Examining interprofessional learning perceptions among students in a simulation-based operating room team training experience

Learning better together? A scoping review of in-person interprofessional undergraduate simulation

BACKGROUND

Given the increasing complexity of contemporary clinical practice, there has never been a more important time to provide interprofessional educational (IPE) activities across the learning continuum to develop collaborative practice. From the outset of health professional training, it is crucial that students not only develop their own professional skills but also gain an awareness of the capabilities of other healthcare professionals and how best to work collaboratively. Despite simulation being a common teaching modality in many undergraduate curricula, little is known about the range of interprofessional activities within these settings. Therefore, this study aims to address the following research question: What is known about undergraduate in-person (IP) simulation-based education (SBE)?

METHODS

We conducted a scoping literature review, adhering to the PRISMA-ScR extension guidelines, and used the Arksey and O'Malley framework. Our search covered three electronic databases: Web of Science (WOS), MEDLINE, and Embase. We utilised Covidence systematic review software to assist in screening articles. To support data charting, we developed a data extraction tool and employed both qualitative and quantitative techniques through numerical and thematic analysis to ensure a comprehensive representation of our data.

RESULTS

A total of 97 studies were included, with most publications originating from the USA, UK, and Australia. Two main themes emerged regarding the impact of IP SBE at an individual level: confidence and role identification. Several themes related to the impact on teams included knowledge of other professional roles/values, communication, and teamwork. The studies identified various barriers and enablers to simulation, particularly logistical barriers and financial challenges associated with complex technologically enabled simulation. Faculty collaboration and resources were reported as primary enablers in facilitating the delivery of simulation activities.

CONCLUSIONS

The impact of IP-SBE on learners and interprofessional teams is predominantly positive, with reported benefits including increased confidence, enhanced role identification, and improved communication and teamwork skills. However, challenges such as logistical barriers and resource constraints highlight the need for collaborative faculty efforts and adequate infrastructure to support IP-SBE implementation. Despite the growing interest in IP-SBE, there remains a notable lack of standardised reporting on simulation design and debriefing processes in both teaching practice and research.

Crisis management in the operating room: A systematic review of simulation training to develop non-technical skills

AIMS

Crises in the operating room, often resulting from human factors, endangers patient safety. Simulation-based training to develop non-technical skills shows promise in managing these crises. This review examines the simulation techniques, targeted healthcare professionals, non-technical skills, crisis scenarios, and evaluation metrics used in operating room crisis management training.

DESIGN

Systematic review.

DATA SOURCES

MEDLINE, APA PsycInfo and Web of Science databases were searched for peer-reviewed articles published between January 2004 and March 2024.

REVIEW METHODS

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol has been registered on the Open Science Framework (OSF) (https://osf.io/7bsc8). The inclusion criteria were as follows: (1) The study population comprised healthcare and medical professionals or students; (2) the intervention involved a simulated learning or training experience; (3) the outcomes focused on non-technical skills or crew resource management; (4) the training setting was the operating room (simulated or real); and (5) the learning scenarios depicted a crisis or an adverse event.

RESULTS

This systematic review identified 29 eligible articles. The findings highlight the predominance of high-fidelity simulations, primarily targeting medical staff rather than nurses or other healthcare professionals. Training focused on communication, teamwork, situation awareness, problem solving, and decision making, with scenarios mostly addressing patient deterioration. Assessments reached up to Kirkpatrick's Level 3, demonstrating a positive training impact through learners' reactions and learning metrics rather than behavior and organizational results.

CONCLUSIONS

Despite their effectiveness, current training practices exhibit limitations. Incorporating nurses and other paramedical staff in interprofessional training, as well as emphasizing team-related scenarios and evaluating behavioral changes in practice, could enhance training effectiveness. This has implications for interprofessional healthcare education and skills transfer to real-world settings, ultimately improving patient safety.

Tools for self- or peer-assessment of interprofessional competencies of healthcare students: a scoping review

Introduction

Healthcare professionals are expected to demonstrate competence in the effective management of chronic disease and long-term health and rehabilitation needs. Care provided by groups of collaborating professionals is currently well recognized as a more effective way to support people living with these conditions than routine, single-profession clinical encounters. Clinical learning contexts provide hands-on opportunities to develop the interprofessional competencies essential for health professional students in training; however, suitable assessment tools are needed to support student attainment of interprofessional competencies with self-assessment espoused as an important component of learning.

Method

A structured approach was taken to locate and review existing tools used for the self-assessment and peer assessment of students' competencies relevant to interprofessional practice.

Results

A range of self- and/or peer assessment approaches are available, including formally structured tools and less structured processes inclusive of focus groups and reflection.

Discussion

The identified tools will usefully inform discussion regarding interprofessional competency self- and peer assessment options by healthcare students participating in a broad range of clinical learning contexts.

Conclusion

Self- and/or peer assessment is a useful approach for those seeking to effectively enhance interprofessional learning and measure the attainment of related competencies.

Nurse anaesthetists' experiences of student nurse anaesthetist learning during clinical practice: a qualitative interview study

BACKGROUND

The professional role of a nurse anaesthetist involves taking a pedagogical approach towards students, including supervision during clinical practice. Although supervisors are facilitators of student learning, they are offered little training in adult learning principles. The aim of this study was to describe supervisors' experience of student nurse anaesthetist learning during clinical practice in the operating room.

METHOD

In this qualitative interview study, 12 semi-structured individual interviews were carried out with clinical supervising nurse anaesthetists. The data were analysed inductively using thematic analysis.

RESULTS

The results are illustrated with one theme and five sub-themes. The clinical learning situation of student nurse anaesthetists is described as a reflection of different cultures coming together. The operating room environment is a new context to students, and students enter with different clinical background and experiences. There is tension in facilitating student learning due to demands for productivity; supervisors suggest the use of separate operating rooms with a special focus on learning in the future.

CONCLUSION

Clinical practice facilitates student learning and is a parallel process to routine care. Thus, it requires the cultures of higher education and healthcare organizations to co-exist. This is illustrated with the theme "Contributing to students' future professional roles by bridging the hospital and university cultures". In the operating room, student learning is challenged by a new context and time pressure as shown by subthemes. To overcome challenges and support student learning in the operating room from a supervisors' perspective, interprofessional student teams are suggested as a future approach and need to be further investigated.

Students' Perception of Servant Leadership by Physical Therapy Faculty Mentors Is Associated With Interprofessional Socialization

INTRODUCTION

Promoting interprofessional collaborative practice (IPCP) is necessary. Consequently, investigating strategies associated with increased interprofessional socialization, the beliefs, behaviors, and attitudes underlying socialization toward IPCP is suggested. The purpose of this study was to examine the relationship, in the presence of control variables, between students' perception of servant leadership by physical therapy faculty mentors and interprofessional socialization.

REVIEW OF THE LITERATURE

Although faculty mentors are associated with influencing students' socialization process and servant leadership is suggested to support collaborative care, investigations exploring these concepts within physical therapy education are limited.

SUBJECTS

Three cohorts of students (60 each) at an entry-level physical therapist education program in the Midwest of the United States. One hundred seventy individuals completed an anonymous paper-based composite survey, with 117 identifying the presence of an informal physical therapy faculty mentor.

METHODS

This cross-sectional survey study, inclusive of student demographic control variables, examined the relationship between interprofessional socialization and perceptions of physical therapy faculty mentors, as measured by the Interprofessional Socialization and Valuing Scale (ISVS-21) and the Servant Leadership Measure (SL-7), respectively. Multiple linear regression was used to obtain the semi-partial correlation (sr) between the SL-7 and the ISVS-21, with significance accepted at P < .05.

RESULTS

Upon necessary assumptions being met, 114 participants were included with an analysis of variance identifying the model to be significant (F(8,105) = 2.59, P = .01). Multiple linear regression analysis found that the SL-7, in the presence of control variables, was associated with a significant proportion of ISVS-21 scores (R2 = 0.17, F(8,105) = 2.59, P = .01). Notably, only the SL-7 demonstrated a significant contribution to ISVS-21 estimates (β = 0.358, P < .001), with a significant and positive sr of 0.34 (P < .001).

DISCUSSION AND CONCLUSION

Perceptions of servant leadership by faculty mentors were positively correlated with interprofessional socialization. Findings bolster the theoretical link between servant leadership and interprofessional socialization, servant leadership in the development of faculty and mentorship programs, and the relevance of informal social interactions.

Self-efficacy in the context of nursing education and transition to practice as a registered practitioner: A systematic review

AIM

The aim of this systematic review is to identify, describe and synthesize evidence from experimental studies conducted to measure and conceptualize self-efficacy within the context of nursing education and the transition of nursing students to practice as a registered practitioners.

DESIGN

Systematic review.

METHODS

Papers were screened by four independent reviewers, and data were extracted using a standardized data extraction tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance and checklists were used to guide this review.

RESULTS

The review included 47 studies, using a quasi-experimental pre-test-post-test design (n = 39) and randomized control trials (n = 8). Various teaching and learning interventions were used to enhance self-efficacy; however, there is no definitive conclusion to be drawn regarding the most effective educational interventions. Various instruments were used in the studies to measure self-efficacy. 10 of these were related to general self-efficacy, while 37 instruments measured self-efficacy in the context of specific skills.

The outcomes of interprofessional education in prelicensure nursing education: An integrative review

OBJECTIVES

Nurses are at the center of patient care, serving as the link between patients and their various healthcare providers. As healthcare complexity grows it is increasingly important for research focused on nursing education. This review synthesizes research on the impact of interprofessional education for prelicensure nursing students with the intent to guide curriculum development.

METHODS

The databases Medline (PubMed), Cochrane Library, CINAHL and EBSCO Qualitative were searched for full text articles in the English language published between January 2016 and July 2021 using MeSH terms "interprofessional education" and "healthcare students" and "multiprofessional" and "impact" and "effectiveness" or "collaborative nursing practice" or "nursing students" or "interprofessional curriculum" or "interdisciplinary education" or "collaboration." A systematic review resulted in 11 selected studies for detailed evaluation.

RESULTS

After evaluation, the following three themes were identified: 1) IPE impact should not only be measured through learners' perceptions; 2) Modifiable and nonmodifiable factors are associated with IPE effectiveness; and 3) Various instruments and methods can be used for measuring outcomes.

CONCLUSION

This review contributes to future development of IPE in prelicensure registered nursing curricula. Educators should incorporate performance changes into evaluation, be aware of both modifiable and non-modifiable factors to increase effectiveness and use appropriate validated instruments to measure desired outcomes. Although literature results regarding IPE are encouraging, more research is needed to identify evidence-based approaches with best practice methods for instruction, content delivery, evaluation, and competency assessment.

Essential Elements of Preregistration Nursing Interprofessional Simulation Training

BACKGROUND

Internationally, interprofessional simulation (IPS) training increasingly is being included in nursing curricula. This systematic review examined the elements of IPS training that prepare nursing students for clinical practice.

METHOD

Five databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], ProQuest, PubMed, Scopus, and Google Scholar) were searched for articles published from 2000 through 2020. Search terms included interprofessional, interdisciplinary, collaboration, collaborative care, teamwork, undergraduate nursing, and simulation. Thematic analysis of included studies was conducted using Braun and Clarke's (2006) six-phase approach.

RESULTS

Twenty-one studies were included. Five key themes emerged: (1) foster safe learning spaces, (2) realism matters, (3) effective debriefing is essential, (4) communication and teamwork increase patient safety, and (5) learning about scopes of practice and roles enables better care.

CONCLUSION

IPS training provides nursing students with learning opportunities that can fundamentally shape their capacity to work effectively in interprofessional and multi-disciplinary settings. [J Nurs Educ. 2023;62(1):28-35.].

Successful Development and Implementation of a Large Virtual Interprofessional Education Activity Applying the Social Determinants of Health

Interprofessional education (IPE) activities provide students insight into healthcare teams, shared decision-making, and social determinants of health (SDOH). Virtual IPE activities with large student populations or across multicampus have not been evaluated. The study aimed to explore the interprofessional competency growth in students, across several disciplines, following participation in a large-scale, virtual IPE activity. Students from pharmacy, medicine, social work, and physician assistant programs across Tennessee participated in an IPE patient case and SDOH in fall 2020 and fall 2021. Pre- and postsurveys included Likert ranking of 16 statements based on the 2011 Interprofessional Education Collaborative (IPEC) framework. A total of 607 students completed surveys (overall response rate, 76%). Wilcoxon signed-rank tests were performed on the pre-/postsurvey data, in aggregate and by discipline. Significant increases in all IPEC competency statements were seen, both in aggregate (100% of statements with p < 0.001) and in pharmacy (100% of statements with p < 0.001) and medicine subgroups (94% of statements with p < 0.001). Implementing large virtual IPE activities involving a complex patient case and SDOH significantly increased student IPEC competency outcomes for participating students, whether in aggregate or on a discipline-specific basis.

Effects of Breathing Meditation Training on Sustained Attention Level, Mindfulness Attention Awareness Level, and Mental State of Operating Room Nurses

OBJECTIVES

In this paper, we explore the effects of breathing meditation training on the sustained attention level, mindfulness attention awareness level, and mental state of nurses in the operating room.

METHODS

We enrolled 40 nurses from September 2019 to December 2019, and divided them into a control group (N=20) and an observation group (N=20) using a random number table. The control group received routine training, based on which the observation group received breathing meditation training. We compared their sustained attention index, fatigue score, mindfulness attention awareness score, mental state score, work stress score, career satisfaction score, and career happiness index.

RESULTS

After training, the sustained attention response time was shorter at 8:00 and 18:00 in the observation group than in the control group (p < .05). The physical fatigue score, mental fatigue score, reduced activity score, reduced motivation score, and overall fatigue score of the observation group were lower than those of the control group (p < .05). The observation group had a higher mindfulness attention awareness score than did the control group (p < .05). The SAS and SDS scores of the observation group were lower than those of the control group (p < .05). The work stress score of the observation group was lower than that of the control group, whereas the career satisfaction score and career happiness index were higher (p < .05).

CONCLUSION

Breathing meditation training can improve the sustained attention level and mindfulness attention awareness level, reduce the feeling of fatigue and work stress, help adjust the mental state, and enhance the career satisfaction and career happiness of nurses in the operating room.

Development and evaluation of an interprofessional student-led influenza vaccination clinic for medical, nursing and pharmacy students

Background

Students in their final years of medicine, nursing and pharmacy degrees were invited to participate in an interprofessional influenza vaccination training course and clinic. Twenty-four students (8 from each discipline) were selected to participate. After vaccination training these students administered free influenza vaccines under supervision in two student-led clinics to 546 students in health and allied health programs prior to their clinical placements.

Objective

To evaluate the students' experience of the interprofessional vaccination training and clinic, and to evaluate the experiences of students who received their vaccination in the student-led clinic.

Methods

Before and after participating, students completed a questionnaire evaluating their perceived knowledge of influenza vaccinations, and their skills and confidence in administering vaccinations and the Readiness for Interprofessional Learning Scale (RIPLS). Eighteen students completed both the pre- and post-questionnaires. All students who received their flu vaccination were also asked to complete a short patient evaluation survey.

Results

The course resulted in significant increases in the students' perceived knowledge of influenza vaccinations (27.5% increase, p<0.001), skills in managing patients receiving influenza vaccines (23.9% increase, p<0.001) and confidence level to administer influenza vaccines (46.0% increase, p<0.001). While there was no significant change in any subscales of the RIPLS, open-ended responses indicated that the students enjoyed and could see the benefits of meeting and learning with and from students from other health disciplines. Of the students who received their influenza vaccination, 97.7% were very likely or somewhat likely to recommend the clinic to fellow students.

Conclusion

The interprofessional vaccination training and influenza vaccination clinic provided effective interprofessional vaccination training and afforded an authentic interprofessional experiential opportunity.

Introduction of an interprofessional gynaecology surgical skills workshop for undergraduate medical and nursing students

BACKGROUND

Medical and nursing students may feel under-prepared to perform basic surgical and gynaecology procedural skills. There also remains scope within undergraduate programs to integrate interprofessional education, and better prepare students for interprofessional collaboration to improve patient care.

AIMS

A simulation-based gynaecology surgical skills workshop program was introduced for undergraduate medical and nursing students. The aim of this study was to explore students' perceptions of a simulation-based interprofessional gynaecological skills program, using students' pre- and post-workshop confidence in taught skills reported in a post-workshop questionnaire as an outcome measure.

MATERIALS AND METHODS

One hundred and sixty undergraduate medical (n = 133) and nursing (n = 27) students attended the workshop program at a tertiary university in Melbourne, Australia. A survey was completed by all students immediately after the workshop, addressing students' perceptions of surgical education, the four skill-stations (gowning/gloving, suturing, intrauterine device insertion, and urethral catheterisation), and interprofessional education. A Wilcoxon signed-rank test was performed to compare students' pre- and post-workshop confidence scores.

RESULTS

Most medical and nursing students (86%) agreed their course should provide more structured surgical education. There was a statistically significant increase in post-workshop self-reported confidence scores for medical and nursing students in all four taught skills. Confidence in interprofessional behaviours also improved in both cohorts, but the improvement in nursing students did not reach statistical significance.

CONCLUSIONS

Simulation-based, interprofessional, gynaecological surgery skills workshops are practical and valuable additions to undergraduate medical and nursing curricula. Further research should explore long-term retention of procedural skills and changes in interprofessional attitudes in clinical practice.

Student perception on the integration of simulation experiences into human physiology curricula

A variety of medical simulators have been developed over recent years for students of all medical professions. These simulators serve to teach basic science concepts, advanced clinical skills, as well as empathy and student confidence. This study aimed to understand the students' perception of the integration of high-fidelity simulation exercises into the teaching of human physiology. Research groups were made up of both osteopathic and podiatric medical students. Data were obtained using a Likert-scale survey. Results indicated that students believed the simulation experiences were beneficial to further understanding of physiological concepts, as well as seeing these concepts in a clinical setting. Variations were noted between podiatric and osteopathic medical students' perception on how the experiences helped them develop clinical and personal confidence, and if the experience helped illustrate correlations between laboratory values and accompanying physiology. Results illustrated no differences in perception between the sexes. Although all students agreed that the experience helped with the understanding of physiology, podiatric medical students did not necessarily find value in the simulation for their development as future clinicians. We predict that differences in perception are largely based on the different curriculums of the students questioned. The present study indicated that incorporation of simulation experiences in the first year of medical school enhanced learning basic science physiology concepts and promoted the development of self-confidence as future clinicians. Incorporating simulation into the didactic coursework should be promoted in other medical schools' curricula.

Impact of interprofessional education on students of the health professions: a systematic review

PURPOSE

Interprofessional education (IPE) is a concept that allows students from different health professions to learn with and from each other as they gain knowledge about their chosen professions and the professions of their colleagues. The purpose of this systematic review was to determine the effectiveness of IPE in the academic preparation of students of the health professions.

METHODS

A search was conducted of the PubMed and CINAHL databases using the following eligibility criteria: IPE including students from 3 or more healthcare professions, IPE exposure within academic coursework, measurement of attitudes and/or perceptions as outcomes, and quantitative reporting of results. Articles were screened by title, abstract, and full text, and data were extracted.

RESULTS

The search yielded 870 total articles. After screening, 7 articles remained for review. All studies reported a positive impact of IPE on the education of students of the health professions.

CONCLUSION

Evidence showed that IPE activities were an effective tool for improving attitudes toward interdisciplinary teamwork, communication, shared problem-solving, and knowledge and skills in preparation for collaboration within interdisciplinary teams.