A2 Impact of the LINKS Workshop on Interprofessional Team Communication Skills in Undergraduate Healthcare Students

Modern medical care increasingly requires coordinated teamwork and communication between healthcare professionals of different disciplines. Unfortunately, healthcare professional students are rarely afforded the opportunity to learn effective methods of interprofessional (IP) communication and teamwork strategies during their education. The question of how to best incorporate IP interactions in the curricula of the schools of health professions remains unanswered. We aim to solve the lack of IP education in the pharmacy curricula through the use of high fidelity simulation (HFS) to allow teams of medical, pharmacy, nursing, physician assistant, and social work students to work together in a controlled environment to solve cases of complex medical and social issues. Once weekly for a 4-week time period, students worked together to complete complex simulation scenarios in small IP teams consisting of pharmacy, medical, nursing, social work, and physician assistant students. Student perception of the use of HFS was evaluated by a survey given at the conclusion of the HFS sessions. Team communication was evaluated through the use of Communication and Teamwork Skills (CATS) Assessment by 2 independent evaluators external to the project. The CATS scores improved from the HFS sessions 1 to 2 (p = 0.01), 2 to 3 (p = 0.035), and overall from 1 to 4 (p = 0.001). The inter-rater reliability between evaluators was high (0.85, 95% CI 0.71, 0.99). Students perceived the HFS improved: their ability to communicate with other professionals (median =4); confidence in patient care in an IP team (median=4). It also stimulated student interest in IP work (median=4.5), and was an efficient use of student time (median=4.5). The use of HFS improved student teamwork and communication and was an accepted teaching modality. This method of exposing students of the health sciences to IP care should be incorporated throughout the curricula.

While most studies focus on individual training of oral communication in English as a Foreign Language (EFL), this study took a social constructivist perspective in examining the effect of an interpersonal process, that is, peer feedback, on the development of oral communication performance and communication strategy use. A mobile application was developed to facilitate learners’ engagement in discussion tasks, replay their conversation as well as carry out peer feedback. To examine the effect of mobile-assisted peer feedback, a quasi-experimental was conducted at a vocational university in Taiwan for five weeks. Forty EFL participants were assigned to an experimental group (n = 20), who received peer feedback on their oral communication performance and strategy use, and a control group (n = 20), who received no peer feedback on their oral communication ability and strategy use. The results show that the use of peer feedback enhanced students’ oral communication performance but did not improve their communication strategy use. The findings suggest that with the support of mobile-based peer feedback, students were able to monitor their oral production and provide/receive corrective feedback that enhanced their overall communication performance. It was also found that the feedback provided by the students was not concrete enough to address the use of the target communication strategies. However, the peer feedback data show that students tended to provide varying communication strategies that were not taught in the study but were considered beneficial to their overall oral communication performance. Possible explanations for the findings and future directions are discussed in this paper.

Hypothesis Modern healthcare is delivered in teams; however, healthcare education has lagged behind practice in providing opportunities for students to learn the skills required to function effectively as a member of an inter-professional (IP) team. Educators are challenged to create effective training activities that expose students to communication skills and allow the opportunity to practice these skills. The outcome of these activities should be students who use these skills in the clinical environment to improve patient care. This highlights a second set of challenges – creating training curricula that effectively transfer these skills from the simulation lab into actual clinical practice, and developing metrics to assess the transfer of training.Our hypothesis is that reflective writing can be used to assess the impact of an IP training curriculum on the students’ application of communication skills in the clinical environment. Methods We developed a simulation-based curriculum for nursing, respiratory (RT), and medical (med) students around critical care topics. In one station, students engaged in faculty facilitated group problem-solving for ventilator alarms, exam and transfer of a ventilated patient. The second station involved immersive simulation in which IP student teams assessed and managed a patient with a cardiac arrhythmia. Within the technical skills training, nursing and medical faculty co-led discussion and demonstration of interprofessional team skills including closed-loop communication, flattened hierarchy, anticipatory behavior, role clarity, and shared mental model. Curriculum effectiveness was evaluated through post workshop survey and participant reflective essays addressing an example of how the skills were applied in practice. 3 independent trained reviewers used qualitative content analysis to identify themes in each of the essays. Differences were resolved through discussion and consensus. Results One-hundred nursing, 20 med, and four RT students participated. Fortynine nursing and 17 med students filled out post surveys. One-hundred nursing and 20 med students completed reflective writing. We coded 20 randomly sampled nursing essays and 20 medical student essays. 65/67 students rated the workshop as good or excellent in teaching teamwork skills. Nursing and med student reflective writing themes were similar. We observed different Kirkpatrick levels of impact in the essays, including multiple levels in a single essay. 75% of students described applying at least one new teamwork skill in clinical practice, and 60% of these students observed an improved patient, team or personal outcome as a result of skill use, including improved efficiency and quality of care, fewer errors and increased confidence. 35% observed a teamwork skill in a team member, and 64% described new knowledge or awareness. The dominant skills used or observed were closed-loop communication, role clarity, and flattened hierarchy. Conclusion This IP simulation-based workshop was well rated by students, who felt this format effectively taught teamwork skills. A single exposure to these skills has incomplete transfer into clinical practice for these undergraduate learners. The reflective writing pieces were completed within one month of training, but we expect that if teamwork skills haven’t been practiced by then, they are not likely to be used without additional training or structured opportunities to practice. Additional measures of participants’ teamwork skills in the lab and in practice would help better understand the correlation between self-reflection and actual effectiveness of teamwork skills in an individual. While much of team training research has been focused on practicing providers, interventions at the early clinical or pre-clinical levels may prove more effective. More work is needed to understand the “dosing” and “frequency” required for effective teamwork skills acquisition and transfer to practice. Disclosures None

The relationship between interprofessional education experience and perceptions, values, and attitudes towards interprofessional collaboration in dietetics practice

Effective interprofessional (IP) communication is crucial to high-quality patient care, but significant obstacles remain regarding implementing IP communication curricula for undergraduate medical students. As such, as part of a bootcamp required for University of Pittsburgh graduating medical students in 2021, we developed and evaluated a workshop using clips from medical television shows (eg, ER) to teach IP communication skills. The workshop was hosted on Zoom videoconferencing software and evaluated using pre- and postcurricular surveys that included adapted Communication Skills Attitude Scale (CSAS) and Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R) instruments. The postcurricular survey also included two open-ended items. We used Wilcoxon signed-rank tests to compare pre- and postcurricular CSAS and SPICE-R scores and used thematic analysis for qualitative data. Approximately 94% (n = 105) of assigned students attended the workshop. Comparison of pre- and postcurricular means for all CSAS and SPICE-R items indicated improvements in attitudes toward communication training and IP communication, with statistically significant (P < 0.05) changes for 4 of 10 (40%) CSAS items and 8 of 10 (80%) SPICE-R items. Thematic analysis of open-ended items suggests that the workshop is acceptable to students and may be efficacious at improving both their IP communication skills and skills related to addressing equity and bias. Results suggest that using clips from fictional medical television programs may be a valuable approach to teaching graduating medical students IP communication skills. Future research could examine whether improved attitudes are sustained over time and the influence of the workshop on clinical IP communication behavior.

Evidence-based practice collectively involves research evidence, clinician expertise, and patient preference while making health care decisions. Due to health care reform legislation, there is grea...

The use of inter-professional (IP) learning events in postgraduate education has been well established over the past few years within the UK. In fact, there is evidence that IP simulation has a much bigger impact on learning than the traditional uni-professional (UP) simulation. Indeed, a study by Watters et al demonstrated that IP simulation training resulted in greater improvements in communication, teamwork and leadership skills for doctors and nurses in comparison with UP simulation.1 Likewise, it is clearly stated in the General Medical Council’s document ‘Outcome for Graduates’ that newly qualified doctors must be able to ‘learn and work effectively within a multi-professional team,’2 demonstrating the importance that is placed on IP working and learning. Although there have been attempts to improve IP education within undergraduate education, there is evidence that these students, particularly those studying medicine, get comparatively inadequate interaction with other groups of health professionals until qualification.3 It was on this premise that the medical educational team at Princess Alexandra Hospital NHS Trust, a district general hospital in the UK, organised IP high-fidelity simulation afternoons involving medical, nursing and physician associate (PA) students. The aims of the sessions were to promote teamwork, communication and leadership skills among the students. In total, there were …

AimTo explore the range and use of communication strategies by Parkinson's nurse specialists, and describe key communication strategies, to support health professionals in their healthcare interactions with people with Parkinson's.DesignA qualitative descriptive study.MethodsDue to the COVID‐19 pandemic, the study took place in an online setting. Online semi‐structured interviews were conducted with eight Australian Parkinson's nurse specialists and one UK Parkinson's nurse between August and October of 2020. Interviews explored healthcare communication, specifically (1) ways Parkinson's nurse specialists support communication during healthcare interactions, (2) factors influencing the use of communication strategies, and (3) how the nurses learned to communicate effectively with people with Parkinson's disease. Reflexive thematic analysis was used to analyse the data.ResultsParkinson's nurse specialists described the importance of establishing strong therapeutic relationships, the key role of the communication partner, adapting communication to reduce cognitive load, ensuring two‐way understanding, and enabling expressive communication for people with Parkinson's. Knowing the person and family, knowing the disease and understanding the symptoms appeared to influence the choice of communication strategies in healthcare interactions. Learning through others, learning through experience and learning through education and research were considered important parts of becoming a skilled healthcare communicator when working with people with Parkinson's.ConclusionKnowledge and use of effective communication strategies to support people with Parkinson's is crucial for all health professionals working with this population, in order to reduce the occurrence of poor healthcare outcomes. A deep understanding of how Parkinson's disease affects communication and experience in implementing communication strategies were reported as contributing to the success of Parkinson's nurses in communicating with their patients.ImpactThis study provides a description of the key, translational communication strategies that can be used by all health professionals to support healthcare interactions with people with Parkinson's.

Application and Student Perceptions of the PEEER© Model for Effective Healthcare Team Communications

Quantitative analysis of formal caregivers’ use of communication strategies while assisting individuals with moderate and severe Alzheimer's disease during oral care

AIM The purpose of this study was to evaluate the efficacy of using crisis resource management (CRM) principles and high-fidelity human patient simulation (HFHPS) for interprofessional (IP) team training of students from undergraduate nursing, nurse anesthesia, medical, and respiratory therapy. BACKGROUND IP education using simulation-based training has the potential to transform education by improving teamwork and communication and breaking down silos in education. METHOD This one-year study used a quasi-experimental design to evaluate students' acquisition and retention of teamwork and communication skills. A convenience sample consisted of 52 students in the fall semester, with 40 students returning in the spring. RESULTS Mean scores increased after training, and skills were retained fairly well. Any loss was regained with repeat training in the spring. CONCLUSION The results suggest that using CRM and HFHPS is an effective pedagogy for teaching communication and teamwork skills to IP student teams.

Objective: To enhance student appreciation for collaboration/team-based care through participation in an interprofessional (IP) history-taking opportunity with individuals diagnosed with Parkinson’s disease (PD). Methods: Eighty-eight self-selected students from Louisiana State University Health-New Orleans and Xavier University College of Pharmacy participated in an IP elective course which included conducting an IP interview with a PD patient. To assess student perspectives regarding the IP interview, the students completed a thirteen item survey and reflection assignment. Results: Eighty-six students completed the survey and twenty-four completed the reflection assignment. 95% of students agreed the team-based interview and the development of an IP plan of care increased their awareness of the multiple perspectives to consider in designing a care plan. The Kruskal-Wallis test indicated a statistically significant difference among programs for survey question numbers two and four. All four IP education competencies (value and ethics, roles/responsibilities, interprofessional communication, teams and teamwork) were highlighted in the reflection assignment. Conclusions: The IP interview allowed students to gain knowledge of PD, better understand the role of other disciplines, and create a holistic plan of care.

There are many forms of communication. The sender can choose different forms of communication to send different messages for different reasons. Whatever form of communication, one thing remains important-communication strategies. The use of appropriate communication strategies ensures that the information is conveyed. The sender (of the information) needs to negotiate meaning so that that message gets understood. Do learners use different categories of communication strategies? This study is done to explore perception of learners on their use of communication strategies. Specifically, this study is done to explore how learners perceive the use of direct and indirect communication strategies. This study si also done to investigate if there is a relationship between direct and indirect communication strategies. The instrument used is a survey with three sections. The first section is the demographic profile. The second and their sections are about direct and indirect communication strategies respectively. This study has shown that learners resort to a variety of communication strategies to get their message across. The use of direct and indirect communication strategies give an impact to how the message is received. The findings bear interesting pedagogical implications in the teaching of oral communication in the language classroom.

ObjectivesObjectives of the current study were to: i) assess residents’ perceptions of barriers and enablers of interprofessional (IP) communication based on experiences and observations in their clinical work environments, ii) investigate how residents were trained to work in IP collaborative practice, iii) collect residents’ recommendations for training in IP communication to address current needs. MethodsFocus group study including fourteen Emergency Medicine (EM) residents, who participated in four focus groups, facilitated by an independent moderator. Focus group interviews were audiotaped, transcribed verbatim, independently reviewed by the authors, and coded for emerging themes. ResultsFour themes of barriers and enablers to IP communication were identified: i) the clinical environment (high acuity; rapidly changing health care teams, work overload, electronic communications), ii) interpersonal relationships (hierarchy, (un)familiarity, mutual respect, feeling part of the team), iii) personal factors (fear, self-confidence, uncontrolled personal emotions, conflict management skills), and iv) training (or lack thereof). Residents indicated that IP communication was learned primarily through trial and error and observing other professionals but expressed a preference for formal training in IP communication. ConclusionsBased on this pilot study, barriers to effective IP communication in the ED were inherent in the system and could be exacerbated by relational dynamics and a lack of formal training. Opportunities for both curricular interventions and systems changes were identified and are presented.

End of life simulation to improve interprofessional competencies: A mixed methods study