Creating an Online Interprofessional Collaborative Team Simulation to Overcome Common Barriers of Interprofessional Education / Eine internetbasierte, interprofessionelle Teamsimulation zur Überwindung organisatorischer Hürden in der interprofessionellen Ausbildung
Published Online: Sep 15, 2017
Page range: 90 - 99
Received: Apr 03, 2016
Accepted: Jun 22, 2017
DOI: https://doi.org/10.1515/ijhp-2017-0022
Keywords
© 2017 Kelli Lee Kramer-Jackman, Dory Sabata, Heather Gibbs, Judy Bielby, Jessie Bucheit, Sarah Bloom, Sarah Shrader, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
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IPOC-SEEDS Simulation Development
| Develop Content | Tasks | Review |
|---|---|---|
| Patient case | Expand a standardised patient case (available from the National League for Nursing) to an interprofessional case to be applicable to all professions involved. Four-day case included multiple IP encounters, orders, laboratory results, vital signs, imaging, medication administration record and intake and output findings. | Multiple iterations with IP faculty and informatics/ technology experts feedback (IP development team) |
| Audio patient encounters | Develop patient-professional visit script for each of the four professions with actor/patient collaboration. Record, save and post securely audio of each uni-professional patient-professional encounter (3–8 min each) on LMS | Multiple iterations of IP faculty and patient expert feedback Successful completion of task with technology expert assistance |
| Team-led debriefing | Develop presentation on how to team debrief after the simulation (10 min) Develop student-led questions to be used during team debrief. | Faculty peer review Modified from evidence, faculty expert feedback |
| Assessment measures | Develop simulation evaluation survey to address learning/study objectives Select PACT-novice tool to review the team encounters Select and modify DASH tool to assess the student-led team debriefing | Modified established competencies through multiple iterations of IP faculty and technical experts feedback ROL to find and modify appropriate tool, IP faculty feedback |
| Electronic health record (EHR) | Determine appropriate EHR documentation forms for each profession Build patient case in EHR including documentation by all providers, orders, vital signs, medication administration record, imaging and flow sheets Develop student and faculty instructions for accessing and navigating EHR Develop IP plan of care team documentation form | Informatics expert assessment Informatics and HIM/ EHR experts consulted to create an EHR Informatics and EHR expert consulted Informatics expert researcher consulted |
| Learning Management System (LMS) | LMS simulation shell development (welcome, simulation directions, 3-week content, evaluation, access to EHR, web-conferencing and e-mailing of team and faculty) Loading of students and faculty into simulation shell | Faculty peer review LMS technology expert consulted |
| Synchronous webconferencing system | Create directions to access, use and record in web conferencing system | Technology expert consulted |
Demographics
| Demographics | Fall 2013 Pilot | N = 100 | Spring 2014 | N=106 |
|---|---|---|---|---|
| Nutrition | 16 | Nutrition | 0 | |
| MSN | 29 | MSN | 30 | |
| DNP | 6 | DNP | 7 | |
| Occupational Therapy | 34 | Occupational Therapy | 29 | |
| Pharmacy | 15 | Pharmacy | 40 | |
| African American | 2 | African American | 2 | |
| Asian | 6 | Asian | 9 | |
| Caucasian | 83 | Caucasian | 86 | |
| Hispanic | 6 | Hispanic | 2 | |
| Native American | 0 | Native American | 1 | |
| Other or not specified | 3 | Other or not specified | 7 | |
| 20–29 | 72 | 20–29 | 75 | |
| 30–39 | 18 | 30–39 | 20 | |
| 40–49 | 8 | 40–49 | 7 | |
| 50–59 | 2 | 50–59 | 2 | |
| Male | 13 | Male | 23 | |
| Female | 87 | Female | 80 | |
| Unspecified | 0 | Unspecified | 3 | |
| < 3 h from KUMC | 86 | < 3 h from KUMC | 77 | |
| > 3 h from KUMC | 14 | > 3 h from KUMC | 29 | |
| Novice | 3 | Novice | 10 | |
| Advance beginner | 21 | Advance beginner | 19 | |
| Competent (2–3yr) | 30 | Competent (2–3yr) | 23 | |
| Proficient (3–5 yr) | 29 | Proficient (3–5 yr) | 31 | |
| Expert (5–10 yr) | 17 | Expert (5–10 yr) | 23 | |
| First EHR Experience | 55 | First EHR Experience | 34 | |
| Using EHR 6 months or more | 16 | Using EHR 6 months or more | 37 | |
| Using EHR 1 yr. or more | 29 | Using EHR 1 yr. or more | 34 | |
Evaluation of Student Team-led Debriefing with Debriefing Assessment for Simulation in Healthcare (DASH) tool
| DASH | Element 2 Maintains an engaging learning environment | Element 3 Structures the debriefing in an organized way | Element 4 Provokes engaging discussion | Element 6 Helps trainees achieve or sustain good future performance |
|---|---|---|---|---|
| Nine Team Overall | Range: 5-7 | Range: 6-7 | Range: 4-7 | Range: 5-6 |
| Scores | Mean: 5.9 | Mean: 6.3 | Mean: 5.7 | Mean: 5.8 |
IPOC-SEEDS Simulation Objectives with Respective Assessment
| Domain | Objective | Assessment |
|---|---|---|
| 1 (RR4) Identify the roles and responsibilities for yourself and other care providers and how the team works together to provide care. | IPOC-SEEDS evaluation:
How often did your team introduce themselves and describe their profession? How often did you fulfill your professional role? Did you feel your team collaborated to come to a consensus on the plan of care? | |
| 2 (TT4) Integrate the knowledge and experience of other professions – appropriate to the specific care situation – to inform care decisions, whilst respecting patient and community values and priorities/ preferences for care. | Assess during IP team meeting Scores on five domains IPOC-SEEDS evaluation How often did you contribute to the plan of care? How often did your team keep the patient’s perspective considered throughout meeting? | |
| 3 (TT5) Apply teamwork principles that support collaborative practice and team effectiveness. | Assess during IP team meeting Scores on five domains IPOC-SEEDS evaluation How often did you feel empowered to speak freely? How often did you feel your opinion was valued? How often did you fulfil you professional role? | |
| 4 (TT8) Reflect on individual and team performance for individual, as well as team, performance improvement. | PACT measure Ratings across four areas: engage learning environment, keep the debrief structured and organised, provoke an engaging discussion and sustain good future performance. DASH measure Scores on debriefing effectiveness IPOC-SEEDS evaluation How often did you speak up/advocate for profession? How often did you contribute to the plan of care? How often did you fulfil your professional role? How often did you fulfil your team role? | |
| Navigate the electronic health record | IPOC-SEEDS evaluation Number of first time EHR users Percent of students who completed the individual documentation assignment. | |
| Was the IPOC-SEEDS simulation effective? | IPOC-SEEDS evaluation Was the case realistic? Did their team collaborate and come to a consensus on the plan? What would you change to improve the effectiveness of this simulation in the future? Did you have enough training to debrief as a team without faculty? | |
| What was the value of the simulation? | IPOC-SEEDS evaluation What value does this simulation have for you and your profession? | |
| Did technology utilisation and delivery work? | IPOC-SEEDS evaluation What would you change to improve the effectiveness of this simulation in the future? | |
Assessment of Interprofessional Team Work Using the Performance, Assessment of Communication and Teamwork (PACT) Tool during an Online Simulation
| PACT Domain | Team Structure | Leadership | Situational Monitoring | Mutual Support | Communication |
|---|---|---|---|---|---|
| Nine Team Overall | Range: 3-4 | Range: 2-5 | Range: 2-5 | Range: 3-5 | Range: 3-5 |
| Scores | Mean: 3.4 | Mean: 3.6 | Mean: 3.4 | Mean: 4.6 | Mean: 3.9 |
Student Evaluation Results
| Evaluation Results | Fall 2013 Pilot N = 100 | Spring 2014 N = 106 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| How often did | Not at all 0% - 5% | Sometimes 25% | Often 50% | Most of the time 75% | Always 95% -100% | Not at all 0–% - 5% | Sometimes 25% | Often 50% | Most of the time 75% | Always 95% -100% |
| Speak up/advocate for profession? | 1% | 12% | 7% | 28% | 52% | 1% | 9% | 14% | 36% | 40% |
| Feel empowered to speak freely? | 0% | 3% | 8% | 21% | 68% | 0% | 2% | 13% | 24% | 62% |
| Feel your opinion was valued? | 0% | 0% | 3% | 11% | 86% | 0% | 1% | 5% | 15% | 80% |
| Contribute to the plan of care? | 0% | 5% | 7% | 24% | 64% | 0% | 4% | 15% | 35% | 47% |
| Fulfil your professional role? | 0% | 0% | 3% | 19% | 78% | 0% | 2% | 4% | 27% | 67% |
| Fulfil your team role? | 1% | 5% | 6% | 21% | 67% | 1% | 3% | 10% | 26% | 60% |
| How often did | Not at all 0% - 5% | Sometimes 25% | Often 50% | Most of the time 75% | Always 95% -100% | Not at all 0% - 5% | Sometimes 25% | Often 50% | Most of the time 75% | Always 95% -100% |
| Introduce selves/ describe profession? | 0% | 3% | 5% | 5% | 87% | 0% | 2% | 9% | 14% | 75% |
| Keep patient’s perspective considered throughout meeting? | 0% | 3% | 4% | 22% | 71% | 0% | 2% | 2% | 22% | 74% |
| Percent of time all opinions were valued? | 0% | 0% | 1% | 9% | 90% | 0% | 0% | 1% | 8% | 92% |