International Journal of Healthcare Simulation

Background:

The benefits of multidisciplinary teamwork in healthcare are well documented [1] and there is growing support for simulation as a vital teaching approach for healthcare professionals [2]. Our aim was to investigate whether a novel multi-professional simulation improves the understanding of nursing and medical students regarding their respective roles, and the role of others, in a multidisciplinary team in community and acute hospital settings. Key learning objectives included understanding of roles within a healthcare team and communication skills, both with the patient and other healthcare professionals.

Methods:

We developed a novel, 4-hour simulation session comprised of three distinct scenarios to run in Summer 2022. A single older person’s patient journey was followed from being found by district nurses after a fall at home, to an acute deterioration within a hospital setting and then the development of delirium in a community rehabilitation hospital. Whilst developing these scenarios, guidance and input was sought from service user focus groups, hospital medical and nursing staff, and community practitioners. 5^th year medical students and 2^nd year nursing students participated in mixed groups, with a maximum of 6 students. A trained actor was used as a simulated patient to maximise the fidelity of the scenarios, with computer-controlled monitoring displaying patient observations relevant to the scenario when necessary. Those not participating in the scenario viewed their colleagues in real-time. Multiple camera angles and microphones meant they could critically appraise and evaluate their colleagues’ simulation to maximise their learning. Following each scenario, there was a student-focused debriefing using the diamond [3] tool facilitated by nursing and medical faculty. The simulated patient also gave non-medical feedback from a patients’ perspective. Students then completed a questionnaire focusing on areas such as understanding their role within the multidisciplinary team and communication with the patient and other healthcare professionals: this was used to quantify the students’ self-reported learning.

Results:

Data analysis focused on the students’ self-reported confidence in understanding the roles of different members of the multidisciplinary team and the effectiveness of their communication in a high-fidelity simulation.

Conclusion:

Interprofessional learning is a valuable tool for teaching medical and nursing students the roles of professionals within a healthcare team. A simulation comprising of community care, acute hospital medicine, and community rehabilitation allows the students to develop an array of skills, from clinical prioritisation and diagnostic medicine to communication skills in a high-fidelity environment.

References

1. Murphy M, Curtis K, McCloughen A. What is the impact of multidisciplinary team simulation training on team performance and efficiency of patient care? An integrative review. Australasian emergency nursing journal. 2016;19(1):44–53.

2. Sanko J, Mckay M, Shekhter I, Motola I, Birnbach DJ. What participants learn, with, from and about each other during inter-professional education encounters: A qualitative analysis. Nurse Education Today. 2020 May 1;88:104386.

3. Jaye P, Thomas L, Reedy G. ‘The Diamond’: a structure for simulation debrief. The clinical teacher. 2015;12(3):171–175.