Interprofessional simulation in undergraduate nursing program: An integrative review

Introduction to Interdisciplinary Roles in a Nursing Leadership Course: If I Understand You, Then I Know How to Work With You

ABSTRACT

Active learning experiences for undergraduate nursing students build upon their understanding of concepts that transfer to new learning skills throughout the curriculum. Faculty implemented a leadership simulation in the classroom focusing on communication skills as a nurse leader to better understand the role of the nurse in the interdisciplinary team. The classroom setting is an ideal platform to teach interdisciplinary collaboration when opportunities do not present in the clinical setting. Scaffolding simulation experiences throughout the curriculum helps bridge the knowledge and skills gap between classroom and clinical experiences.

High-fidelity simulation-based education in pre-registration healthcare programmes: a systematic review of reviews to inform collaborative and interprofessional best practice

Simulation-based education (SBE) is recognized as an effective interprofessional teaching and learning method. Whilst there is a large volume of research evidence concerning elements of SBE there is a lack of clarity concerning foundational principles of best practice. This is important for educators wishing to utilize high-quality SBE to deliver interprofessional education. The aim of this review is to synthesize review evidence of SBE best practice in a broad range of pre-registration healthcare programs and contextualize findings in light of relevant educational theory. A systematic search of PubMed, Scopus, Medline/Ovid, British Nursing Index, and the Cochrane Library databases was undertaken in February 2020. Data extraction and quality evaluation were undertaken by two authors. Fifteen reviews were included. In addition to identifying barriers and enablers to implementation, three interdependent themes regarding SBE best practice were found: curriculum level integration and planning (curriculum level integration, the opportunity for deliberate repeated practice, distribution, and sequencing); simulation design and delivery (clearly defined learning outcomes and benchmarks, pre-brief, multiple learning strategies, interactivity and individualized learning, feedback, and debrief); and resources (facilitator competency, controlled environments). These themes broadly align with the social constructivist theory of experiential learning whereby structured opportunities to learn via concrete experience, reflective observation, abstract conceptualization, and active experimentation are provided through effective planning, design, and delivery of SBE. Interdependencies suggest that integration of SBE at curriculum-level enables planning and implementation of best practice principles which are associated with effective learning, which also inform and facilitate the availability of adequate simulation resources.

The Student Navigator Project (SNaP): Preparing Students Through Longitudinal Learning

INTRODUCTION

Early medical school education has historically focused on teaching basic medical sciences. More recently, medical schools are encouraged to incorporate health systems science (HSS) into early curricula. Addressing all of these components in an overcrowded curriculum remains challenging.

METHODS

We report on the Student Navigator Project (SNaP), a pre-clinical experience where students engage longitudinally with medically and socially complex patients. SNaP is built on a foundation of trust, responsibility, and ownership in the student-patient relationship. Early learners take an active role in navigating, advocating, and coaching for their patients. In addition, students are integrated as medical assistants into a primary care clinic; complete a mentored, team-based quality improvement project; and engage in evidence-based medicine, teaching, and handoff activities.

RESULTS

As a result of these activities, students learn firsthand about HSS, contribute meaningfully to their patients' care, and are immersed in a systems-based practice approach early in their medical school education. Preliminary outcomes (2016-2019) show satisfaction with the program and knowledge of program focus areas.

CONCLUSIONS

The authors are engaged in improvement cycles to modify program structure and curriculum in order to promote dissemination in diverse clinical settings. Ultimately, we plan to measure longer-term outcomes, including clerkship and residency preparation, career choice, and practice setting.

A Comparison of Patient Safety Competencies between Clinical and Classroom Settings among Nursing Students

Background: As nurses play an important role in the implementation of patient safety in hospitals, competencies of patient safety should be developed and enhanced among nursing students. Self-assessment is a method that can be used to assess patient safety and its dimensions to help the students prepare themselves before entering the work life.Purpose: This study aimed to investigate differences in patient safety competencies between classroom and clinical settings among nursing students using a self-assessment method.Methods: A descriptive study using the Health Professional Education in Patient Safety Survey (H-PEPSS) questionnaire was conducted among 181 nursing students in a public university in Indonesia. Paired t-test, ANOVA, and independent t-test were performed to determine the comparison in the values of patient safety dimensions across classroom, clinical learning, and year of nursing course.Results: Nursing students showed a higher mean value in the classroom setting than the clinical setting. Out of the seven dimensions of patient safety competencies, “clinical safety” (M=4.36) and “communicate effectively” (M=4.29) obtained the highest score in classroom setting, while “adverse events” showed the lowest (M=4.03). In the clinical setting, “clinical safety” (M=4.19) and “communicate effectively” (M=4.12) obtained the highest score, while “working in teams” (M=3.82) was the lowest. The third-year students showed a better score than the fourth year in most dimensions.Conclusion: In this study, the patient safety competencies among nursing students were higher in the classroom setting than in the clinical setting. It is recommended to investigate the factors that can increase the achievement of patient safety competence among nursing student in the clinical setting.

Effects of a single interprofessional simulation session on medical and nursing students' attitudes toward interprofessional learning and professional identity: a questionnaire study

BACKGROUND

Participation in simulation-based interprofessional education (sim-IPE) may affect students' attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the 'fit' of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK.

METHOD

Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured. Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures.

RESULTS

A total of 194 medical and 266 nursing students completed questionnaires. A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site. Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students.

CONCLUSIONS

Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace. Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect.

Experiences of Arab male nursing students during high fidelity maternity simulation training

BACKGROUND

In Arab countries, many nursing schools rely heavily on simulation-based activities to provide experiential learning to male students with regard to maternal and child care; however, no study has been conducted to explore their experiences with such simulation training.

AIM

To describe the experiences of male nursing students who were exposed to high-fidelity simulation training related to maternity and child care.

METHODS

Husserl's approach to phenomenology guided this study, through the use of a structured interview with 15 Arab male nursing students. A thematic analysis technique served as a framework for the data analysis.

FINDINGS

Thematic analysis revealed four essential themes: gained competency; compensation for missed clinical experience; overcoming of cultural or religious barriers; and challenges related to the use of simulation technologies.

CONCLUSIONS

High-fidelity simulation can be a viable option to clinical training for enhancing Arab male nursing student competencies when providing maternal and child nursing care, which are often not available in the clinical area or are considered to be off limits due to cultural or religious reasons.

High-fidelity simulation and nursing students' anxiety and self-confidence: A systematic review

BACKGROUND

As a complementary teaching pedagogy, high-fidelity simulation remains as an effective form of simulation modality. Empirical evidence has additionally shown high-fidelity simulation (HFS) to be an effective contributor to students' learning outcomes.

PURPOSE

This paper critically appraised existing scientific articles that covered the influence of utilizing HFS on the effects of nursing students' anxiety and self-confidence during undergraduate nursing education.

METHODS

This was a systematic review of scientific articles conducted from 2007 to 2017 on the topic of the influence of using HFS on students' self-confidence and anxiety. The literature of six electronic databases (Proquest, SCOPUS, MEDLINE, PubMed Central, CINAHL, and PsychINFO) was reviewed.

RESULTS

Following the literature search, 35 articles were selected. This review provides updated evidence on the efficacy of HFS in reducing anxiety and enhancing self-confidence among nursing students when performing nursing duties or managing patients. Moreover, this review highlights the need for more research that examines the impact of HFS on students' anxiety.

CONCLUSION

As this form of simulation is found to be effective in the enhancement of nursing student self-confidence and the reduction of their anxiety when caring for patients and/or employing nursing skills, the inclusion of simulation-based activities in all clinical nursing courses is vital.

Students' experiences and perceptions of interprofessional education during rural placement: A mixed methods study

BACKGROUND

Interprofessional collaboration is key to addressing the complexity of contemporary health care, therefore it is imperative that students from different disciplines have access to interprofessional education to equip them with the requisite skills and attributes. While interprofessional education promotes a person-centred approach and mutual recognition of one another's contributions to health outcomes, interprofessional education in Australian universities is fragmented and presents challenges that can be addressed through clinical placements.

OBJECTIVES

This article reports student perceptions and readiness for interprofessional education in the rural clinical learning environment in one region of Australia.

DESIGN

A mixed methods approach.

SETTINGS

Rural clinical learning environments in one geographic area in Victoria, Australia.

PARTICIPANTS

60 undergraduate healthcare students from allied health, medicine, nursing and midwifery.

METHODS

A survey incorporating Readiness for Interprofessional Learning Scale, Interdisciplinary Education Perception Scale and focused interprofessional questions. Qualitative data were collected via survey comments, interviews and focus groups.

RESULTS

Students had numerous opportunities for interprofessional education, to observe role modelling in the workplace and considered that learning with other professions would help them become more effective members of the health care team. Students valued learning about collaborative practice, the roles of other professions and identified activities that enhanced interprofessional engagement.

CONCLUSIONS

This study provides important insights regarding students' perceptions and readiness for interprofessional education. These results demonstrate that there are numerous opportunities to embed interprofessional education within the rural clinical learning environment and offer new insights into students' experiences and preferences for potential activities. These findings may resonate with others implementing interprofessional education in the workplace and guide facilitators in planning activities for students. Factors influencing differences in attitudes towards interprofessional education and how students acquire an understanding of their professional or disciplinary role warrant further study.

The efficacy of interprofessional simulation in improving collaborative attitude between nursing students and residents in medicine. A study protocol for a randomised controlled trial

Background: Effective collaboration among health professionals is an essential component to ensure quality of care. Many adverse events experienced by patients are attributed to misunderstanding or poor communication among members of the interprofessional team. Interprofessional simulation is a learning strategy used to improve collaboration and facilitate communication between medical and nursing students. Aim of the work: To determine the efficacy of educational program based on high-fidelity interprofessional simulation aimed at improving collaborative attitude. Method: For this purpose, a protocol for a planned single-center, non-blinded and Randomized Controlled Trial (RCT) was chosen. The present has been approved by the Ethics Committee of Area Vasta Emilia Nord (Italy) (n° 479/2018). All students attending the second and third year of nursing and all resident physicians in anesthesia, reanimation, intensive care and pain management of University of Modena and Reggio Emilia, will be recruited and randomly assigned to two groups. The Experimental Group (EG) will receive an educational intervention based on high-fidelity simulation and the Control Group (CG) will attend a traditional classroom lesson. Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC) and Readiness for Interprofessional Learning Scale (RIPLS) will be administered before and after the educational program in both the EG and CG. Conclusion: Expected outcomes is that, at the end of the study, nursing students and resident physicians who participated in the interprofessional simulation show significantly higher levels of interprofessional collaboration compared to the CG, evaluated through the JSAPNC.