Using interprofessional simulation to improve collaborative competences for nursing, physiotherapy, and respiratory therapy students

Nursing students' perceived ability to practice interprofessional collaboration after the inclusion of virtual and immersion interprofessional education activities: A quantitative exploration

BACKGROUND

Little is known about the influence of interprofessional education (IPE) on interprofessional collaboration (IPC), particularly following the COVID 19 pandemic.

AIM

To examine nursing students' perceived ability to practice IPC after exposure to virtual lectures and immersive clinical IPE activities founded on the competencies from the National Interprofessional Competency Framework.

DESIGN

A cross-sectional design was used.

METHODS

Third year nursing students (n=105) enrolled in a pediatric theory and clinical completed surveys including: Demographic items, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS) and the Interprofessional Education Collaborative Competency Self-Assessment (IPEC) (Version 3). Students completed reflective questions about their IPE experiences. Descriptive statistics, paired t-tests, confidence intervals, and point estimates were used to measure the differences from pre- to post-participation for all items of the ICCAS and IPEC.

RESULTS

Participants reported improved IPC competence on every item and overall, after the IPE activities. Participants from urban campuses had lower ICCAS scores (PE 0.38, 95 % CI, 0.12-0.65) than those from rural campuses (PE 0.45 95 % CI, 0.18-0.72). Students who identified as men had higher team functioning scores before participating in the IPE activities than women (PE 0.50; 95 % CI,: 0.05-0.95). The IPEC Interaction items mean score was 4.03 ±.50 and IPE values items were higher with a mean of 4.62 ± 0.46.

CONCLUSIONS

The findings can guide development and implementation of IPE experiences for nursing and allied healthcare students.

Simulation-Based Teaching and Learning in Respiratory Care Education: A Narrative Review

Simulation-based pedagogy has become an essential aspect of healthcare education. However, there is a significant gap in the literature regarding the application of simulation-based modalities in respiratory care education. This review aims to address this gap by providing insight into the theory and current uses of simulation, its effectiveness in respiratory care education, and strategies to enhance faculty development. The study utilizes a narrative synthesis approach to review relevant literature and provide a comprehensive understanding of the topic. The research involved comprehensive searches of electronic databases, including PubMed and Google Scholar, to identify relevant literature, encompassing original articles, reviews, and other pertinent content, focusing on simulation-based teaching and learning in respiratory care education published between 1990 and 2022. Findings suggest that simulation-based education is an effective tool for improving respiratory care education and can enhance the clinical skills of learners. The study concludes by discussing the future of simulation in respiratory care education and the potential benefits it may offer.

Fostering collaborative practice through interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students

Literature regarding simulation for learning interprofessional collaborative practice (IPCP) indicates a need to include a range of health professions and to focus on students' development of team communication and conflict resolution skills in day-to-day healthcare delivery. This study evaluated the impact of interprofessional simulation for occupational therapy, physiotherapy, dietetics, and nursing students on interprofessional collaboration competencies, specifically collaborative communication and conflict resolution during day-to-day interactions, and their intention for IPCP during placement. A series of simulations featuring the potential for interprofessional conflict and involving explicit coaching on communication and conflict resolution were conducted. A single cohort pre-test post-test design included the Students' Perceptions of Interprofessional Clinical Education Revised (SPICE-R), the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), and an open response survey question on future intended practice. A total of 237 students participated in the simulation experience. Overall scores and scores on all IPCP competencies in the ICASS (n = 193) and SPICE-R (n = 226) improved for all professions post-simulation. The mean score of the ICCAS increased for 98% of the respondents and similarly the mean score of the SPICE-R increased for 71% of the respondents. Open-ended responses indicated students' intentions to pursue self-leadership in IPCP. Students who participated in an interprofessional simulation reported perceived improvements in IPCP competencies and were encouraged to initiate IPCP when on placement in the practice setting.

Health Care Clinical Preceptors' Attitudes Towards Interprofessional Education in Saudi Arabia: A Cross-Sectional Study

Introduction

IPE fosters a dynamic learning environment that may promote students' knowledge, abilities, and collaborative approach towards addressing challenging clinical circumstances. While much has been reported in the literature regarding these diverse IPE learning environments, limited information exists regarding clinical preceptors' attitude and perceptions of IPE, especially in Saudi Arabia. Given the impact clinical preceptors have on the formation of healthcare students exploring their perceptions, which may impact their actions is imperative.

Methodology

The study focused on understanding the attitudes and perceptions of clinical preceptors towards IPE in a healthcare setting in Saudi Arabia. The study was conducted in Saudi Arabia. Data was collected via Email letter of solicitation (LOS) which included a link to the Readiness for Interprofessional Learning Scale (RIPLS) survey. The LOS was sent to all the health care programs in Saudi Arabia.

Results

The study surveyed 182 clinical preceptors. The findings revealed consistent favorable opinions towards "Teamwork and Collaboration". The majority of preceptors concurred that learning alongside other students would increase students' efficiency on healthcare teams and deepen their comprehension of clinical issues. The "Roles and Responsibilities" category, however, obtained lower ranks in general from the preceptors. Not surprising, differences in rankings were greatest between preceptors who had and did not have IPE exposure, there were significant variations in views toward "Teamwork and Collaboration", "Negative Professional Identity", and "Roles and Responsibilities". Preceptors exposed to IPE showed lower median ratings for "Negative Professional Identity" and "Roles and Responsibilities" and better median scores for "Teamwork and Collaboration".

Conclusion

The attitudes and perceptions of preceptors who had experienced IPE were more favorable toward IPE and thus may foster it more effectively in the students they work with. Therefore, ensuring that all preceptors are aware of and have experience with IPE is important as we seek to promote person-centered care.

Interprofessional collaboration skills and motivation one year after an interprofessional educational intervention for undergraduate medical and nursing students

BACKGROUND

The increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other?

METHODS

During a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence.

RESULTS

In the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group.

CONCLUSIONS

The perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.

Society for Simulation in Healthcare Guidelines for Simulation Training

BACKGROUND

Simulation has become a staple in the training of healthcare professionals with accumulating evidence on its effectiveness. However, guidelines for optimal methods of simulation training do not currently exist.

METHODS

Systematic reviews of the literature on 16 identified key questions were conducted and expert panel consensus recommendations determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.

OBJECTIVE

These evidence-based guidelines from the Society for Simulation in Healthcare intend to support healthcare professionals in decisions on the most effective methods for simulation training in healthcare.

RESULTS

Twenty recommendations on 16 questions were determined using GRADE. Four expert recommendations were also provided.

CONCLUSIONS

The first evidence-based guidelines for simulation training are provided to guide instructors and learners on the most effective use of simulation in healthcare.

The Use of Standardized Patients to Teach Communication Skills-A Systematic Review

OBJECTIVES

The aim of this systematic review was to synthesize research completed between 2011 and 2021 to report the current state of the science on the use of standardized patients (SPs) to teach communication skills. The research question that guided this study was, "Among health care professionals, does the use of SP methodology as a means of teaching communication skills result in improved learner knowledge, skills, attitudes, and/or patient outcomes when compared with other simulation methodologies?"

DESIGN

This review was reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Data SourcesFour databases (CINAHL, Ovid Embase, Ovid Medline, and Scopus) were searched using a combination of medical subject headings, or Mesh terms, as well as keywords to retrieve nonindexed citations.Review MethodsThe inclusion criteria were broad to complete a comprehensive search of the literature. To be eligible for inclusion, a study had to be original research that compared simulation using an SP to another simulation methodology. The study had to evaluate communication knowledge, skill, attitude, and/or patient outcome with an academic or practicing health care professional.

RESULTS

The initial database search strategy yielded 8058 citations. These results were narrowed down to 18 studies through an in-depth analysis of each article using identified inclusion criteria. The SPs were superior to role play in 1 (33%, n = 3) study where knowledge was evaluated, 6 (75%, n = 8) studies where skills were evaluated, and 1 (20%, n = 5) study where attitude was evaluated. The SPs were compared with a manikin in 5 studies. The SPs were superior to a manikin in 3 (60%, n = 5) studies where knowledge was measured and in 1 (100%, n = 1) study where attitude was measured. No study measured the outcome knowledge of an SP to a manikin. Finally, SPs were compared with a virtual SP in 3 studies. When knowledge was evaluated, SPs were superior to a virtual SP in 1 study (100%, n = 1). When skills were evaluated, SPs were superior to a virtual SP in 1 study (50%, n = 2), and when attitude was evaluated, SPs were superior to a virtual SP in no study (0%, n = 2). No study evaluated patient outcomes in the comparison of an SP to another simulation methodology.

CONCLUSIONS

Studies show a weak indication that SP-based education is superior to other simulation methodologies in most contexts. However more rigorous studies with larger sample sizes, validated instruments, and effects on patient outcomes are needed to definitively determine the optimal method/modality for teaching communication to health care professionals.

Piloting an interprofessional virtual cadaveric dissection course: Responding to COVID-19

Interprofessional learning improves students' clinical and interprofessional competencies. COVID-19 prevented delivering in-person education and motivated the development of a virtual interprofessional cadaveric dissection (ICD) course. This study reports on the effects of a virtual ICD course compared to a previously delivered in-person course, on students' readiness for, and perceptions about, interprofessional learning. Students attending the ICD course in-person (2019-2020) or virtually (2020-2021) completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Students in the virtual course also provided written feedback. Thirty-two (24 women; Median: 24 [Q1-Q3: 22-25] years) and 23 students (18 women; 22 [21-23] years) attended the in-person and virtual courses, respectively. In the virtual cohort, the RIPLS total score (82 [76-87] vs. 85 [78-90]; p = 0.034) and the roles and responsibilities sub-score (11 [9-12] vs. 12 [11-13]; p = 0.001) improved significantly. In the in-person cohort, the roles and responsibilities sub-score improved significantly (12 [10-14] vs. 13 [11-14]; p = 0.017). No significant differences were observed between cohorts (p < 0.05). Themes identified in the qualitative analysis were advantages and positive experiences, competencies acquired, disadvantages and challenges, and preferences and suggestions. In-person and virtual ICD courses seem to have similar effects on students' interprofessional learning. However, students reported preferring the in-person setting for learning anatomy-dissection skills.

Using an interprofessional competency framework to enhance collaborative pediatric nursing education and practice

Background

Interprofessional education (IPE) provides healthcare students with the knowledge and skills necessary to provide safe and effective collaborative care in a variety of clinical settings. Inclusion of IPE in nursing curricula is required for program accreditation in Canada; a variety of learning strategies at varied levels are used to meet this requirement. As this formal requirement only occurred over the last decade, development, facilitation, and evaluation of IPE interventions are ongoing.

Purpose

The purpose of this study was to examine if exposure to an introductory IPE activity influenced third-year undergraduate nursing students’ perceived ability to practice competent interprofessional collaboration (IPC).

Methods

The introductory IPE activity included ten-hours of interactive lectures and related case studies, grounded in the National Interprofessional Competency Framework, delivered by various healthcare professionals in a third-year nursing theory and clinical course. Following completion of the courses, quantitative data were collected via the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) which was used to evaluate nursing students’ change in competencies for IPC. Frequencies, percentages, and means were used to analyze the demographic data, the Cronbach’s alpha coefficient was used to evaluate the internal reliability of the ICCAS, and paired t-tests were conducted to measure the difference from pre- to post-participation for all 20 items and 6 subscales of the ICCAS.

Results

Study participants (n = 111) completed the ICCAS at the end of the courses to measure change in six competencies. The survey results indicated improvements in all competencies following the IPE activity.

Conclusions

The significant findings demonstrate that exposure to introductory IPE activities, involving nursing students and other healthcare professionals, hold promise for enhancing IPC in pediatric clinical settings. These findings can be used to inform the development of formal IPE interventions.

Use of clinical simulation to train healthcare teams in conflict management: A scoping review

OBJECTIVE

To assess and analyze the impact of clinical simulation as a training tool in healthcare teams ability to resolve and manage conflicts, through an exploratory systematic review.

METHODS

A structured literature review was performed with the terms [Clinical Simulation OR Patient Simulation OR Simulation Training OR High Fidelity simulation Training] AND [Conflict OR Conflict Resolution] in the following databases: MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS y DOCUMED. Articles were considered if they involved clinical simulation oriented to training of healthcare professionals or trainees in conflict management, using clinical scenarios, and excluding those studies older than 20 years. Absence of debriefing was not considered an exclusion criterion, neither the use of simulation along with other methodologies. A quantitative analysis was performed.

RESULTS

10 articles were retrieved, mostly with quasi-experimental designs, in which clinical simulation was designed as an interprofessional training and was used with multiple other methodologies like roleplay, reflexive practice and audiovisual aids, strategy that suggest an increase its effectivity. Different scenarios have been recreated, like decision-making divergences and management of medical errors, in order to apply the competences of mediation, communication, emotional skills among others, and followed by debriefing. The use of validated scales and conventional assessment methods reveal a positive impact on satisfaction, perception and learning of students, as well as transfer to clinical practice and decrease in errors.

CONCLUSION

Multiple studies describe and support the use of clinical simulation for training in management and resolution of conflicts among healthcare professionals. Simulation is accepted by participants, developing transfer of skills and competences and impact at the organizational level. Nonetheless, studies are recent and limited in number, making this area a developing field that promotes future research.

Exploring healthcare students' interprofessional teamwork in primary care simulation scenarios: collaboration to create a shared treatment plan

BACKGROUND

Primary care providers assume responsibility for patients with increasingly complex problems requiring interprofessional collaboration. Introducing interprofessional education in healthcare curricula prepares healthcare students for this reality. Solving simulation scenarios as an educational strategy is promoted to support interprofessional education in health care, and is mostly used in acute clinical situations. This paper aims to explore how healthcare students' actions influence interprofessional collaboration and treatment plan identification when they solve common, sub-acute patient scenarios in primary care situations.

METHODS

Interaction analysis of video recordings from the simulation scenarios was performed with a focus on the students' joint actions; specifically how these actions unfold and how productive the students were in terms of developing treatment plans.

RESULTS

We found variation in the groups' interactions, the paths they followed, and the quality of their knowledge output in their shared treatment plan. The groups with the capacity to collaborate and engage in sharing information, and explain and elaborate on concepts, were more successful in developing comprehensive treatment plans. Furthermore, these groups managed the duality of defining and solving the immediate problem and collaboratively preparing for future care.

CONCLUSIONS

Analysis of the activities in our scenarios showed the students' potential to practice interprofessional collaboration. Our study illustrates that simulation of sub-acute scenarios in primary care is an underexplored but suitable arena to train communication and teamwork in complex situations. The simulation scenarios are also feasible for use on-site in an educational facility or in practice with minimal equipment and resources.

Simulated Learning Experience in Advance Care Planning Conversations

The Centers for Disease Control and Prevention reports that one-third of all Americans have not done any advance care planning, which is essential for maintaining autonomy when people are no longer able to communicate wishes directly at the end of life. The Institute of Medicine reports that providers have limited training in communication techniques and low confidence in holding advance care planning conversations. Forty-four family nurse practitioner students received classroom communication training using evidence-based end-of-life nursing education consortium materials and role-play opportunities. One month later, students participated in a palliative care simulation experience in a high-fidelity simulated medical office environment with standardized patient. The family practice nurse practitioner students were required to communicate bad news of a poor diagnosis to a family member and begin the advance care planning conversation using the SPIKES protocol. Findings include a significant increase in postintervention advance care planning communication knowledge scores and self-confidence in holding these conversations (mean, 30.55 [SD, 2.992]; 95% confidence interval, 29.64-31.46; median, 31; range, 11-35) and satisfaction with the learning experience (mean, 18.14 [SD, 2.11]; 95% confidence interval, 17.50-18.78; median, 19; with range between 13 and 20).

Knowledge and readiness for inter professional education and collaborative practice among undergraduate nursing students in a Middle Eastern country - A pilot study

BACKGROUND

Inter Professional Education and Collaboration (IPEC) is grounded on mutual respect, enhances collaborative practice, and increases satisfaction among health care professionals.

PURPOSE

The study was conducted to assess the level of knowledge and readiness for IPEC among nursing students.

METHODS

The student's level of knowledge was assessed using a 20 item questionnaire while their readiness for IPEC was measured using the Readiness for Interprofessional Learning Scale (RIPLS) comprising 19 items. A total of 125 nursing students participated in the study and data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25 DISCUSSION: The mean level of knowledge was 44.41 with SD of 4.72. The mean readiness score was 79.09 with the SD of 11.77. There is no significant association between the knowledge and readiness of nursing students regarding IPEC and their demographic variables at 0.05 confidence level.

CONCLUSIONS

Majority of the students had moderately adequate knowledge about IPEC and high level of readiness towards IPEC. This implies that when appropriately implemented, the students will reap the benefits of IPEC, which has the potential to improve their ability to provide holistic nursing care to their patients.

Use of clinical simulation to train healthcare teams in conflict management: a scoping review

OBJECTIVE

To assess and analyze the impact of clinical simulation as a training tool in healthcare teams ability to resolve and manage conflicts, through an exploratory systematic review.

METHODS

A structured literature review was performed with the terms clinical simulation OR patientsimulation OR simulation training OR high fidelity simulation training AND conflict OR conflict resolution in the following databases: MEDLINE, LILACS, Cochrane, Scielo, PubMed, CINHAL, ScienceDirect, MEDES, IBECS and DOCUMED. Articles were considered if they involved clinical simulation oriented to training of healthcare professionals or trainees in conflict management, using clinical scenarios, and excluding those studies older than 20 years. Absence of debriefing was not considered an exclusion criterion, neither the use of simulation along with other methodologies. A quantitative analysis was performed.

RESULTS

10 articles were retrieved, mostly with quasi-experimental designs, in which clinical simulation was designed as an interprofessional training and was used with multiple other methodologies like roleplay, reflexive practice and audiovisual aids, strategy that suggest an increase its effectivity. Different scenarios have been recreated, like decision-making divergences and management of medical errors, in order to apply the competences of mediation, communication, emotional skills among others, and followed by debriefing. The use of validated scales and conventional assessment methods reveal a positive impact on satisfaction, perception and learning of students, as well as transfer to clinical practice and decrease in errors.

CONCLUSION

Multiple studies describe and support the use of clinical simulation for training in management and resolution of conflicts among healthcare professionals. Simulation is accepted by participants, developing transfer of skills and competences and impact at the organizational level. Nonetheless, studies are recent and limited in number, making this area a developing field that promotes future research.

Exploring the role of simulation to foster interprofessional teamwork among medical and nursing students: A mixed-method pilot investigation in Hong Kong

Effective teamwork is a critical component of maintaining patient safety. However, there is lack of clarity on the best teaching approach to interprofessional teamwork training in medical and nursing curricula. This study aimed to compare the effects of blended classroom plus clinical simulation versus clinical simulation alone on teamwork attitudes, perceptions and performance in medical and nursing students in Hong Kong. This was a pilot study with a mixed-method research design, with both quantitative and qualitative evaluations. Students who studied medicine or nursing courses at a university in Hong Kong were invited to this study. They were assigned into two groups: clinical simulation alone versus blended classroom plus clinical simulation. The primary outcome was attitudinal change related to teamwork behaviours, which was measured using the Human Factors Attitude Survey. The secondary outcomes were perceptions of team-based learning and teamwork performance, which were accessed by the Team-Based Learning Student Assessment Instrument and Ottawa Global Rating Scale, respectively. Four focus group interviews were conducted after the training sessions. Conventional content analysis using inductive coding was performed with the qualitative data. Forty-six students participated in this study. There was a significant increase in the participants' positive attitudes on teamwork for both groups (intervention: MD = 5.36 and control: MD = 3.6, p <.05); however, there was no significant difference on increasing positive attitudes between the groups (estimate = 1.76, 95% CI [-8.59, 5.06], p = .61). Qualitative analysis identified four themes: (1) reconsidering professional roles in managing patients; (2) embodying the experience to share responsibility and complement each other's skills; (3) realizing the importance of trust and communication; and (4) engaging to achieve the mission within a limited time. This pilot study found that a blended classroom did not further improve teamwork attitudes, perceptions and performance in medical and nursing students compared with clinical simulation alone. Qualitative findings showed that students had reconsidered their professional roles in managing patients and realized the importance of teamwork in caring patients.

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.

Interprofessional simulation effects for healthcare students: A systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review of studies describing the effects of interprofessional education (IPE) on collaborative competence using simulated-based training of undergraduate healthcare students.

DESIGN

A systematic review and meta-analysis based on PRISMA guidelines.

DATA SOURCES

PubMed and Cumulative Index to Nursing and Allied Health Literature databases were searched to identify articles in all languages published up to 2018. The systematic review protocol was registered at PROSPERO under number 133330.

REVIEW METHODS

In total, 419 articles were identified. The following articles were excluded: non-English articles, articles for which the full text was not available, articles that did not employ a validated tool, articles that did not use quasi-experimental methods and that did not assess healthcare student populations. Eleven studies were included, and 6 were submitted to meta-analysis using forest plots through RevMan 5.3.

RESULTS

Interprofessional simulation analysis yielded results regarding participants, protocols, scenarios, validated tools, collaborative competencies and primary outcomes. The meta-analysis was organized based on assessment tool, and summary value, confidence interval, and Z test results for the random-effects model are presented.

CONCLUSION

Quantitative analysis reveals a positive impact and the effectiveness of interprofessional simulation. However, more research should be conducted utilizing clinical trials with distinguished analyses for each collaborative competency factor to assess long-term effects on the outcome.

The Use of Theoretical Frameworks Guiding Interprofessional Simulation: An Integrative Review

AIM

The aim of the review was to describe and summarize the use of theoretical premises noted in published studies on the implementation of interprofessional simulation (IPE-Sim).

BACKGROUND

IPE-Sim is an educational methodology being used throughout nursing, allied health, and health science programs of study. Understanding frameworks currently used in IPE-Sim is essential in advancing the knowledge of this type of educational methodology.

METHOD

An integrative literature review on the use of theories and models guiding IPE-Sim was performed.

RESULTS

Ten studies meeting the inclusion criteria were categorized into theoretical frameworks (n = 4) or competency frameworks (n = 6) guiding the development and implementation of IPE-Sim and were included in the review. The literature review revealed a lack of consistent theoretical and competency-based frameworks guiding the development, implementation, assessment, and research of IPE-Sim.

CONCLUSION

The integrative literature review describes specific theoretical and competency frameworks currently used in the literature on IPE-Sim.

Interprofessional education in geriatric medicine: towards best practice. A controlled before-after study of medical and nursing students

OBJECTIVES

To investigate nursing and medical students' readiness for interprofessional learning before and after implementing geriatric interprofessional education (IPE), based on problem-based learning (PBL) case scenarios. To define the optimal number of geriatric IPE sessions, the size and the ratio of participants from each profession in the learner groups, the outcomes related to the Kirkpatrick four-level typology of learning evaluation, students' concerns about joint learning and impact of geriatric IPE on these concerns. The study looked at the perception of roles and expertise of the 'other' profession in interprofessional teams, and students' choice of topics for future sessions. Students' expectations, experience, learning points and the influence on the understanding of IP collaboration, as well as their readiness to participate in such education again were investigated.

DESIGN

A controlled before-after study (2014/2015, 2015/2016) with data collected immediately before and after the intervention period. Study includes additional comparison of the results from the intervention with a control group of students. Outcomes were determined with a validated 'Readiness for Interprofessional Learning' questionnaire, to which we added questions with free comments, combining quantitative and qualitative research methods. The teaching sessions were facilitated by experienced practitioners/educators, so each group had both, a clinician (either geratology consultant or registrar) and a senior nurse.

PARTICIPANTS

300 medical, 150 nursing students.

SETTING

Tertiary care university teaching hospital.

RESULTS

Analysis of the returned forms in the intervention group had shown that nursing students scored higher on teamwork and collaboration post-IPE (M=40.78, SD=4.05) than pre-IPE (M=34.59, SD=10.36)-statistically significant. On negative professional identity, they scored lower post-IPE (M=7.21, SD=4.2) than pre-IPE (M=8.46, SD=4.1)-statistically significant. The higher score on positive professional identity post-IPE (M=16.43, SD=2.76) than pre-IPE (M=14.32, SD=4.59) was also statistically significant. Likewise, the lower score on roles and responsibilities post-IPE (M=5.41, SD=1.63) than pre-IPE (M=6.84, SD=2.75).Medical students scored higher on teamwork and collaboration post-IPE (M=36.66, SD=5.1) than pre-IPE (M=32.68, SD=7.4)-statistically significant. Higher positive professional identity post-IPE (M=14.3, SD=3.2) than pre-IPE (M=13.1, SD=4.31)-statistically significant. The lower negative professional identity post-IPE (M=7.6, SD=3.17) than pre-IPE (M=8.36, SD=2.91) was not statistically significant. Nor was the post-IPE difference over roles and responsibilities (M=7.4, SD=1.85), pre-IPE (M=7.85, SD=2.1).In the control group, medical students scored higher for teamwork and collaboration post-IPE (M=36.07, SD=3.8) than pre-IPE (M=33.95, SD=3.37)-statistically significant, same for positive professional identity post-IPE (M=13.74, SD=2.64), pre-IPE (M=12.8, SD=2.29), while negative professional identity post-IPE (M=8.48, SD=2.52), pre-IPE (M=9, SD=2.07), and roles and responsibilities post-IPE (M=7.89, SD=1.69), pre-IPE (M=7.91, SD=1.51) shown no statistically significant differences. Student concerns, enhanced understanding of collaboration and readiness for future joint work were addressed, but not understanding of roles.

CONCLUSIONS

Educators with nursing and medical backgrounds delivered geriatric IPE through case-based PBL. The optimal learner group size was determined. The equal numbers of participants from each profession for successful IPE are not necessary. The IPE delivered by clinicians and senior nurses had an overall positive impact on all participants, but more markedly on nursing students. Surprisingly, it had the same impact on medical students regardless if it was delivered to the mixed groups with nursing students, or to medical students alone. Teaching successfully addressed students' concerns about joint learning and communication and ethics were most commonly suggested topics for the future.

Simulation-based education improves student self-efficacy in physiotherapy assessment and management of paediatric patients

BACKGROUND

The Australian Physiotherapy Council mandates that physiotherapy clinical education be sufficient to produce graduates who are competent to practice across the lifespan. Due to a lack of opportunities for paediatric clinical placements, there is a risk of graduates not having the opportunity to develop competency in paediatric physiotherapy. To address this risk, simulation-based education (SBE) has been proposed as an educational strategy to address the placement shortfall. Despite encouraging evidence for its use in physiotherapy education, there is limited evidence supporting its use specifically in paediatric populations. The aims of this research were to investigate the effect of SBE on student self-efficacy in the physiotherapy assessment and management of paediatric clients, and to determine student satisfaction with SBE as a learning strategy.

METHODS

Three interactive SBE sessions were run during the undergraduate paediatric physiotherapy unit at the campus of one Australian university. Self-efficacy was surveyed before and after each session, to determine confidence in clinical skills, clinical decision-making, treatment preparation and planning, communication skills; evaluating and modifying interventions, and interprofessional practice. Student satisfaction with SBE as a learning strategy was surveyed after the final SBE session.

RESULTS

For the 164 participants included in this study, self-efficacy survey response rate varied from 77 to 96% for each session. Significant increases in mean student self-efficacy were recorded for all questions (p <  0.001). A total of 139 (85%) responded to the learning reactionnaire with 78.6% indicating they were very satisfied with SBE as a learning strategy. Written comments from 41 participants identified 'experience' as the primary theme.

CONCLUSION

SBE had a significant positive effect on student self-efficacy in the physiotherapy assessment and management of paediatric patients. Students also perceived SBE to be a valuable learning experience. Future research is needed to investigate whether the improvement in self-efficacy achieved through SBE translates into improved student performance during workplace-based clinical placements.

Taking a closer look at undergraduate acute care interprofessional simulations: lessons learnt

Interprofessional undergraduate/pre-registration simulations (UIPSims) are growing in popularity but remain under researched and without pedagogic instruction. We report on an evaluation of final year healthcare student UIPSims, focussed on safe practice using a mixed methods study. The evaluation combines traditional methods with direct observations of students. Students completed a pre and post-course questionnaire with scored and free text questions and in addition an ethnographer observed the UIPSims supported with video recordings. Final year students participated (medical, nursing, operating department practitioner, pharmacy; n = 230). The scored questions were significant (p < .01) with student comments confirming the value of the learning. The observations identified strengths and weaknesses. The students were professional and patient-centered, but were unable to function as a team, communicate effectively for shared decision making or recognize and highlight patient safety concerns. The facilitators mainly guided rather than facilitated proceedings. Despite having completed a theme of interprofessional education (IPE) designed to develop team working abilities, final year healthcare students were unable to function as a student team in order to apply theory to practice. The findings highlight how an interprofessional simulation at the end of an undergraduate curriculum offers a litmus test on student readiness for teamworking. The findings support an IPE curriculum with a set of theoretical principles aligned to a set of team working skills in readiness for participating in an UIPSims. In addition, facilitators should be trained on the principles for IPE as well as on best practice for simulations. Briefing is vital, enabling students to come together to form a team and find their collective voice. Observational research offers a powerful evaluation tool illuminating what is happening in these teaching situations. More research on the constituent components of UIPSims is required.

Collaboration of Dental Hygiene and Nursing Students on Hospital Units: An Interprofessional Education Experience

The aims of this study were to implement and evaluate an innovative collaborative event with hospitalized patients to help develop dental hygiene and nursing students' interprofessional competence. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used to assess the students' perceptions of interprofessional skill acquisition. Participants were 24 dental hygiene and 25 nursing students at the University of Southern Indiana in spring 2016. The results showed that all students had statistically significant improvement on the ICCAS items from pretest to posttest. There were no significant differences in improvement between the two groups on any single posttest item as the impact of the responses was similar. These results suggest that incorporating collaborative experiences in hospital settings can be an effective means to develop students' skills in interprofessional competence.

An interprofessional team simulation exercise about a complex geriatric patient

Interprofessional collaboration is an essential skill to optimize the care of older adults with complex problems. We successfully developed and evaluated an interprofessional teamwork simulation exercise for medical, nursing, pharmacy, and social work students. Pharmacy students participated via video conferencing. Before the simulation, students watched a teamwork video and reviewed the patient case. Following an icebreaker exercise, interdisciplinary faculty facilitated a discussion highlighting effective teamwork strategies. Students then collaborated to develop a discharge plan, followed by a simulated family meeting with a theater student. Interdisciplinary faculty again provided structured debriefing highlighting principles of effective teamwork. Students self-rated interprofessional practice core competencies were evaluated using a retrospective pre/post survey and analyzed using paired t-tests. We qualitatively examined the use of distance technology and assessed learner's satisfaction with the project. All core competency categories for all disciplines demonstrated significant improvements in mean scores. Students' qualitative comments demonstrated positive impact on learning interprofessional core competencies.

Use of the Online Discussion Board in Health Professions Education: Contributions, Challenges, and Considerations

Online discussion boards offer opportunities for individualized and interactive learning in higher education and are frequently used in health professions education. This article investigates the ways in which discussion board activities foster cognitive and affective domain learning among health professions students and contribute to the professional competencies that are required of emerging clinicians. In addition, pedagogical challenges, including the need to develop sophisticated interpersonal affective domain skills, promote problem-based learning, and prepare students for standardized examinations, are addressed. Considerations for practice, which include the importance of specific teaching strategies such as the shaping of student and instructor roles, scaffolding, and online debates and role-playing, are discussed.

Simulation Experiences in Canadian Physiotherapy Programmes: A Description of Current Practices

Purpose: Although health care professional education programmes around the world are increasingly using sophisticated simulation technology, the scope of simulation use in Canadian physiotherapy programmes is currently undefined. The current study explores the definitions of simulation, its current use, and the perceived benefits and barriers in Canadian entry-to-practice physiotherapy programmes. Method: Using a qualitative, descriptive study approach, we contacted Canadian physiotherapy programmes to identify faculty members with simulation experience. Using a semi-structured interview format, we asked participants to discuss their perspectives of simulation in their physiotherapy programmes. Interviews were audio recorded, transcribed, and analyzed for themes. Results: Of 13 eligible Canadian physiotherapy programmes, participants from 8 were interviewed. The interviews revealed three major themes: (1) variability in the definition of fidelity in simulation, (2) variability in simulation use, and (3) the benefits of and barriers to the use of simulation. Conclusions: Variability in the definition of fidelity in simulation among Canadian physiotherapy programmes is consistent with the current literature, highlighting a spectrum of complexity from low fidelity to high fidelity. Physiotherapy programmes are using a variety of simulations, with the aim of creating a bridge from theoretical knowledge to clinical practice. This study describes the starting point for characterizing simulation implementation in Canadian physiotherapy programmes and reflects the diversity that exists across the country.

Interprofessional simulation in undergraduate nursing program: An integrative review

OBJECTIVES

Interprofessional (IP) competencies are critical for successful collaborative practice. Nurse education, through interprofessional simulation, plays a critical role in preparing nursing students achieve these competencies. Although considerable research has been conducted on this topic, a broader perspective is lacking. This review systematically appraised and synthesized evidence examining the effects of interprofessional simulation on nursing students' outcomes.

DESIGN

An integrative review method guided this review.

DATA SOURCES

Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO, and MEDLINE) were searched to locate articles published from 2010 onwards. Search and MeSH terms included: interprofessional, interdisciplinary, simulation, nurse education, nursing, and student. Thirty (30) articles were included in this review.

RESULTS

Findings of content analysis revealed five essential themes: interprofessional communication, appreciation of interprofessional team roles, interprofessional teamwork or collaboration, self-confidence or self-efficacy, and positive attitudes or readiness toward interprofessional learning.

CONCLUSIONS

This review provides a current state of knowledge on the efficacy of interprofessional simulation in enhancing interprofessional learning and competencies in nursing students. However, more research should be done utilizing a more robust method of research and reliable assessment methods. Through interprofessional simulation experiences, nurse academe can adequately prepare nursing students for future collaborative practice. Inclusions of interprofessional simulation activities in all clinical nursing courses can help prepare nursing students achieve inter-professional learning.

Designing and Evaluating an Interprofessional Practice Experience Involving Dental and Pharmacy Students

Objective. To prepare pharmacy and dental students to collaborate as members of an interprofessional team by participating in an interprofessional practice experience. Methods. An interprofessional practice experience was implemented within a dental admissions clinic. Pharmacy and dental students collaboratively conducted medical histories and provided tobacco cessation education. Pharmacy student performance was measured using a standardized assessment rubric; pharmacy and dental student perceptions were measured using the SPICE-R tool; and faculty feedback was captured for evaluation purposes. Results. Pharmacy students achieved performance expectations upon completion. There was a statistically significant increase in the mean scores for a majority of the SPICE-R factors for pharmacy and dental students. Overall, faculty perceptions of the practice experience were positive. Conclusion. A collaboration between pharmacy and dental schools is a novel approach to meeting interprofessional and experiential curricular goals. Evaluating performance in practice experiences and perceptions can be used to demonstrate learner outcomes within interprofessional education. Furthermore, faculty feedback should be used to improve practice experiences.

Increasing Awareness of the Roles, Knowledge, and Skills of Respiratory Therapists Through an Interprofessional Education Experience

BACKGROUND

The objectives of this study were: (1) to assess the use of interprofessional education (IPE) to improve the knowledge and skill levels of nursing and occupational therapy students regarding respiratory therapy (RT) medical devices and techniques, nursing and RT students regarding safe patient transfers, and RT and occupational therapy students regarding safe handling of a patient's medical lines during transfers and (2) to promote collaborative behaviors.

METHODS

A prospective mixed methods approach was used for data collection of an IPE high-fidelity simulation experience involving 73 nursing, occupational therapy, and RT students at an academic medical institution. The Interprofessional Education Collaborative roles and responsibilities and interprofessional communication sub-competency guided the development of the IPE experience.

RESULTS

The pre-post paired survey response rate was 82.2%. Significant increases in student perception of learning differed by profession. Student evaluations of the IPE experience suggested that IPE increased students' knowledge of the procedures performed by the other represented professions and that students were more likely to collaborate with these professions in the future.

CONCLUSIONS

IPE improved student knowledge in the roles and responsibilities competency domain. In particular, nursing and occupational therapy students became more aware of the knowledge and skill set of the RT profession.