Establishing a Sustainable, Integrated Pre-professional Interprofessional Simulation Program

Simulation as an Effective Strategy for Interprofessional Education

Purpose: Mental health care involves multiple professionals from diverse backgrounds providing interdependent and complex services. Accordingly, care needs to be planned skillfully in partnership with health and social care providers and mental health service users. Working from an interprofessional lens enables professionals to work collaboratively to affect care that is safe and improves health outcomes. Yet, in practice there is often a disconnect between mental health care professionals that hinders collaborative practice and impacts the quality of care. Furthermore, stigmatization of mental illness continues to pervade health care professionals’ attitudes which serves to further compromise health outcomes. Interprofessional education (IPE) using simulation is proposed as an effective teaching and learning method to improve collaborative practice and decrease stigma amongst mental health care professionals in undergraduate education. Approach: Undergraduate nursing and pharmacy students from two universities participated in a one-day IPE event. During the event, students collaboratively interviewed standardized patients portraying mental health service users and developed an interprofessional plan of care. Faculty perspectives of the event were gathered to identify challenges and recommendations for ongoing implementation. Findings: Current literature and faculty facilitator feedback supports IPE using simulation as an effective teaching and learning strategy to develop therapeutic communication skills, address stigma amongst students prior to practice, clarify professional roles, and improve interprofessional collaboration. Faculty facilitator recommendations to improve the implementation of IPE with healthcare professionals during undergraduate education include early introduction of IPE, adequate preparation for students, realistic case scenarios, facilitator and standardized patient training, and funding to support events. Conclusion: The use of standardized patients in the context of interprofessional mental health education is a strategy with the potential to improve collaborative practice and address mental illness stigma amongst health care professionals. Further research with students is needed to evaluate the effectiveness of simulation in mental health IPE.

Introduction: Interprofessional education (IPE) has emerged as an essential component of training for students in the health and social care professions. Standardised patients (SPs) have also been developed as an important simulation-based learning modality in health and social care curricula due to the authenticity and realism of the patient or client encounter that may be replicated. Reports evaluating the use of SPs across an IPE curriculum in the health and social care professions are limited. Methods: This evaluation study used a causal-comparative research design to examine the effect of SPs as an instructional method in an IPE curriculum. Evaluative outcomes of the educational experiences of students attending 37 IPE learning modules offered between Autumn 2006 and Winter 2012 were analysed. Results: A total of 6,561 students from seven health and social care professions rated the usefulness of the instructional methods used in each module through post- module surveys. Students consistently rated SPs as significantly more useful than other instructional methods, and overall mean satisfaction scores were significantly higher for IPE modules that incorporated SPs. Conclusions: This study’s findings demonstrate the positive effect that SPs can have on the learning experiences of health and social care students. By Using SPs in IPE curricula, the authenticity of classroom-based interprofessional learning experiences can be enhanced and lead to more positive IPE learning outcomes.

Interprofessional Education (IPE) occurs when two or more professions learn from, with, and about one another. There is a growing body of research indicating that IPE leads to enhanced professional practice, improved knowledge and skills, more enjoyable learning experiences, and can result in long term cost control from overall improvements in patient safety. Simulation learning, or the reenactment of routine or critical clinical events is now being incorporated into many IPE programs. Program participants work together to perform emergent care skills and scenarios in a controlled environment on high‐fidelity human patient simulators. Interprofessional collaboration and simulation is essential in pediatric care asit contributes to overall patient wellbeing and offers an opportunity to practice the skills used in an acute care incident, events that occur at low frequency in childhood. A research study through the Faculty of Health Sciences, evaluates the introduction of an interprofessional pediatrics educational module amongst nursing and medical students at Queen’s University. This study is part of an innovative pilot project aimed at improving patient welfare and safety through interprofessional health education using patient simulators.

Interprofessional health education has received increased attention from educators and health care institutions over the past decades. In the Institute of Medicine's The Future of Nursing: Leading Change, Advancing Health report, the necessity of nursing professionals becoming full partners with other health care professionals is described. In 2011, a group of faculty members in northeast Indiana formed an interprofessional education (IPE) consortium, which included faculty from several universities. The members were from a larger community group who met monthly and realized they shared a common interest in developing an IPE program. The purpose of this article is to describe the unique interprofessional and multi-institutional educational series that has been offered as a result of the collaborative efforts of this consortium. The initiative is continuous and now enters the second phase of the IPE learning series. This initiative may help others make the necessary changes in health care education.

It is expected that, by 2050, there will be 83.7 million adults aged 65 and older in the United States1 and 1.6 billion world-wide.2 Already there exists an unrecognized crisis in dementia and mental health care for this rapidly growing population.3 Further, the workforce with expertise in aging, dementia, and mental health/substance use (MH/SU) continues to decline, contributing to health disparities.3 As noted by both the Institute of Medicine (IOM)4 and the World Health Organization (WHO),5 interprofessional teams can play an important role in the improvement of population health outcomes for older adults. Interprofessional teams are not new to geriatrics and gerontology.6 Over the past decade, emerging strategies and models of care for interprofessional education and collaboration have built on foundations laid by several organizations.4 For example, the WHO generated the widely accepted definition and framework for interprofessional education and collaboration.5 For over 50 years, the IOM4,7–8 has supported interprofessional education and collaboration and raised awareness of workforce needs for older adults with MH/SU.3 The National Center for Interprofessional Practice and Education9 has partnered with the Robert Wood Johnson Foundation,10 the Josiah Macy Jr. Foundation,9 the John A. Hartford Foundation,9,11 and the Gordon and Betty Moore Foundation,9 to further the work of the Geriatric Interdisciplinary Team Training and Geriatric Interdisciplinary Teams in Practice programs.6,9,11 The Partnership for Health and Aging (PHA)12 developed competencies for geriatrics and gerontology. Finally, the PHA and the American Geriatrics Society13 published a position statement to support team training. Yet, despite longstanding and broad support for interprofessional education and collaboration in the care of older adults, physical and mental health disparities persist. In this supplement, Farrell et al.14 recommend a unified effort to integrate geriatric and gerontology competencies, content and principles into interprofessional curricula that are aligned with objectives for health systems science.15 Those objectives aim to transform curricula to improve population health, team-based care, high-value care, leadership, quality improvement, patient safety and health policy.15 Farrell et al.14 posit that an intentional, systematic approach by health science educators, health care systems leaders and clinicians is essential to advancing innovation for positive outcomes around aging, dementia and MH/SU. Guided by the Interprofessional Learning Continuum (IPLC) model4 (see Farrell et al.,14 Figure 1), this Commentary reinforces and extends the Farrell et al.14 recommendations by highlighting national and international innovations in interprofessional geriatrics and gerontology, especially related to dementia and mental health. The comprehensive IPLC model grew out of recognition in the IOM’s “Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes”4 that curriculum reform and collaborative practice redesign are prerequisite to improving health and system outcomes.16 In that context, this Commentary provides a discussion of curriculum reform, collaborative practice redesign and their linkages to health and systems outcomes15,16 and concludes with a brief global perspective17 on interprofessional education and practice as they relate to aging, dementia and MH/SU in older adults. Innovation exemplars in interprofessional education aim to challenge and stimulate leadership in interprofessional geriatrics and gerontology.

Background/Aim. Health professions education is facing emerging issues. A comprehensive situation analysis was performed among academic staff, healthcare practitioners, and healthcare science students to address and respond to new trends. The aim of the study was to investigate the attitude, perception, and the recognized needs towards experiential education (EE), interprofessional education (IPE), and teaching competencies development (TCD). The critical evaluation of the existing quality standards for further quality improvement in health professions education in Serbia was provided. Methods. The survey on EE, IPE, and TCD was conducted within the Reinforcement of the Framework for Experiential Education in Serbia (ReFEEHS) project, co-funded by the Erasmus+ program of the European Comission at four Serbian universities (the University of Belgrade, the University of Kragujevac, the University of Nis, and the University of Novi Sad). Four task groups were appointed to perform a desk review of the existing curricula, recommendations, and practices within each of the four health professions education (Medicine, Pharmacy, Dentistry, and Nursing) in Serbia and assess the level of compliance with relevant educational policies and practices in the European Union. Results. A total of 1,507 respondents completed the survey. A highly expressed positive attitude was found towards EE, IPE, and TCD among all the respondents. The majority of the respondents (> 70%) shared that EE should be organized in real-life practice and involve students? work under the supervision of a qualified supervisor, as well as interactions with patients and healthcare professionals. About 90% of the respondents supported the inclusion of IPE teaching activities into EE, with 77% of students expressing high motivation to attend those classes, whereas 93% of academic staff was eager to deliver and teach joint IPE subjects. Only 20% of academic staff has already attended some TCD program, while 75% recognized the need for its organization. Moreover, 90% of healthcare practitioners have recognized that mentors/clinical supervisors also need additional skills for effective mentoring work within health science education. Based on the survey results, recommendations for improvement were given within three educational fields, healthcare science curricula, professional practice (traineeship), teaching staff, and regulations. Conclusion. The results derived from the survey served as a starting but also a vital point for higher education improvement in Serbia. All interested parties ? academia, students, healthcare professionals, and regulatory bodies should collaborate on achieving improved, contemporary, and transformative health professions education.

Interprofessional simulation-based education offers a secure platform for various professions to learn how to collaborate effectively. However, it presents numerous challenges, and strategies for overcoming these are outlined in the article "Twelve tips for a successful interprofessional team-based high-fidelity simulation education session" by S. Boet et al., Medical Teacher 2014. Building upon this, we aim to delve into Tip 7: "Put all the professions on the same page: The importance of pre-briefing," emphasizing the need to "establish clear rules for pre-briefing, including basic assumptions and setting the session's atmosphere." But what exactly are these basic assumptions? What if students, future nurses, and doctors find themselves collaborating for the first time in a high-fidelity environment, where actions are inherently rapid, and there's no time for an extensive introduction regarding competencies? Ideally, such discussions should take place in courses preceding high-fidelity simulations, but in our case, this was not feasible. Consequently, we encountered a misunderstanding of competencies, resulting in miscommunication, passivity, and a lack of scenario effectiveness. To address these challenges, we turn to the ABCDE scheme plan as the foundation for pre-briefing, using it as both a framework for the core of the pre-briefing session and a tool for assigning roles and responsibilities within the interprofessional team. The acronym ABCDE stands for airway, breathing, circulation, disability, and exposure, and is employed by major resuscitation councils as a guide for rapidly assessing patients along with applying emergency procedures. Our experiences are promising. In Poland, as in many other places, the competencies of nurses undergo continuous changes. The very essence of the nursing profession changes quite rapidly, and medical students, may not necessarily keep pace with these changes. Focusing on the ABCDE framework in pre-briefing provides an excellent opportunity to practically assess which competencies in resuscitation skills align more with a particular professional group. Additionally, it allows for significant flexibility in dealing with differences in competencies at various stages of professional development. One can simply focus on specific actions without delving into the intricacies of regulations, smoothly transitioning into practice, which is often the fate of our graduates immediately after completing undergraduate education.

Purpose: The COVID-19 pandemic required higher education institutions to quickly transition to a virtual platform. This was challenging for those involved in interprofessional education (IPE), given the goal that students from two or more professions learn about, from, and with one another. The Big Ten IPE Alliance is a subgroup of the larger Big Ten Academic Alliance. The purpose of this paper is to share the collective experiences of multiple large, research intensive universities in addressing the challenge of implementing IPE programs under the conditions established by the COVID-19 pandemic. Methods: To better understand how the Big Ten schools dealt with the transition to virtual learning for didactic and clinical IPE given the COVID-19 pandemic, a subset of representatives from the Big Ten IPE Alliance met to discuss best practices for virtual learning in the IPE realm. Each participating university completed an electronic 14 question survey related to their IPE curriculum during the COVID-19 pandemic from March 2020 thru August 2020 and the responses were analyzed. Results: Four categories were identified as needing to be addressed to develop and implement successful interprofessional didactic and clinical experiences. The categories identified included content/assessment, virtual technologies, faculty and facilitators, and learners. Conclusions/Recommendations: Consider including authentic and innovative mechanisms to deliver IPE experiences that meet the learning needs and accreditation requirements. Interinstitutional collaborations such as within the Big Ten IPE Alliance can be beneficial in assessing current and future best practices in IPE.

IntroductionHigh-Fidelity Simulation (HFS) involving a mix of healthcare students provides a controlled environment for the development of technical and non-technical clinical skills in conjunction with a greater understanding of the...

Interprofessional education (IPE) is a well-supported concept in medical education and a priority for leadership. How students experience IPE is unclear. This pilot study evaluated how medical and nursing students perceived and experienced IPE. Ten medical and 10 nursing students participated in a clinical simulation-based IPE exercise with 2 medical and 2 nursing students per group. Participants completed the KidSIM ATTITUDES questionnaire before and after the exercise. Students gave verbal feedback during the post-exercise debrief. Statistical analyses showed perceptions of the group became more positive with the exercise. With statistical significance across all the domains (relevance of IPE and simulation, communication, situation awareness, and roles/responsibilities), verbal comments were positive. A single clinical simulation-based IPE exercise improved perceptions of IPE among these students. These results provide further impetus to continue to study IPE for medical and nursing students. The findings also support the inclusion of IPE in medical education.

Interprofessional education (IPE) prepares health students to become collaboration-ready healthcare professionals. Assessing students’ baseline attitudes toward IPE and collaborative practice is essential to inform development of IPE curricula. Kuwait University Health Sciences Center (HSC) is early in its IPE journey but is planning to join the broader global movement toward IPE. A cross-sectional survey was conducted to explore the attitudes of HSC students from Faculties of Medicine, Dentistry, Pharmacy, and Allied Health Sciences toward collaborative practice and IPE at early and late stages of study. A total of 770 students completed the survey (81.1% response rate). Students expressed positive attitudes toward interprofessional healthcare teams and IPE (median [IQR] overall attitudes were rated 4.0 [1.0] and 4.0 [2.0], respectively, on a scale of 5). Overall attitudes toward both scales were significantly more positive among pharmacy students than students from other faculties (p < .001). Final-year students reported more positive attitudes toward healthcare teams than early- and middle-year students, while early- and final-year students expressed more positive attitudes toward IPE than middle-year students (p < .001). There were no significant differences in overall attitudes between female and male students toward the two scales (p > .05). These findings have implications for engaging students from different professions in IPE initiatives.

Using a Common Reading as an IPE strategy

How medical inter-professional (IP) education should be introduced to students is still a matter of research. We evaluated IP student attitudes before and after a busy “hands-on” clinical experience.During 3 separate trips, first/second year medical and physician assistant students and third/fourth year nursing students traveled to Central America to work together for 1 week in an underserved clinical setting. Student opinions on inter-professional education were obtained before and after Brigade-1 using the Readiness for Inter-professional Learning Scale validated questionnaire. From these results, a modified version of the survey was developed that included quantitative and qualitative responses. For brigades-2 and -3, students received this modified version of the survey pre and post brigade. Quantitative data was analyzed via paired student t test, and qualitative data was analyzed to identify emerging themes using constant comparative methodology by three separate investigators.No significant quantitative differences between IP student groups were observed in their evaluation of the importance of inter-professional education either before or after the brigades. Qualitative data noted pre-brigade expectations of positive IP, experiential and patient-centered cultural learning. Pre- and post-brigade student perspectives maintained a strong belief that high functioning IP care benefited the patient. Post-brigade perspectives revealed a shift in attitude from purely positive expectations to more practical aspects of teamwork, respect, and interpersonal relationships.Students believe that patient care benefits from IP collaboration. After a busy clinical experience requiring collaboration, students realized that functional teams require appropriate skills, roles, and respectful interpersonal relationships.

Although there are many benefits of interprofessional health care, no previous research has sought to define the status of interprofessional education (IPE) in U.S. dental hygiene programs. The aims of this study were to assess how these programs engage in IPE, the challenges they encounter, and the value they place on IPE. Additionally, the study explored how program characteristics are related to IPE. Data were collected with a web-based survey sent to all 322 U.S. dental hygiene program directors (response rate: 33% of the 305 successfully contacted). The majority of the responding programs were located at institutions with nursing (90%) and other allied health programs (85%). They were likely to collaborate with nursing (50%), other allied health (44%), and dental assisting programs (41%), but were less likely to collaborate with dental schools (28%). IPE was most likely to occur in volunteer activities (68%), basic science courses (65%), and communication training/behavioral science courses (63%/59%). The most frequently reported challenges for IPE were schedule coordination (92%) and curriculum overload (76%). The majority of the respondents agreed that IPE was a priority for the dental hygiene profession in the U.S. (59%) and for the program directors personally (56%). Programs granting bachelor degrees were more likely to have IPE as a priority than programs that did not grant such degrees (scale of 1-5 with 5=most important: 3.81 vs. 2.88; p<0.01). The longer the students spent in the programs, the more those programs engaged in IPE (r=0.21; p<0.05). The data collected in this study can contribute to future efforts to help dental hygiene programs engage in meaningful IPE and contribute to developing interprofessional care in the U.S. health care system.