Readiness for Interprofessional Learning After Participation in an Obstetric Simulation

https://doi.org/10.1016/j.teln.2016.06.004Get rights and content

Highlights

  • Interprofessional education (IPE), using an obstetric simulation, is one means to improve teamwork and communication in the health care setting.

  • Overall, the majority of medicine and nursing students were very positive about IPE before the simulation.

  • Students not initially perceiving teamwork/communication and personal professional identity as highly positive had score changes indicating a statistically significant positive change of perception after engaging in an IPE obstetric simulation.

  • Establishing student readiness for IPE allows educators to focus on design and implementation of IPE programs across the world.

Abstract

Purpose

The importance of interprofessional education (IPE) is widely documented yet remains underutilized in clinical education. The purpose of this study is to determine student readiness for continued IPE after engaging in an obstetric simulation.

Methodology

A pre/postsurvey with a descriptive design was implemented.

Results

Students were very positive about IPE even before the simulation. Students who did not initially view IPE favorably had a significant increase in readiness for IPE after the simulation experience.

Introduction

Educational strategies to improve teamwork and communication are widely documented in the literature but remain underutilized in clinical education. Different health care disciplines, such as medicine and nursing, may work in close physical proximity without frequent and meaningful interaction (Bae et al., 2015, Ceravolo et al., 2012). Interprofessional simulation experiences are a strategy to prepare learners for the realities of a complex and interdependent health care environment. The concern from nursing faculty is whether student learners are prepared for this type of learning activity. The purpose of this study is to determine student learner readiness for continued interprofessional learning after engaging in an interprofessional obstetric simulation. The specific research questions are the following: Does an obstetric interprofessional education (IPE) simulation improve student perception of teamwork and collaboration? and Does an obstetric interprofessional collaborative simulation heighten learner perception of personal professional identity in the interdisciplinary team?

Nurses and physicians are traditionally educated in discipline-specific schools. Developing skill in teamwork and team communications is essential for safe practice and quality care (Liaw, Siau, Zhou, & Lau, 2014). Seventy percent of health care errors are rooted in teamwork and communication breakdown (Zhang, Miller, Volkman, Meza, & Jones, 2015). In the obstetric setting, a lack of health care team communication and teamwork failure may have catastrophic consequences. The occurrence of a sentinel event derived from poor communication is 10% higher in a perinatal care setting than a medical–surgical environment (Gardner et al., 2008, Goffman et al., 2013). Although the Institute of Medicine urges the development and implementation of IPE models in an effort to reduce errors and improve patient safety, the majority of health care education occurs in silos (Alinier et al., 2014).

IPE “occurs when two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” (WHO, 2010). IPE simulation is a safe credible way to practice team skills (Clark, Fisher, Arafeh, & Druzin, 2010). The understanding of professional roles and attitudes derived from IPE simulation can improve student communication and collaboration skills. Improving understanding of the interdependent nature of roles and the knowledge unique to each discipline can be achieved during an IPE simulation experience. IPE simulation has been used in undergraduate and graduate educational programs and multiple health care settings including obstetrics, medical–surgical practice, emergency room, anesthesia, the operating room, and intensive care units (Alinier et al., 2014, Clark et al., 2010, Gardner et al., 2008, Robertson et al., 2009, Weller et al., 2011). Multiple research studies report an increase in student confidence, knowledge, leadership, teamwork, and communication skills after an IPE simulation (Alinier et al., 2014, Gough et al., 2012, Hood et al., 2014, Weller et al., 2011).

It is unclear how many schools actually engage in IPE simulation and if students are truly eager for this educational change (Zhang et al., 2011). According to adult learning theory, students in higher education must be motivated by educational activities designed to transform them into their respective professional roles. Knowledge able to be immediately applied to solving real-life problems is an effective educational strategy for adult learners (Merriam & Bierema, 2014). The first step in adult learning theory stresses the importance of assessing the adult student need and readiness for learning. Evidence of learner readiness to engage in IPE is necessary prior to implementing widespread curricular change (Knowles, Holton, & Swanson, 2015). This article reports the findings of a study to determine student readiness for continued interprofessional learning after engaging in an IPE obstetric simulation.

Section snippets

Methods

A descriptive study using a pre/postsimulation survey was implemented. The study protocol was approved by the university's Institutional Review Board.

The Readiness of Health Care Students for Interprofessional Learning Survey (RIPLS), created by Parsell and Bligh (1999), was used to measure student readiness, or student beliefs, about shared learning. The RIPLS is an 18-item survey with a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Initially developed using eight health care

Results

Table 2 lists each of the survey items with the number and percentage of students who responded to each category. Overall, students were very positive, with approximately one third indicating the highest levels of positive perception and agreement to both teamwork/collaboration and professional identity scores. Fig. 1 depicts the increase from pre- to postsurvey on both scales.

A paired t test was calculated to compare the mean on the presimulation survey and postsimulation survey to identify if

Discussion

The purpose of this study was to determine student readiness for continued interprofessional learning after engaging in an obstetric simulation. This research supports health care students' readiness for interprofessional learning using simulation as an educational tool. In the preexperience survey, the majority of students positively perceived teamwork, communication, and professional identity as critical factors in an interdisciplinary team. For students who did not initially perceive

Conclusion

Patient conditions can rapidly change in the clinical environment. A well-orchestrated team manages the situation in a proficient calm and safe manner. Chaos, frustration, and anger in the midst of a crisis can lead to ineffective teamwork, lack of communication, and unsafe care. To create a substantial change in the health care environment educators' need to instruct future providers on teamwork and communication before ineffective communication patterns develop into life-long habits.

References (19)

There are more references available in the full text version of this article.
View full text