Board 234 - Program Innovations Abstract A Seven Year Collaboration Between Three Colleges to Learn Interprofessional Skills During a CPR Team Behavior Simulation (Submission #1037)

Abstract

Introduction/Background Teamwork failures and breakdowns in communication are consistently associated with adverse events in patient care.1,2 According to statistics released by the Joint Commission in 2004, communication failures are the primary root cause in over 70% of sentinel events.3 Studies have shown that simulation can be used effectively to teach teamwork skills and that skills acquired through simulation can improve student performance in clinical environments.4–9 The purpose of this study was to evaluate the effectiveness of an interprofessional CPR team behavior simulation program in introducing professional entry students at the University of Arizona Health Sciences Center (AHSC) to vital elements of interprofessional collaborative practice.10 In particular, we wanted to assess the impact of this course on student perception of teamwork skills such as closed-loop communication, constructive intervention, knowledge sharing, re-evaluation and summarizing,and mutual respect in the context of a critical code scenario. Methods In the seventh year of the program, we enrolled 374 students from the Colleges of Medicine (n=114), Nursing (n=163) and Pharmacy (n=97) in a cardiopulmonary resuscitation (CPR) simulation course. Simulation exercises were conducted simultaneously over a four week period at the Arizona Simulation Technology and Education Center (ASTEC) and the Steele Innovation Learning Center (SILC) at the University of Arizona. Prior to the simulation exercise, students were provided with the American Heart Association CPR video, reading material and a CPR lecture detailing the critical elements of effective resuscitation team dynamics.11 The students were then assigned to interprofessional teams of five to eight students for a one hour CPR simulation in which the team worked to resuscitate a human patient simulator that had gone into cardiac arrest. The composition of each team was designed to maximize professional heterogeneity. Students were assigned one of the following roles irrespective of their professional training: team leader, chest compressor (2), ventilator, defibrillator, IV/medication administrator, and code recorder. Roles were rotated in repeated iterations of the CPR simulation; each student was given the opportunity to be the team leader. A short debriefing was conducted by trained facilitators after each simulation to reinforce the elements of team dynamics and to discuss ways to improve teamwork in subsequent simulations. Retrospective pre-post surveys were collected to assess the effectiveness of the training on the students’ understanding and perception of core competencies in interprofessional collaborative practice. Survey items were rated on a 5-point qualitative Likert scale. These Results are based on an 81% survey response rate (n=303). Student’s self ratings showed significant improvement in understanding the elements of effective team dynamics (Pre 2.59±1.03, Post 4.14±0.74; P<0.001) and the different roles and responsibilities of the various healthcare providers during CPR (Pre 2.55±1.00, Post 4.11±0.81; P<0.001). Self perceived understanding of behaviors necessary to be an effective team leader during crisis management increased significantly post-training (Pre 3.09±0.92, Post 4.36±0.64; P<0.001). Eighty-nine percent of students felt that the simulation helped them understand the degree to which clear communication leads to better patient outcomes. Pharmacy students rated their initial knowledge lower than medicine and nursing students in all survey questions. Results: Conclusion The interprofessional CPR team behavior simulation provided an effective platform to combine professional students from three colleges in the Healthcare Sciences to emphasize the importance of interdisciplinary collaboration and teamwork in crisis management situations. The simulation improved the student’s knowledge of vital team and communication skills and attitudes towards working in interprofessional teams.