EXPERIENTAL INTERPROFESSIONAL SIMULATION-BASED EDUCATION IMPROVES KNOWLEDGE, PERCIEVED PROFICIENCY AND VALUE IN COLLABORATIVE CRITICAL CARE

Abstract

TOPIC: Education, Research, and Quality Improvement TYPE: Original Investigations PURPOSE: Interprofessional care teams are the pillars of intensive care units (ICUs) where severity of illness is high and care requires unique knowledge, skills and experience. Despite this model, programs rarely integrate different professions in training. ICU rotations present unique challenges, especially the rapid recognition of clinical deterioration. Many trainees are expected to have working knowledge of these without previously setting foot in an ICU. Simulation provides "hands-on" practice in a safe environment and also allows for the integration of teamwork into knowledge and skill training. Our study is important as it assesses the impact of this much needed interprofessional training in a novel but practical ICU simulation. We assessed the impact on knowledge, skills, comfort level with providing ICU care in a collaborative approach following participation in a simulation experience designed to educate and provide opportunities to lead, make decisions, and manage crises in critical patients. METHODS: This pilot study was designed as a mixed method study in a simulated environment where all participants took part in a three-hour immersive interprofessional learning. They completed a pre-survey followed by simulations meant to represent skills critical to the ICU setting in multi-disciplinary groups. Learners rotated through different stations such as the Ventilator knowledge hub where they received an overview of respiratory physiology, and ventilator mechanics. This was followed by a Ventilator simulation and using "VentiSim" software. They were also educated about the different oxygen delivery devices. They then partook in ultrasound-guided central line placement on a mannequin, cardiac rhythm recognition, and simulated Megacode using high fidelity simulators. A post survey was completed for assessment of knowledge, skills, and comfort level of participants. A three-tiered approach to debriefing was implemented for all participants. RESULTS: There were 74 participants of which 48% were medical residents, 19% nursing students, 16% medical students, 10% respiratory therapy students, 5% pharmacy trainees. Paired t-test was used to analyze the knowledge, and skills data which showed significant improvement with P-value < 0.0001(95% CI 1.16 to 2.20). Based on the Post-intervention survey, 99% agreed that it was worth their time to attend the session. 96% believed their ability to deliver patient care improved, 80% felt their anxiety reduced about rotating in ICU. During debriefing an overwhelming majority of learners commented how much they appreciated, “getting to interact with other professions”. There was strong feedback that we needed to conduct more workshops. CONCLUSIONS: Our novel ICU simulation workshop provided a statistically significant improvement in the knowledge base and understanding of common ICU procedures and concepts in a multidisciplinary team of healthcare trainees. It was evident during debriefing that participants appreciated the importance of an interprofessional, collaborative approach to critical care during their training. CLINICAL IMPLICATIONS: We will continue to refine our educational tool to bridge the gap in learning and collaboration. Although implementing such a detailed workshop was challenging, we feel it is essential for learning critical care skills in a safe environment and also to prioritize teamwork and communication in the ICU setting. DISCLOSURES: No relevant relationships by Nalini Kalanadhabhatta, source=Web Response No relevant relationships by Rajesh Kunadharaju, source=Web Response No relevant relationships by Archana Mishra, source=Web Response No relevant relationships by Alexander Pomakov, source=Web Response No relevant relationships by Raj Thapar, source=Web Response