Interprofessional Simulation-based Learning Research Articles

Interprofessional simulations to promote spring break safety and cultural awareness for healthcare students

Interprofessional simulation-based learning provides collegiate students with safe, realistic scenarios to learn and refine vital health related skills. This article describes an innovative project that engages college students from various disciplines in simulation-based activities to enhance health and professional knowledge, promote safety awareness, and improve cultural sensitivity. Additionally, the theme of traveling domestically and/or abroad during spring break provided a true-to-life backdrop. The Activity Theory provides the framework for this study emphasizing collaborative learning toward shared goals. Six spring break themed simulation scenarios were created and evaluated using a mix-methods design. Pre-posttest measures were conducted using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, and open-ended responses. Twenty-eight students completed the survey showing statistically significant change scores from pre-post. Qualitative findings identified three overarching themes of participants’ gains: 1) knowledge of other healthcare professionals’ roles, 2) healthcare professions’ contributions to patient care, 3) being respectful of other cultures, being prepared when traveling, and knowing how to improvise while traveling abroad. Students enjoyed a meaningful and engaging interprofessional activity while learning about one another’s professions, appreciating other healthcare professions’ roles, developing awareness and respect for other cultures, and practicing skills that may be needed during challenging encounters while traveling.

Outcomes of an interprofessional peer facilitators program: Building a confident, competent, and collaboration ready healthcare workforce

Peer facilitation during interprofessional simulation-based learning enables students from diverse professions and backgrounds to enrich each other's learning in small groups. Peer facilitators are interprofessional role models and serve to maintain neutrality, listen actively, and respond to group dynamics supporting interprofessional education (IPE). This paper will report the outcomes of an interprofessional peer facilitation program as part of a larger IPE curriculum in a graduate program in the health professions. The authors conducted a mixed methods evaluation of peer facilitators' development measured through a peer facilitator knowledge and self-efficacy tool. Results of qualitative and quantitative data from four years of the program are discussed, documenting the outcomes serving as a peer facilitator has on entry-level health professions learners.

Psychosocial interprofessional perinatal education: Design and evaluation of an interprofessional learning experience to improve students’ collaboration skills in perinatal mental health

BackgroundPerinatal mental health disorders are one of the leading causes of maternal illness and suffering and care and services need to be well coordinated by an interprofessional team who are skilled in working collaboratively. AimThe aim of this paper is to describe the design and evaluation of an innovative interprofessional education initiative to increase midwives and other health professional students’ knowledge and skills in caring collaboratively for women with psychosocial issues in the perinatal period, including women experiencing domestic and family violence. MethodsThe Psychosocial Interprofessional Perinatal Education workshop was designed for midwifery, psychology, social work and medical students. It provided a simulated learning experience with case studies based on real life situations. Students undertook pre and post surveys to measure changes in students’ perceptions of interprofessional collaboration and their experiences of participating in the interprofessional simulation-based learning activity. Quantitative survey data were analysed using paired t-tests and a qualitative content analysis was undertaken on the open-ended questions in the survey. FindingsComparison of pre and post surveys found students from all disciplines reported feeling more confident working interprofessionally following the workshop. The following categories were generated from analysis of the open ended survey data: Greater understanding of each others’ roles; Recognising benefits of interprofessional collaboration; Building on sense of professional identity; Respecting each other and creating a level playing field; and Filling a pedagogical gap. ConclusionThrough this innovative, simulated interprofessional education workshop students developed skills essential for future collaborative practice to support women and families experiencing psychosocial distress.

Professional competence development through interprofessional simulation-based learning assists perioperative nurses in postgraduation acute clinical practice situations: A qualitative study.

To explore recently graduated perioperative nurses' experiences of interprofessional simulation-based learning during postgraduate education and investigate whether and how this learning approach contributed to the development of their professional competence in meeting acute clinical situations. Perioperative nursing requires specialised education that offers professional development to ensure high-quality nursing care and patient safety in acute situations. Interprofessional simulation-based learning exposes students to acute situations in a safe environment without the risk of harming the patient, and it prepares postgraduate nursing students for clinical practice. Despite extensive research regarding simulation-based learning, there is a lack of knowledge on what impact such training has on perioperative nursing students after graduation. An explorative qualitative design was used, and this study is reported in accordance with the COREQ guidelines. Between March 2019-November 2020, 16 perioperative nurses participated in semi-structured individual interviews three to five months after their graduation from five different educational institutions. During their postgraduate education, they had participated in interprofessional simulation-based learning that included acute clinical situations. A phenomenological hermeneutical analysis was applied to the data involving three steps: naïve reading, structural analysis and comprehensive understanding. During the naïve reading, three themes emerged: competence in handling acute situations, competence in interprofessional teamwork and professional identity development. Interprofessional simulation-based learning in perioperative nursing education developed relevant and important competence, including professional identity development, among perioperative nursing students. As recent graduates, their professional competence was transferred to clinical practice and developed further. Findings indicate that interprofessional simulation-based learning is an important educational approach in perioperative nursing education. It is essential to use effective learning approaches to develop competencies that are transferable to clinical practice and improve perioperative nurses' performance as recent graduates. Therefore, interprofessional simulation-based learning should be implemented into perioperative nursing education.

Use of interprofessional simulation-based learning to develop perioperative nursing students’ self-efficacy in responding to acute situations

Self-efficacy is an essential concept regarding academic performance and persistence in higher education. Research indicates that interprofessional simulation-based learning influences participants’ self-efficacy and points to a need for more research on self-efficacy and its development. This study describes perioperative nursing students’ experiences with how interprofessional simulation-based learning contributes to self-efficacy in communication, interdisciplinary collaboration, and prioritising tasks in acute situations. Six qualitative focus group interviews were conducted with thirty-four perioperative nursing students from four universities and university colleges in Norway. Qualitative directed content analysis was applied in accordance with Bandura's social cognitive theory which specifies four sources influencing self-efficacy. Results showed that well-designed/prepared interprofessional simulation-based learning can develop self-efficacy concerning communication, interdisciplinary collaboration, and prioritising tasks in acute situations.

Key Design Characteristics of Interprofessional Simulation-based Learning Experiences as Rated by Allied Health and Nursing Students

BackgroundThis study reports the first non-nursing application of the Jeffries Simulation Design Scale (SDS) tool in dietetics education to assess design features of two interprofessional simulation activities for perceived learner importance. MethodThe SDS tool was modified to decrease nurse-specific terminology and increase usability, then administered to all nursing and allied health students prior to (n = 243) and after (n = 294) a palliative care simulation and a communication simulation. ResultsThree hundred and thirty-four students (167 students each year in 2018 and 2019) from five disciplines (dietetics, exercise physiology, pharmacy, social work, and nursing) participated. Ratings by these mixed-profession groups emphasized the perceived importance of feedback, support, and fidelity, as has been reported previously for nursing-only groups. ConclusionsFurther validation of the modified SDS tool for non-nursing application is warranted to provide simulation designers an evaluation tool to further improve simulation activities.

A qualitative study of perioperative nursing students' experiences of interprofessional simulation-based learning.

To explore perioperative nursing students' experiences of interprofessional simulation-based learning to gain a deeper understanding of how this educational tool can be used to support students' learning and enable them to achieve the intended learning outcomes. Despite extensive research, it remains unclear what and how participants learn from interprofessional simulation-based learning. There is a need to specify how interprofessional simulation-based learning should be organised to support and promote learning processes, especially for postgraduate learners. In particular, there seems to be little evidence in the existing literature in the field of educating perioperative nurses, where advanced technical skills and high-quality nursing care are required. The study's qualitative and explorative design is reported in accordance with the COREQ guideline. Between May-October 2019, thirty-four perioperative nursing students from four educational institutions participated in six focus group interviews, with four to eight students in each. All participants had previous experience of interprofessional simulation-based learning in acute settings. Data were transcribed verbatim and were then subjected to phenomenological hermeneutical analysis involving three steps: naïve reading, structural analysis and comprehensive understanding. Three themes were identified the following: customised interprofessional simulation-based learning; reality of the experience of interprofessional simulation-based learning; and preparedness for clinical practice. Customised interprofessional simulation-based learning was found to be of value to the participants and reflected their feeling of mental preparedness entering interprofessional simulation-based learning. Furthermore, participants' experience of reality when using the tool was a key theme that also impacted how prepared participants felt for clinical practice. The study findings contribute to the further expansion of interprofessional simulation-based learning in perioperative nursing education as a means of developing students' professional competence. This is essential knowledge, as professional practitioners must reflect on practice to further enhance that practice and patient safety.

Emergency scenarios in maternity: An exploratory study of a midwifery and medical student simulation-based learning collaboration

Background and problemIn Australia, interprofessional education has been embedded into pre-registration course accreditation standards. Little is known about Australian midwifery and medical students experiences of interprofessional learning when the focus is on emergency scenarios during birth. AimThis study aimed to evaluate student experience of Interprofessional Simulation-Based Learning workshops focused on emergency scenarios with midwifery and medical students. MethodsThis was a descriptive, exploratory study of an educational activity designed to enhance inter-professional and collaborative learning between Bachelor of Midwifery students and Bachelor of Medicine students at a Simulation Centre in Sydney, Australia. A pre and post survey design enabled data collection before and after the 6-h simulation-based workshop. FindingsA total of 45 students attended two interprofessional simulation learning days, 14 were midwifery students and 31 medical students. Students disclosed a level of apprehension in the pre workshop survey and ambivalence towards the values of collaborative simulation-based learning. Following the workshop students reported that the workshop enhanced their ability to work collaboratively in practice. Both student cohorts commented on a perceived power imbalance and a sense of each profession having to ‘prove’ their knowledge levels. Students stated that learning to work together in a safe environment allowed them to develop an appreciation for each other’s scope of practice and responsibilities in an emergency situation. ConclusionThis form of collaborative learning has the potential to improve new graduate experience in the workplace, especially during emergency situations, and ultimately improve care for women and babies.

Preliminary Psychometrics of the Knowledge and Attitudes Toward SBAR Instrument (KA-SBAR).

When measuring new practice approaches for improving patient safety in the clinical setting, researchers need instruments with evidence of reliability and validity. The purpose of this analysis was to examine the reliability and validity of an instrument to assess knowledge and attitudes toward communication using situation-background-assessment-recommendation (SBAR; KA-SBAR). This psychometric analysis was conducted with data from an interprofessional simulation-based learning experience with doctor of nursing practice students (n = 19) and physical therapy students (n = 52). Internal consistency reliability and construct validity tests including factor analysis for the KA-SBAR were conducted. The KA-SBAR instrument had adequate internal consistency reliability and evidence of construct validity, including identification of two factors that explained 70% of the instrument's variance. However, there may be a ceiling effect of scores, making it difficult to show change. The KA-SBAR instrument may be useful in assessing clinicians' perceptions of SBAR communication in education and practice settings. When selecting data collection measures, nurses need to carefully consider the purpose of the measure and evidence of the instrument's reliability and validity. Educators need to consider the clinical expertise of the students in designing challenging simulations to advance learning.

Using simulation-based learning to provide interprofessional education in diabetes to nutrition and dietetics and exercise physiology students through telehealth

BackgroundCurrent workforce demands require new graduates to competently work within health care teams and often in remote settings. To better prepare students for this work, universities have spent much time developing interprofessional education (IPE) activities. The body of literature supporting IPE of allied health students is growing. Simulation-based learning with simulated patients is one platform through which IPE can be implemented in a dedicated, supported environment and potentially at scale. This study describes an interprofessional simulation-based learning experience with nutrition and dietetics and exercise physiology students. The common practice area of interacting with patients who have type 2 diabetes was targeted, and the simulation was delivered in partnership with simulated patients via a telehealth platform to allow interprofessional teams to work collaboratively in remote locations.MethodsTen nutrition and dietetics and 13 exercise physiology students participated in a simulation module in which students observed and collaborated in the development and delivery of an interprofessional treatment plan for patients with diabetes. Learning outcomes were measured according to the first two levels of Kirkpatrick’s (1994) model for training evaluation (i.e. reaction and learning), as well as the perceived impact on behaviour.ResultsThe students’ confidence in communication, assessment, management and ability to work with another health professional significantly increased (p < 0.05) post-activity. Students perceived that the simulation-based learning would have a positive impact on their clinical skills and ability to work with other health professionals. Students reported that the most effective aspects of the simulation module were learning from and about each other, the opportunity for experiential learning and the supportive learning environment. However, the telehealth platform audio clarity and delay had negative impact on the learning experiences for students.ConclusionThe overall positive results demonstrate the potential of simulation-based learning activities for preparing allied health students for working in interprofessional teams. Although remote access was possible, the telehealth platform was identified as a limiting factor to this simulation-based learning experience. However, videoconferencing technology has advanced considerably since this study. Hence, there is an opportunity to employ more reliable technology for future simulations.

Tracing the prescription journey: a qualitative evaluation of an interprofessional simulation-based learning activity

BackgroundIn many countries across the world, the majority of prescribing occurs within the community setting. Close collaboration between general practitioners (GPs) and pharmacists is required to ensure effective therapeutic treatment of patients, whilst minimising prescribing and dispensing errors. Despite the need to work collaboratively, medical and pharmacy training is often unilateral. Interprofessional education (IPE) and simulation-based education (SBE) are teaching approaches widely used by healthcare professionals to foster collaborative practice. At Queen’s University Belfast (QUB), an innovative IPE activity was developed for medical and pharmacy undergraduate students that aimed to develop a greater understanding of their roles and duties in community prescribing and dispensing. This study set out to evaluate the impact of such a SBE activity on students’ attitudes towards collaborative practice in prescribing and dispensing medication in the community.MethodsInterprofessional groups of year 3 pharmacy (n = 10) and year 4 medical (n = 9) students took part in a SBE activity. This focused on the IPE team clinically assessing, diagnosing, writing prescriptions, dispensing medication(s) and counselling a simulated patient (in a simulated practice and pharmacy setting). Using a questioning guide, four focus groups of medical and pharmacy students were used to evaluate their attitudes towards the simulated IPE activity. Interviews were audio-recorded, transcribed and analysed iteratively using thematic analysis.ResultsFour main themes emerged from the analysis: (1) IPE simulation activity: creating a broader learning experience; (2) patient-centred practice: a shared understanding; (3) professional skills: explored and shared; and (4) professional roles: a journey of discovery, respect and stereotypes.ConclusionsStudents broadened their knowledge of each other’s expertise in skills and clinical roles whilst working together. Furthermore, students valued the opportunity to strengthen cooperation with their future colleagues with the shared goal of improving patient-centred care.

An Interprofessional Simulation-Based Learning Activity for Nursing and Physiotherapy Students

BackgroundThe ability to work interprofessionally is considered a core competency for healthcare graduates because it promotes collaborative patient-centred clinical practice. MethodsThis mixed methods observational study utilised simulation of a patient-centred scenario to deliver an interprofessional learning activity to both nursing and physiotherapy students. ResultsOver one day during 2015, 198 students undertook the activity, with all completing two surveys evaluating the experience. Results suggested that they both enjoyed and valued the experience, especially in relation to the clinical interaction and learning that took place and the opportunity the scenario provided them to work as a team member. ConclusionsFuture interprofessional simulation activities will be able to utilise the generic self and peer-assessment framework and timetabling resources developed.

Understanding the Continuing Education Needs of Rural Midwestern Nurses

Background: The continuing education needs of rural nurses are not well understood. Rural hospitals face special challenges that serve as barriers to the attainment of continuing education. The purpose of this study was to assess the educational needs and barriers identified by rural nurses in two midwestern states. Method: A 12-item needs assessment survey developed by the researchers and administered at forums in nine rural hospitals was completed by 119 nurses. Results: The areas identified as the highest need included postpartum hemorrhage, preterm labor, pediatric care, preeclampsia, shoulder dystocia, and embolism. The barriers to obtaining updated education included distance to travel for educational opportunities and lack of staff for coverage while attending the programs. Conclusion: Identifying the learning needs, preferred learning strategies, and potential barriers to continuing education of rural nurses is a critical step in designing educational offerings that enhance their knowledge. Interprofessional simulation-based learning may be particularly helpful in enhancing the clinical competence and confidence necessary to provide safe patient care in rural settings. J Contin Nurs Educ. 2017;48(6):265–269.

Development and Evaluation of an Interprofessional Simulation-Based Learning Module on Infection Control Skills for Prelicensure Health Professional Students

IntroductionPoor adherence to infection control standards among health care professionals is widespread, putting patients at substantial risk. Basic infection control skills are typically learned uniprofessionally outside the clinical environment. In real clinical settings, the cognitive load associated with simultaneously managing challenging clinical problems as part of an interprofessional team compounds difficulties in applying infection control standards. This mixed methods study evaluated an interprofessional education infection control module as part of a larger action research project aimed at developing interprofessional health education using simulation. MethodsStudents from medicine, nursing, and physiotherapy (N = 24) participated in a pilot infection control simulation. Participants completed a survey regarding confidence performing infection control skills, perceptions of interprofessional communication and collaboration, and satisfaction with the module. Qualitative feedback was obtained from facilitators and participants. ResultsParticipants reported confidence with all skills except enhanced precautions and found the interprofessional simulation-based training valuable. Observers identified instances where infection control practices were not appropriately followed within the clinical context but noted strong teamwork and collaboration amongst team members. Several barriers to learning were identified. The majority of participants indicated that the interprofessional infection control module should be mandatory for health sciences students. Qualitative analysis revealed recommendations on ways to make this type of session more effective. ConclusionsThis pilot project demonstrated the feasibility of using high-fidelity patient simulation to reinforce infection control skills and promote interprofessional communication and teamwork. Study results support the need for senior health professional students to learn and practice infection control skills in an interprofessional manner and to incorporate complex clinical scenarios in the training.