A Large Scale Interprofessional Simulation Experience for Medical, Nursing, and Pharmacy Students

Publication ID Published Volume
10018 March 2, 2015 11

Abstract

The Framework for Action on Interprofessional Education and Collaborative Practice published by the World Health Organization calls for schools of health sciences to train students who are ready to enter the workforce as a member of an interprofessional (IP) team. Interprofessional education (IPE) occurs when students of at least two or more professions learn about, from, and with each profession enhancing the delivery of patient care. This IP exercise engaged students in teams composed of three health care professions to provide care to a patient transitioning from the ambulatory to the acute care setting. The case of “Ace on the Eighth” involved a common critical medical condition. It highlighted the need to triage patients in a timely manner, identified the need for transition of care, and provided effective communication during hand-off from ambulatory to acute care settings. Although this experience was done on a large scale, it can be adjusted for any number of students. Students were from two different schools, one private and one public. The level of learners included second-year medical students, third-year pharmacy students, and first- and second-year graduate pre-licensure nursing students. Students worked in IP teams to assess a standardized patient (SP), determine the diagnosis, transfer care to the acute care setting and create a collaborative plan of care. Faculty facilitators from participating programs observed the student teams and lead debriefing sessions. The scenario from orientation to debriefing took approximately four hours.

In May 2013, we implemented the IPE experience for 285 students and 88 facilitators over two half days. The following year, 293 students and 100 facilitators took part in the experience.

Achievement of the learning objectives was evaluated through student and faculty surveys, which showed overall positive responses. Students agreed or strongly agreed that the case developed their clinical reasoning skills 84%, developed their clinical decision making abilities 84%, demonstrate their clinical decision reasoning skills 83%, allowed them to reflect on clinical abilities 94%, apply team based communication training 91%, recognize clinical strengths and weaknesses 88%, reflect and discuss performance 94% and enabled learning through feedback 88%. Overall, 91% of students felt that the IPE was a valuable learning experience. Response rate 65.4% (N=193). From the open-ended survey responses and our experience facilitating the school debriefing sessions, students clearly valued the opportunity to work in an IP team with a SP, observe the roles of each student and to formulate a care plan together. Despite having an integrated pharmacy and medicine curriculum at UCSD, the students felt that the IPE was much more effective for role exploration than traditional shared didactic curriculum.

When the participating faculty was asked about the usefulness of the IPE, 81% felt that the IPE was extremely useful or very useful for the assessment of the students' clinical reasoning and critical thinking and 95% for the assessment of clinical teamwork and communication. Response rate 81.4% (N=79).

The IPE resulted in substantial changes in the curriculum for the pharmacy and medical schools. After the first year, the medical students requested additional content knowledge on hand off of critically ill patients. The medical faculty responded by providing additional education on SBAR within the curriculum. The pharmacy faculty added 10 hours of practical training in the preparation of sterile products and five simulations involving standardized patients to the curriculum. In the second year, we developed a “Master’s” video to demonstrate how experienced clinicians would care for the same patient based on student feedback.

Citation

Zheng A, Macauley K, Namba J, et al. A large scale interprofessional simulation experience for medical, nursing, and pharmacy students. MedEdPORTAL Publications. 2015;11:10018. http://doi.org/10.15766/mep_2374-8265.10018

Contains time-sensitive information that will likely be inaccurate, obsolete, or irrelevant by May 08, 2017

Educational Objectives

Interprofessional Team:

  1. Demonstrate ability to select group leaders for both ambulatory/clinic and hospital-based/ED patient care teams.
  2. Demonstrate ability to meet in healthcare team briefs or huddles to determine roles, responsibilities and patient-centered treatment options.
  3. Demonstrate ability to communicate any concerns they have about the safety of the patient.
  4. Demonstrate ability to recognize emergent situation and recommend higher level of care.
  5. Demonstrate ability to communicate hand-off information using a standardized tool (SBAR).
  6. Summarize what went well and what can be improved through a facilitated team debriefing.

Medical Students:

  1. Demonstrate ability to obtain a focused history from the patient.
  2. Demonstrate ability to perform a focused physical examination.
  3. Demonstrate ability to diagnose ST elevation myocardial infarction on EKG.
  4. Demonstrate ability to explain the differential diagnosis and treatment plan to the patient.

Nursing Students:

  1. Demonstrate ability to obtain a focused history from the patient.
  2. Demonstrate ability to perform a focused physical examination.
  3. Demonstrate ability to implement appropriate interventions using nursing diagnoses.
  4. Demonstrate ability to communicate necessary interventions to the patient.

Pharmacy Students:

  1. Demonstrate ability to obtain patient information relevant to the appropriate selection, dosing and monitoring of medications.
  2. Demonstrate ability to interpret diagnostic results relevant to the appropriate selection, dosing and monitoring of medications.
  3. Demonstrate ability to select the appropriate medications for the patient.
  4. Demonstrate ability to prepare a sterile product in a timely manner.
  5. Demonstrate ability to counsel the patient about the indications for medications.

Keywords

  • Standardized Patients, Interprofessional Education, Patient Simulation, Large Scale, Medicine, Nursing, Pharmacy, Healthcare Education, TeamSTEPPS, Patient Handoff, Teamwork

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ISSN 2374-8265