Effects of a Virtual Simulation on Student Understanding of Structured Communication in the Surgical Learning Environment

Abstract

INTRODUCTION: Ineffective structured communication in handovers can result in medical errors and patient harm. Common frameworks include SBAR and IPASS. Simulation-based education can improve competency in structured communication. The goal of this project was to increase student understanding of structured communication in the surgical learning environment. METHODS: Students participated in a pilot for an asynchronous, virtual simulation focused on structured communication prior to their surgical rotation. The simulation was embedded into an existing module for teaching other teamwork competencies. In the simulation, students watched didactic videos about structured communication, reviewed patient documents, listened to pre-recorded patient calls, and created handover statements for 2 simulated discharged postoperative patients using either SBAR or IPASS: (1) an ileocecectomy patient without complications, and (2) a cholecystectomy patient with complications. Before and after the activity, students completed a survey assessing knowledge of, attitudes toward, and confidence in skills relating to structured communication. RESULTS: 14 students piloted the simulation and surveys. Students demonstrated significant improvement in knowledge of IPASS components (p = 0.0159) and maintained a high level of knowledge of SBAR components (92.9% for pre- and post-survey) (Table). Attitudes toward the importance of structured communication in clinical practice improved on a 5-point Likert scale of strongly disagree to strongly agree, although not significant (p = 0.38209). Improvement to confidence in using structured communication was significant (p = 0.00082). Table. - Knowledge, Attitudes, and Confidence in Skills Before and after Virtual Handover Simulation Pre-survey Post-survey p Value Knowledge (% Correct) IPASS Knowledge 57.1% 100% 0.0159 SBAR Knowledge 92.9% 92.9% 1 Attitudes (Likert Scale, Strongly Agree to Strongly Disagree) % Agree 14.3% 7.1% 0.38209 % Strongly Agree 85.7% 92.9% Confidence in Skills (0-100) Average Confidence Rating 27.4 63.8 0.00082 CONCLUSION: Asynchronous, virtual simulations may improve student competency in structured communication. Further implementation of the piloted simulation must adapt to time limitations of students on surgical rotations to optimize completion and fidelity outcomes.