perceived competence and positively increased perceptions of learning and working with other health profession students.

Focus group describing simulation-based learning for cardiovascular topics in US colleges and schools of pharmacy

INTRODUCTION

This qualitative focus group study sought to describe how colleges of pharmacy use simulation-based learning (SBL) to teach cardiovascular topics and to identify challenges and benefits.

MATERIAL AND METHODS

Participants were recruited from a screening survey disseminated via e-mail to select American College of Clinical Pharmacy Practice and Research networks. Subjects were selected based on diversity in institution and simulation types. Two 1-hour focus group sessions were conducted by the primary investigator following a script designed by the research team. Each recorded session was independently reviewed by all investigators and coded into final themes. Results are reported in a qualitative fashion.

RESULTS

Five individuals provided consent and participated. Themes identified include topics, formats, interprofessional education, challenges, strategies for success, and benefits. Frequent topics included advanced cardiac life support, heart failure, hypertension, and transitions of care. Multiple formats were used including standardized patients or providers, task trainers, and high-fidelity mannequins. Multiple institutions reported simulating interprofessional teams by involving students from other health professions. Scheduling, pharmacy program size, faculty availability, and logistics around planning and/or conducting an event were identified challenges. Institutions reported success when clear expectations were provided to students and skill development progressed from low-stakes to high-stakes events. Benefits reported included real world applicability with participants noting that students do not realize the importance of SBL until they have reached rotations.

CONCLUSIONS

Various topics and simulation methods were employed to teach cardiovascular topics. While challenges exist, institutions have identified strategies for success and report students recognized the benefits to their learning.

Senior nursing student's perceptions of an interprofessional simulation-based education (IPSE): A qualitative study

Purpose

The purpose of this study was to explore the perceptions and attitudes toward interprofessional simulation-based education among Lebanese senior nursing students.

Methods

The study used an exploratory descriptive qualitative approach and collected data through focus groups. All focus group discussions were audiotaped, transcribed verbatim, and narratives were compared with the recordings to establish accuracy, credibility and reliability of data. Qualitative narratives were translated to English and analyzed through an inductive thematic content analysis. This study was reported according to the Standards for Reporting Qualitative Research (SRQR).

Results

Four major themes were identified: understanding roles and responsibilities, enhancing collaboration, improve personal and interpersonal skills, and patient outcomes.

Conclusion

The senior nursing students showed a positive perception and attitude toward interprofessional simulation-based education. They found that interprofessional simulation-based education increased their knowledge and understanding of the importance of the roles of other professions, as well as their own role in providing patient care. Furthermore, they perceived that interprofessional simulation-based education improved their personal and interpersonal skills. These positive findings may contribute to their future success in an interprofessional team, which could lead to improved patient outcomes. Therefore, future research is needed to see how the reported benefits of interprofessional simulation-based education training are reflected in clinical practice and related to patient outcomes.

Pharmacy Students' Perspectives on Interprofessional Learning in a Simulated Patient Care Ward Environment

Objective. To assess pharmacy students' opinions of an interprofessional learning (IPL) course in their final year of the Bachelor of Pharmacy program at The University of Auckland. Methods. Pharmacy students participated in the second day of a two-day simulation-based course, WardSim, alongside medical and nursing students in an acute care, hospital ward setting. After finishing the course, all students were asked to complete a questionnaire. The responses of pharmacy, nursing, and medical students on the scaled questions were compared. An in-depth thematic analysis of the pharmacy students' responses to the open-ended questions was completed using an iterative process. Results. Significant differences were found among the students' responses regarding the prioritization of care, systematic assessment of patients, and communication strategies. Pharmacy students had less favourable responses regarding the IPL experience than medical and nursing students. However, overall responses were positive. Some of the themes that emerged among the pharmacy students' responses included: learning communication tools, being assertive in communicating with other health care professionals, and understanding their own and others' roles in the health care team. Furthermore, some pharmacy students reported feeling underprepared for and underutilized during patient care scenarios. Conclusion. An IPL experience in an acute patient care setting demonstrated clear and beneficial learning outcomes for pharmacy students, especially in regards to communicating and understanding their roles and those of others on their team. Tailoring the pre-work or scenarios for the IPL experience to be more pharmacy orientated and having pharmacy students participate on both days may improve the preparedness for IPL.

An interprofessional clinical toxicology advanced pharmacy practice experience

BACKGROUND AND PURPOSE

Clinical toxicology is a blend of science, research, and patient management practices involving human poisonings from exposure to natural and synthetic toxins. The objective of this study was to describe the components of an elective advanced pharmacy practice experience (APPE) in clinical toxicology at California Poison Control System (CPCS).

EDUCATIONAL ACTIVITY AND SETTING

The APPE requirements included a mix of active participation in case management and supplemental educational exercises, case presentations and consultations, and a structured self-study component consisting of readings and on-line modules. In addition, there were two active learning activities, high acuity poisoning simulation scenarios utilizing a high-fidelity mannequin, and an antidote tasting session.

FINDINGS

From April 2012 to October 2017, 82 student pharmacists completed this APPE. Pharmacy students completed 85 pre-simulation surveys and 80 post-simulation surveys. Survey results showed an increase in pharmacy student beliefs that a clinical pharmacist should be involved in the differential diagnosis and management of patients (60% pre-simulation vs. 78.8% post-simulation, p = 0.009). APPE pharmacy students completed an evaluation of the preceptors(s), site, and learning experience. The average score for all areas on the preceptor and site evaluations was >4.5 on a 5-point Likert scale. Qualitative data themes included student satisfaction with opportunities, feedback, and the interprofessional and collaborative environment.

SUMMARY

An APPE in the CPCS was successfully designed and implemented. The APPE provides an interprofessional collaborative learning environment that allows student pharmacists to understand the unique role of the pharmacist in this setting.

Interprofessional Perceptions and Attitudes Among Pharmacy and Family Nurse Practitioner Students

INTRODUCTION

Interprofessional education (IPE) activities involving pharmacy (PharmD) and family nurse practitioner (FNP) students is understudied. Interactions between PharmD and FNP students have become important since most recent Accreditation Council for Pharmacy Education standards included a requirement for schools of pharmacy to have IPE. The primary objective of this study is to evaluate the perceptions and attitudes among PharmD and FNP students towards an IPE activity.

METHODS

Atleast 1 student from each discipline was assigned to one team and participated in simulated ambulatory care scenarios. A survey was completed by students after the activity, which mapped each survey statement to an Interprofessional Education Collaborative (IPEC) core competency.

RESULTS

Perceptions and attitudes between PharmD and FNP students were similar, with no significant differences except with 2 statements, one survey statement in the Teams and Teamwork core competency and another in the Roles/Responsibilities core competency. A less favorable response with more than half of FNP students reporting "strongly agree" (18%) and "agree" (35%) resulted for the statement regarding their professional roles in the IPE activity.

CONCLUSION

PharmD and FNP students reported favorable perceptions and attitudes in each IPEC core competency after participation in the IPE activity. There may be a need to review the discipline's professional role before participating in the activity.

An interprofessional team simulation exercise about a complex geriatric patient

Interprofessional collaboration is an essential skill to optimize the care of older adults with complex problems. We successfully developed and evaluated an interprofessional teamwork simulation exercise for medical, nursing, pharmacy, and social work students. Pharmacy students participated via video conferencing. Before the simulation, students watched a teamwork video and reviewed the patient case. Following an icebreaker exercise, interdisciplinary faculty facilitated a discussion highlighting effective teamwork strategies. Students then collaborated to develop a discharge plan, followed by a simulated family meeting with a theater student. Interdisciplinary faculty again provided structured debriefing highlighting principles of effective teamwork. Students self-rated interprofessional practice core competencies were evaluated using a retrospective pre/post survey and analyzed using paired t-tests. We qualitatively examined the use of distance technology and assessed learner's satisfaction with the project. All core competency categories for all disciplines demonstrated significant improvements in mean scores. Students' qualitative comments demonstrated positive impact on learning interprofessional core competencies.

Improving Collaboration Among Social Work and Nursing Students Through Interprofessional Simulation

This project implemented first-time simulation with nursing and social work students. Students participated in a contextual learning experience through a patient simulation of interprofessional practice as a health care team member and reflection through debriefing and open response comments. Simulation offers a means to practice interprofessional collaboration prior to entering practice. Participants reported an increased understanding of the scope of practice of other team members through their reflections following simulation. In addition, participants reported increased comprehension of team dynamics and their relationship to improved patient care. Overall, the simulation encouraged development of the skills necessary to function as part of a collaborative, interprofessional team.

Heart rate variability can clarify students' level of stress during nursing simulation

Simulation is regarded as an effective educational method for the delivery of clinical scenarios. However, exposure to unfamiliar environments during simulation can cause excessive stress among students, possibly leading to unnatural speech/behavior and poor skill learning (Yerkes-Dodson’s law). Thus, assessing students’ stress in a simulation can provide educators with a better understanding of their mental state. This study sought to clarify stress changes throughout the progression of the simulation by measuring heart rate variability and students’ subjective reactions in 74 nursing students. Heart rate variability was calculated in terms of its high-frequency (HF) and low-frequency/high-frequency (LF/HF) components during 4 phases—the break, patient care, reporting, and debriefing. Students were interviewed about stress experienced during the simulation. The results showed that HF decreased significantly from the break to the patient care and reporting phases. Furthermore, LF/HF increased significantly from the break to the reporting phases. Approximately 55 students felt stressed during the simulation, 24 of whom felt most stressed during the reporting phase. Therefore, the reporting phase involved high objective and subjective stress. It may be possible that the educator’s evaluative attitude increased students’ stress. Therefore, a stress intervention during the reporting phase might further improve students’ performance during that phase. The debriefing phase did not significantly differ from the break phase for objective stress, and students did not report feeling stressed. Thus, in this phase, they were released from the stress of the reporting phase and the unfamiliar environment. During this phase, they might be able to learn what they could not understand owing to high stress in the patient care and reporting phases. This study provides objective and subjective evidence of students’ stress during simulation, and indicates the necessity of providing support during the reporting phase and the importance of debriefing when using clinical scenarios for teaching clinical skills.

Integrating Interprofessional Education and Cultural Competency Training to Address Health Disparities

PROBLEM

Many U.S. medical schools have accreditation requirements for interprofessional education and training in cultural competency, yet few programs have developed programs to meet both of these requirements simultaneously. Furthermore, most training programs to address these requirements are broad in nature and do not focus on addressing health disparities. The lack of integration may reduce the students' ability to apply the knowledge learned. Innovative programs that combine these two learning objectives and focus on disenfranchised communities are needed to train the next generation of health professionals.

INTERVENTION

A unique interprofessional education program was developed at the University of Arkansas for Medical Sciences Northwest. The program includes experiential learning, cultural exposure, and competence-building activities for interprofessional teams of medicine, nursing, and pharmacy students. The activities include (a) educational seminars, (b) clinical experiential learning in a student-led clinic, and (c) community-based service-learning through health assessments and survey research events.

CONTEXT

The program focuses on interprofessional collaboration to address the health disparities experienced by the Marshallese community in northwest Arkansas. The Marshallese are Pacific Islanders who suffer from significant health disparities related to chronic and infectious diseases.

OUTCOME

Comparison tests revealed statistically significant changes in participants' retrospectively reported pre/posttest scores for Subscales 1 and 2 of the Readiness for Interpersonal Learning Scale and for the Caffrey Cultural Competence in Healthcare Scale. However, no significant change was found for Subscale 3 of the Readiness for Interpersonal Learning Scale. Qualitative findings demonstrated a change in students' knowledge, attitudes, and behavior toward working with other professions and the underserved population.

LESSONS LEARNED

The program had to be flexible enough to meet the educational requirements and class schedules of the different health professions' education programs. The target community spoke limited English, so providing interpretation services using bilingual Marshallese community health workers was integral to the program's success.

Students' Perspectives on Interprofessional Teamwork Before and After an Interprofessional Pain Education Course

Objective. To evaluate changes in pharmacy and nursing student perspectives before and after completion of an interprofessional education (IPE) course. Methods. A pre- and post-perception scale descriptive prospective study design utilizing Interdisciplinary Education Perception Scale (IEPS) and Collaboration and Satisfaction about Care Decisions (CSACD) with self-reported statements of knowledge and importance of professional roles was used. Results. Significant improvement was shown for IEPS and CSACD overall and for both pharmacy and nursing students. Post-scores improved from 2013 to 2014, with significant improvements for IEPS. Pharmacy student findings show an increase in knowledge and importance of their roles and those of nursing students. Nursing students grew significantly in their knowledge of the pharmacist's role only. Conclusion. An IPE course for nursing and pharmacy students, taught by diverse health professionals with a care plan and simulation assignments, fosters the Interprofessional Education Collaborative panel's competencies for IPE.

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

STATEMENT

This review explores the state of prelicensure interprofessional education (IPE) using simulation-based education (SBE) by examining studies that use SBE for prelicensure IPE through a critical review of the research literature. We focus particularly on studies that included experiential SBE with reported measures and formal IPE with prelicensure participants from at least 2 health care professions. Fifty-four studies met criteria. We explore these studies, providing a compilation of information (e.g., educational, simulation, and research methods used; outcome measures reported; and demographics of learner groups), identifying themes that may affect learning, as well as surfacing challenges and gaps in the field. The quality and rigor of the existing literature is inadequate to confidently determine factors that affect learning through simulation-enhanced IPE. We suggest that more rigorous research criteria be included in future studies and a list of reporting items be provided, where future publications can enhance knowledge to guide best practice in simulation-enhanced IPE.

Currently Available Tools and Teaching Strategies for the Interprofessional Education of Students in Health Professions: Literature review

Interprofessional education (IPE) is designed to provide students from different health sectors with opportunities to work together to enhance future collaboration. The implementation of IPE activities is a current trend in various countries. This review exclusively targets IPE issues involving undergraduate health profession students and highlights various approaches in different regions. A total of 28 articles published in peer-reviewed journals between January 2012 and July 2015 were assessed to determine recent trends in IPE implementation. Nine main strategies were identified: simulation-based education programmes; rotations in rural and community settings; interprofessional training wards; patient-centred case studies; theme-centred workshops; student seminars; student-delivered lectures; health promotion activities; and interactive lectures in a common setting. Many of these institutions had not restricted themselves to a single strategy and supplemented these activities with additional teaching or learning methods. Recommendations gathered from these diverse approaches may assist the development of sustainable strategies for implementing IPE in undergraduate medical curricula.