Simulation-enhanced Interprofessional Education Research Articles

Attitude and perception of medical and nursing undergraduates and faculty towards simulation-enhanced interprofessional education at an institute in India

Attitude and perception of medical and nursing undergraduates and faculty towards simulation-enhanced interprofessional education at an institute in India

Establishing a simulation-enhanced interprofessional education (Sim-IPE) program at your institution

Establishing a simulation-enhanced interprofessional education (Sim-IPE) program at your institution

Interprofessional collaboration between health professional learners when breaking bad news: a scoping review of teaching approaches.

The objective of this scoping review was to examine teaching approaches used to teach interprofessional health professional learners how to break bad news collaboratively. When breaking bad news, health professionals must be equipped to deliver it skillfully and collaboratively; however, the literature shows that this skill receives little attention in program curricula. Consequently, health professionals can feel inadequately prepared to deliver bad news, which may lead to increased burnout, distress, and compassion fatigue. Studies that describe teaching approaches used to teach learners how to break bad news collaboratively were considered for inclusion. Studies must have included 2 or more undergraduate and/or postgraduate learners working toward a professional health or social care qualification/degree at a university or college. Studies including lay, complementary and alternative, or non-health/social care learners were excluded. Due to the primary language of the research team, only English articles were included. The JBI 3-step process was followed for developing the search. Databases searched included MEDLINE (Ovid), CINAHL (EBSCOhost), Embase, Education Resource Complete (EBSCOhost), and Social Work Abstracts (EBSCOhost). The initial search was conducted on February 11, 2021, and was updated on May 17, 2022. Title and abstract screening and data extraction were completed by 2 independent reviewers. Disagreements were resolved through discussion or with a third reviewer. Results are presented in tabular or diagrammatic format, together with a narrative summary. Thirteen studies were included in the scoping review, with a range of methodologies and designs (pre/post surveys, qualitative, feasibility, mixed methods, cross-sectional, quality improvement, and methodological triangulation). The majority of papers were from the United States (n=8; 61.5%). All but 1 study used simulation-enhanced interprofessional education as the preferred method to teach interprofessional cohorts of learners how to break bad news. The bulk of simulations were face-to-face (n=11; 84.6%). Three studies (23.1%) were reported as high fidelity, while the remainder did not disclose fidelity. All studies that used simulation to teach students how to break bad news utilized simulated participants/patients to portray patients and/or family in the simulations. The academic level of participants varied, with the majority noted as undergraduate (n=7; 53.8%); 3 studies (23.1%) indicated a mix of undergraduate and graduate participants, 2 (15.4%) were graduate only, and 1 (7.7%) was not disclosed. There was a range of health professional programs represented by participants, with medicine and nursing equally in the majority (n=10; 76.9%). Simulation-enhanced interprofessional education was the most reported teaching approach to teach interprofessional cohorts of students how to break bad news collaboratively. Inconsistencies were noted in the language used to describe bad news, use of breaking bad news and interprofessional competency frameworks, and integration of interprofessional education and simulation best practices. Further research should focus on other interprofessional approaches to teaching how to break bad news, how best to incorporate interprofessional competencies into interprofessional breaking bad news education, whether interprofessional education is enhancing collaborative breaking bad news, and whether what is learned about breaking bad news is being retained over the long-term and incorporated into practice. Future simulation-specific research should explore whether and how the Healthcare Simulation Standards of Best Practice are being implemented and whether simulation is resulting in student satisfaction and enhanced learning.

1826 Development of inter-professional simulation-based education in geriatric medicine

Abstract Background Understanding human factors involved in patient care is a focus of the Geriatric Medicine Training curriculum including the leadership of and communication within an interprofessional team. Geriatric Medicine Specialty Trainees (ST4+) need advanced communication skills and confidence in managing complex situations. Simulation-enhanced Interprofessional Education (Sim-IPE) provides insight into other disciplines roles (1). We hypothesised that the implementation of a Sim-IPE programme dedicated to communication skills could improve confidence. Method We organised a one-day Sim-IPE programme for our Geriatric Medicine ST4+. Faculty consisted of doctors, advanced nurse practitioner, social worker, occupational therapist, physiotherapist and speech and language therapist. Communication scenarios, with faculty as simulated participants, were undertaken including establishing a ceiling of treatment, management of delirium, breaking bad news, ethical feeding dilemmas, complex discharge planning and capacity assessment. Debrief discussions followed each scenario. Mixed-method evaluation was used with questionnaires collected from learners’ pre and post session in a 10-point Likert scale to compare confidence levels. Qualitative feedback was collected from learners and faculty. Results Ten Geriatric Medicine ST4+ attended plus nine faculty including two facilitators. Positive feedback was received from learners and faculty. There was improvement in confidence across all six scenarios (one being “not at all confident” and ten “extremely confident”). Pre-session average confidence was 7.2, post-session 8.7. All trainees would recommend the programme to a colleague. Common learning themes included gaining feedback from debrief discussions and shared learning from our allied-health professionals. Learners and faculty commented on the enjoyment, usefulness and value of learning within a safe team environment. Conclusion Sim-IPE can improve confidence in complex communication scenarios and human factor skills. Feedback highlighted that this programme would be useful for all General Internal Medicine Specialty Trainees.

A Roadmap to Using Simulation-Enhanced Interprofessional Education to Incorporate Interprofessional Activities in Athletic Training Educational Programs

Context Interprofessional education and collaborative practice (IPECP) is a priority in health care. Collaborative care that includes clinicians across disciplines has been shown across health care to ensure quality patient outcomes. In athletic training, a team approach to clinical practice has been promoted for nearly a decade and continues to gain attention. Interprofessional education (IPE) is a core curricular content standard that requires programs to teach students to practice in collaboration with other health care professionals. Interprofessional education and collaborative practice necessitates students have opportunities to practice before being expected to demonstrate skills clinically. Background To effectively demonstrate IPECP, athletic trainers need exposure to and training in IPECP core competencies during education. Simulation-enhanced IPE (Sim-IPE) is one strategy to integrate these experiences. Between classroom learning and clinical practice, simulation provides an opportunity for students to apply knowledge in a realistic but low-stakes clinical environment. Objective This article will detail strategies to identify and develop Sim-IPE experiences that support achieving educational standards and prepare students for effective IPECP. Description Healthcare Simulation Standards of Best Practice™ and the Association of Standardized Patient Educators best practices were established to guide the design of quality Sim-IPE. This manuscript will provide a roadmap for these best practices, including conducting a needs assessment, coordinating event logistics, designing prebrief sessions, and selecting debrief models. Clinical Advantage(s) Students can gain valuable experience during Sim-IPE. Participation in Sim-IPE improves student understanding of the roles and responsibilities, communication techniques, and teamwork. These factors combine to achieve improved patient outcomes. Conclusion(s) Athletic training programs implementing Sim-IPE should use simulation best practices to provide quality IPECP opportunities.

Longitudinal outcomes of simulation enhanced interprofessional education within a physical therapist education program

Purpose: Simulation-enhanced interprofessional education (Sim-IPE) has been shown in cross-sectional studies to be beneficial in improving students’ perceptions of interprofessional teamwork and collaboration. However, there is limited literature regarding the progression of these perceptions over time. Therefore, this study aimed to explore the influence of multiple sim-IPE embedded across a physical therapy education program on student perceptions of collaborative patient care over a 2-year period. Methods: A sample of convenience of students in an entry-level Doctor of Physical Therapy program (n = 94) was utilized. Students were placed in one of three groups with students completing either three sim-IPE experiences across the first 2 years of the program (n = 57), one simulation at the beginning of the program (n = 17), or one experience prior to their second full-time clinical experience (n = 20). The Interprofessional Socialization and Values Scale-21 (ISVS-21) was used to assess student perceptions of interprofessional collaboration. Scores across the program were analyzed using a Friedman analysis with a post hoc Wilcoxon matched pairs test. To assess the influence of maturation on student perceptions, performance on the ISVS-21 for students completing three experiences was compared with students completing one sim-IPE experience within the program. Results: Overall, scores on the ISVS-21 demonstrated a statistically significant improvement across the three simulations occurring within the program (P < 0.001). Furthermore, students completing three sim-IPE experiences demonstrated statistically significantly higher scores on the ISVS-21 compared to students completing just one experience, regardless of the placement of the experience within the program. Conclusion: Multiple sim-IPE performed across a professional education program may be an effective learning strategy to influence perceptions of interprofessional collaboration. Further research is needed to determine the number and placement of simulations for optimal preparation for interprofessional practice.

276 Development of inter-professional simulation-based education in geriatric medicine

Abstract Background Understanding human factors involved in patient care is a focus of the Geriatric Medicine Training curriculum including the leadership of and communication required within an interprofessional team. Geriatric Medicine Specialty Trainees (ST4+) need advanced communication skills and confidence in managing complex situations. Simulation-enhanced Interprofessional Education (Sim-IPE) provides insight into other disciplines roles. We hypothesised that the implementation of a Sim-IPE programme dedicated to communication skills could improve confidence. Methods We organised a one-day Sim-IPE programme for our Geriatric Medicine ST4+. Faculty consisted of doctors, advanced nurse practitioner, social worker, occupational therapist, physiotherapist and speech and language therapist. Communication scenarios, with faculty as simulated participants, were undertaken including establishing a ceiling of treatment, management of delirium, breaking bad news, ethical feeding dilemmas, complex discharge planning and capacity assessment. Debrief discussions followed each scenario. Mixed-method evaluation was used with questionnaires collected from learners’ pre and post session in a 10-point Likert scale to compare confidence levels. Qualitative feedback was collected from learners and faculty. Results Ten Geriatric Medicine ST4+ attended plus nine faculty including two facilitators. Positive feedback was received from learners and faculty. There was improvement in confidence across all six scenarios (one being ‘not at all confident’ and ten ‘extremely confident’). Pre-session average confidence was 7.2, post-session 8.7. All trainees would recommend the programme to a colleague. Common learning themes included gaining feedback from debrief discussions and shared learning from our allied-health professionals. Learners and faculty commented on the enjoyment, usefulness and value of learning within a safe team environment. Conclusion Sim-IPE can improve confidence in complex communication scenarios and human factor skills. Feedback highlighted that this programme would be useful for all General Internal Medicine Specialty Trainees.

Simulation-Enhanced Interprofessional Education for Ambulatory Care Registered Nurses and Health Professions Students.

Ambulatory care RNs and health professions students have limited education on interprofessional care before entering clinical settings. This article describes a program evaluation of a simulation-enhanced interprofessional education (Sim-IPE) experience designed for ambulatory care RNs and health professions students. An 11-item electronic post-Sim-IPE survey was administered to collect perceptions of the Sim-IPE experience. Most responses indicated the Sim-IPE promoted learning about each other's roles, was designed for their level of knowledge and skills, and provided sufficient information. The participants indicated that they felt supported and would use their learning in a clinical setting. Open-ended survey responses identified positive aspects of the Sim-IPE, areas for improvement, and suggestions for future Sim-IPE. The National League for Nursing Jeffries Simulation Theory was used to guide a program evaluation of the Sim-IPE. The program evaluation identified positive aspects and areas for improvement for future interprofessional education experiences. [J Contin Educ Nurs. 2023;54(5):226-232.].

Scoping Review: Interprofessional Simulation as an Effective Modality to Teaching Interprofessional Collaborative Competencies in the Emergency Department

Background: A scoping review was conducted to map the current body of research pertaining to simulation-enhanced interprofessional education (Sim-IPE) as a modality for teaching interprofessional collaboration (IPC) in the emergencydepartment (ED). Methods and Findings: The research team followed the PRISMA Extension for Scoping Reviews framework. Studies were included if they involved two or more healthcare professions, utilized simulation as the learning method for interprofessional education (IPE), involved simulation pertaining to the ED, and identified at least one Canadian Interprofessional Health Collaborative or Interprofessional Education Collaborative IPC competency as a learning outcome. In total, 896 studies were included for title and abstract screening and 806 were deemed irrelevant. Ninety full-text studies were assessed for eligibility and 34 were included in the review. Conclusions: Eighteen studies found Sim-IPE to be an effective method for teaching interprofessional competencies in the ED. Simulation-enhanced interprofessional education appears to be a promising methodology for teaching IPC competencies to ED healthcare professionals. Interprofessional collaboration competency frameworks should be utilized to guide Sim-IPE, and assessment tools specific to interprofessional competencies should be used in the assessment phase of Sim-IPE. Faculty development is a crucial component of Sim-IPE. Further longitudinal and outcome-based research is required.

Building interprofessional team competence through online synchronous simulation of palliative care scenarios

Simulation-enhanced interprofessional education (Sim-IPE) is increasingly used in health professional programs to promote team competence. Sim-IPE using online technology incorporating palliative care (PC) scenarios may be an attractive option for including distance learners, overcoming clinical-site restrictions, and increasing proficiency in difficult conversations. To evaluate outcomes of Sim-IPE using a web-conferencing platform in an interprofessional (IP) PC course. Repeated measures were used to evaluate self-efficacy and competent performance in IP PC scenarios among enrolled students (N = 24) during a two-part simulation in two separate semesters. Student health professions included nursing, medicine, pharmacy, social work, occupational therapy, and physical therapy. Significant self-efficacy increases were found between Simulations 1 and 2 in both course offerings, with competent student team performance in each simulation. Distance Sim-IPE using PC scenarios are effective pedagogy for IP students to develop competence in how to engage, collaborate, and communicate among teams for patient-centered care.

Adaptation of Geriatric Interprofessional Education from In-Person to Virtual Simulation

We modified an in-person simulation-enhanced interprofessional education model as necessitated by COVID-19 restrictions to a fully virtual education experience. Online prework remained unchanged but adjustments were made related to previously in-person activities. Diverging from the in-person training we held live virtual poster sessions with learner-presenter interaction. In preparation for their role in the team meeting simulation, learners were moved into preassigned profession-specific breakout rooms for a live virtual huddle with facilitators. Next, learners were moved to preassigned interprofessional breakout rooms where they began the simulated team meeting. After initial discussion, a standardized patient joined the breakout room to present the patient/caregiver perspective. The event ends with a virtual reflective debrief focused on interprofessional collaborative competencies.

The Effect of a Geriatric Simulation-enhanced Interprofessional Education on Health Profession Students

BackgroundAlzheimer's disease is the most common form of dementia, making it urgent to prepare health providers in interprofessional teams to care for those affected. MethodsAn unfolding geriatric simulation-enhanced interprofessional education program was designed using an ACE.S case and breakout activities for an interprofessional group of nursing, social work, speech therapy and nutrition students. ResultsPre post education measures revealed a decrease in perceived challenges for interprofessional collaboration, with no change in readiness for interprofessional learning. Satisfaction with the education design was rated positively, and individual education components were rated as valuable. ConclusionsThis study offers educators an effective example of an unfolding active interprofessional geriatric education related to Alzheimer's care.

Healthcare Simulation Standards of Best PracticeTM Simulation-Enhanced Interprofessional Education

Healthcare Simulation Standards of Best PracticeTM Simulation-Enhanced Interprofessional Education

Health Care Professional Students' Perceptions of Teamwork and Roles After an Interprofessional Critical Care Simulation.

Educational opportunities for health care professional students to learn collaborative communication and the roles and responsibilities of other disciplines are minimal unless faculty are intentional about facilitating this interdisciplinary learning. The aim of this study was to determine how a simulation-enhanced interprofessional education (Sim-IPE) teaching strategy fostered communication and interdisciplinary awareness between students from multiple disciplines. This pretest-posttest design surveyed undergraduate students from 5 disciplines. The Student Perceptions of Interprofessional Clinical Education-Revised tool examined students' perceptions of teamwork and roles after an in-depth, multistate critical care simulation experience. All students' perceptions of teamwork increased after the Sim-IPE. More experience in the health care field is associated with an increased perception of teamwork and roles/responsibilities. On the basis of these findings, the critical care Sim-IPE was an effective teaching strategy to increase the perception of roles and responsibilities of interprofessional critical care team members with applicability to many other specialty topics.

Real-time, simulation-enhanced interprofessional education in the care of older adults with multiple chronic comorbidities: a utilization-focused evaluation.

Interprofessional education (IPE) is a curricular requirement for all healthcare professional education standards. To foster learning about, from and with each other, consistent with the Interprofessional Education Consortium's Core Competencies, many graduate schools are integrating interprofessional (IP) simulation experiences throughout their educational curricula, providing multiple opportunities for health professional students to collaborate and practice together. High-fidelity, real-time simulations help students from diverse professional backgrounds to apply their classroom learning in realistic clinical situations, utilize mobile technology to access clinical decision support (CDS) software, and receive feedback in a safe setting, ensuring they are practice-ready upon graduation. New York University Rory Meyers College of Nursing (NYU) and Long Island University College of Pharmacy (LIU) partnered for two consecutive years to create, coordinate and implement two interprofessional educational simulations involving patients with chronic cardiovascular disease. A utilization-focused evaluation of high-fidelity, simulation-enhanced IPE (Sim-IPE) was implemented to assess students' IP competencies before and after their participation in the IPE-simulation and their overall satisfaction with the experience. The Interprofessional Collaborative Competency Attainment Survey (ICCAS), a reliable instrument, was administered to both doctor of pharmacy students and primary care advanced practice nursing students before and after each simulation experience. Additionally, student satisfaction surveys were administered following the IPE-simulation. Aggregated means revealed statistically significant improvements in each of the six domains including communication, collaboration, roles and responsibilities, collaborative patient/family approach, conflict resolution and team functioning. Student ratings revealed positive experiences with the IPE-simulations. High-fidelity, real-time IPE-simulation is a powerful pedagogy to help graduate students from different professional backgrounds practice applying IP competencies in simulated experiences. Quality improvement studies and research studies are needed to assess the impact of high-fidelity, real-time simulations throughout graduate curricula with different types of patients to improve coordinated, team approaches to treatment.

Real-time, simulation-enhanced interprofessional education in the care of older adults with multiple chronic comorbidities: a utilization-focused evaluation

Background: Interprofessional education (IPE) is a curricular requirement for all healthcare professional education standards. To foster learning about, from and with each other, consistent with the Interprofessional Education Consortium’s Core Competencies, many graduate schools are integrating interprofessional (IP) simulation experiences throughout their educational curricula, providing multiple opportunities for health professional students to collaborate and practice together. High-fidelity, real-time simulations help students from diverse professional backgrounds to apply their classroom learning in realistic clinical situations, utilize mobile technology to access clinical decision support (CDS) software, and receive feedback in a safe setting, ensuring they are practice-ready upon graduation.

Interprofessional Simulation: From the Classroom to Clinical Practice.

Interprofessional simulation (IPS), frequently referred to in the literature as simulation-enhanced interprofessional education (IPE), has been widely studied in nursing and medical education. For decades, the literature has suggested IPE as a valuable strategy for enhancing communication and collaboration among health professionals. Interprofessional collaborative practice (IPCP) is foundational to developing high-functioning healthcare teams and can lead to reduced medical errors and increased patient safety. This chapter addresses IPS from both the academic and practice perspectives. The foundations of IPE and IPCP are reviewed, as well as the standards of best practice in simulation. Planning, development, and implementation will be discussed, including benefits, barriers, and possible solutions. Recommendations from relevant research on debriefing and evaluation of IPS are also reviewed. Outcomes from the growing body of research on IPS will be presented and include perceptions of interprofessional practice, better understanding of professional roles and responsibilities, development of communication and teamwork skills, and shared problem-solving and decision-making. Future implications and recommendations are provided based on the state of the science on IPS. Optimum design, implementation, and evaluation of IPS, along with a thorough understanding of the benefits, barriers, and opportunities, can help faculty and clinical educators prepare a collaborative healthcare workforce and reduce medical errors to ultimately improve patient outcomes.

Attitudes and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large Academic Medical Center.

The increasing rates of comorbidities among patients and the complexity of care have warranted interprofessional collaboration (IPC) as an important component of the healthcare structure. An initial step towards assessing the effectiveness of collaboration requires the exploration of the attitudes and experience of healthcare professionals towards IPC. This online survey aimed to examine the attitudes of healthcare professionals working in a large public academic medical center toward IPC in patient care and the healthcare team, and their behavior and experience regarding IPC. The rankings, according to the perceived importance among the respondents, of the four Interprofessional Education Collaborative (IPEC) core competencies (values/ethics, roles/responsibilities, interprofessional communication, teams/teamwork) were assessed. There were strong but varying levels of consensus among healthcare professionals (N = 551) that IPC facilitates efficient patient care, improves patient problem-solving ability, and increases better clinical outcomes for patients. They acknowledged that IPC promotes mutual respect within the healthcare team and providers’ ability to make optimal patient care decisions. However, overall more than 35% of the respondents did not attend multidisciplinary education sessions (grand rounds, seminars, etc.), and about 23% did not participate in bedside patient care rounds. Interprofessional communication was ranked as the most important IPEC core competence. Although the attitude towards IPC among healthcare professionals is strongly positive, many healthcare professionals face challenges in participating in IPC. Institutional policies that facilitate interprofessional learning and interactions for this group of healthcare professionals should be formulated. Online distance learning and interactions, and simulation-enhanced interprofessional education, are options for addressing this barrier. Hospital administrators should facilitate conducive work environments that promote IPC, based on IPEC core competencies, and promote programs that address the challenges of IPC.

Online Non-Technical Skill Simulation: Enhanced Interprofessional Education: Changes in Attitudes and Behaviors of Health Professions Graduate Students

INTRODUCTION Challenges to the successful implementation of interprofessional education (IPE) include attitudes, logistics and resources. Online non-technical simulation-enhanced interprofessional education (SIM-IPE) is a scalable, low-cost educational strategy that lacks representation in the literature. The objective of this study was to measure the effectiveness of online non-technical skill (ONTS) SIM-IPE to change attitudes toward interprofessional teams and the team approach to care. METHODS A quasi-experimental pre/post-test design using an online survey explored the effectiveness of ONTS SIM-IPE. Graduate health professions students’ attitudes toward interprofessional teams and team approach to care was measured using the SPICE-R2. RESULTS Post-test scores on the Student Perception of Interprofessional Clinical Education Revised (SPICE-R2)revealed significant differences in the following subscales: Roles/Responsibility (Z=-.313, p

Faculty Reflections on Effective Strategies Utilized to Implement Simulation-Enhanced IPE for Future Health Care Providers

BackgroundWith the recent emphasis on implementation of interprofessional education (IPE), simulation can be a successful and impactful pedagogy to train health profession learners. Simulation allows opportunities to practice decision-making and working in teams in a realistic and safe environment. Participants learn with and about other professions and have the chance to clarify roles within their team. Simulation-enhanced IPE can present challenges for faculty. This article seeks to provide insight into key aspects of interprofessional simulation to maximize its successful implementation. MethodsOur team has identified key lessons learned in how we successfully implemented IPE using simulation. We have collectively overcome challenges and barriers as we have implemented simulation-based IPE at our university. ResultsTo implement effective simulation-enhanced IPE, teams should consider an overall need assessment, curriculum integration, logistical plans, faculty development, a structured prebrief and debrief plan, and a process for evaluation. ConclusionsAlthough IPE is an important component of training for future health care providers, simulation can be an effective strategy for implementation of interprofessional activities. However, it is essential to consider key aspects to ensure a quality and consistent experience for learners.