Interprofessional Education: Using Live Simulation to Enhance Collaboration and Communication

The purpose of the simulation was to expose healthcare students in nursing, occupational therapy, and social work to the benefits of and barriers to interprofessional collaboration and communication through a live patient lab simulation. The interprofessional lab simulation was divided into three phases which included: 1) preparation through various teaching methods and lab simulation tours, 2) participating in the actual simulated case scenarios followed by interprofessional medical rounds and reflective exercises, and 3) group presentation of collaborative findings and discharge planning, and learning experiences. The collaboration between the professional program students aimed to link classroom teaching with clinical practice by fostering team work, problem-solving, communication, leadership, and critical thinking. Feedback from students was positive, where many indicated that more types of interprofessional experiences should be embedded throughout the programs and would be valuable for the development of important clinical skills. Received: 07/15/2015 Accepted: 09/07/2015 Published: 11/09/2015 © 2015 Chown et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Using Live Simulation in Interprofessional Education EDUCATIONAL STRATEGY 2(3):eP1089 | 2 Introduction According to the World Health Organization (WHO) (2010), “Interprofessional education [IPE] occurs when two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” (p. 13). Interprofessional collaboration and communication require students to have an understanding of the roles of other professionals in the delivery of patient care. Safe patient care requires communication and collaboration between members of all healthcare disciplines. The Joint Commission (2012) identified communication as a fundamental cause of errors in the healthcare environment. The Institute of Medicine (IOM) in 2009 discussed the need for interprofessional communication and collaboration to promote safe patient care. “Just being around people from other professions is not enough. People need to work through problems together, often with the aid of a coach or facilitator” (IOM, 2009, p. 41). Simulation can provide a safe environment for students to explore, practice, and reflect upon patient outcomes based on their ability to communicate and collaborate across professional boundaries in a facilitated experience. Team work, problem-solving, communication, leadership, and critical thinking are skills utilized by healthcare professionals in daily practice. Although students in professional programs of study have exposure during fieldwork to other healthcare professionals, courses are often taught only within the discipline. According to Moyers and Metzler (2014), “health profession entry-level education has occurred and, in many cases, continues to occur in discipline silos. As a result, the separate functioning of practitioners is perpetuated in spite of the demand for team collaboration as a major component of patientcentered care” (p. 502). In order to foster participation between different health disciplines, an interprofessional lab simulation experience was created, allowing students to be submerged in a clinical situation and practice clinical reasoning skills within a safe environment. This teaching methodology has underpinnings in cognitive, constructivist, and social learning theories and can facilitate student learning. Simulation also enhances deeper thinking through reflection (RutherfordHemming, 2012). Nagle, McHale, Alexander, and French (2009) discussed the effectiveness of simulation in promoting learning in communication and teamwork. “As learners work together to discuss their learning and share their experiences, they construct shared understanding and knowledge at higher levels. Clinical simulation can become part of global collaborative team education and communication training for health care teams” (Kaddoura, 2010, p. 514). Application to Nursing Interprofessional education is supported by the American Association of Colleges of Nursing (AACN) in The Essentials of Baccalaureate Education for Professional Nursing Practice (AACN, 2008). Essential VI addresses the need for educational experiences for undergraduate nursing students that targets collaboration and communication with other professionals. Nurses are often requested to coordinate interprofessional teams. Nurses provide a key leadership role in all healthcare settings to assess, identify, plan, and evaluate patient outcomes through collaboration with colleagues from all aspects of the healthcare delivery system. Identified as an essential part of the educational experience, AACN (2008) accentuated the importance of interprofessional learning to provide safe nursing care. Realizing that healthcare is a complex system that requires multifaceted communication and conscious collaboration efforts to prevent omission and assure patient safety, interprofessional learning was identified as a corner stone for developing safe practices in novice nurses. Goals for the interprofessional simulation were developed in alignment with Essential VI and best practices related to communication, collaboration, and leadership. In 2011, the Society for Simulation in Healthcare (SSH) and the National League for Nursing (NLN) identified an opportunity to enhance interprofessional education outcomes utilizing simulation to facilitate interprofessional education and practice. Both the National League for Nursing Accrediting Commission (NLNAC) and the Commission of Collegiate Nursing Education (CCNE) address IPE in their nursing education accreditation documents supporting incorp-oration of simulation learning, especially when focusing on IPE, team work, and patient safety (Interprofessional Education Collaborative Expert Panel, 2011). H IP & ISSN 2159-1253 Health & Interprofessional Practice | commons.pacificu.edu/hip 2(3):eP1089 | 3 The development of clinical reasoning skills in nursing students is the cornerstone of healthcare education. Clinical reasoning allows for the application of didactic learning to patient care and allows the clinician to respond to varying clinical situations in a safe and effective manner. Learning clinical reasoning requires submersion in the clinical environment with the opportunity for the student to reflect on actions and outcomes (Koharchik, Cauti, Robb, & Culleiton, 2015). Furthermore, being able to work effectively as members of clinical teams, while in the student role, is a fundamental part of student learning. How to assist students in learning interprofessional competencies continues to be an issue for today’s educational programs. Effective at improving healthcare students’ knowledge and communication skills, simulationbased methodologies help to model the real world of clinical practice, where teamwork often happens asynchronously across time and space. Application to Occupational Therapy Occupational therapists must be able to work with multiple disciplines to ensure the best outcomes for clients. In order to practice with other healthcare providers, occupational therapy students need to develop important skills such as communication, problem-solving, teamwork, critical thinking, and leadership. Furthermore, students need to recognize the roles and benefits of other disciplines. These essential skills and knowledge should be developed early during the educational process through interprofessional education. According to the 2011 Accreditation Council for Occupational Therapy Education (ACOTE®) Standards and Interpretive Guide Preamble, students upon graduation from an ACOTE® accredited master’s degree-level occupational therapy program must be “prepared to effectively communicate and work interprofessionally with those who provide care for individuals and/or populations in order to clarify each member’s responsibilities in executing components of an intervention plan” (American Occupational Therapy Association [AOTA], 2012, p. 1). Standard number B.4.1 from 2011 ACOTE® requires that students be able to consult with other professionals regarding screening and evaluation of clients in order to determine the need for occupational therapy intervention. Standard number B.5.20 requires students be able to“effectively interact through written, oral, and nonverbal communication with the client, family, significant others, colleagues, other health providers, and the public in a professionally acceptable manner” (AOTA, 2012, p. 26). Furthermore, standard B.5.21 requires that students upon graduation are able to “effectively communicate and work interprofessionally with those who provide services to individuals, organizations, and/or populations in order to clarify each member’s responsibilities in executing an intervention plan” (AOTA, 2012, p. 26). Application to Social Work Social workers apply the person-in-environment perspective, focusing on the strengths of the client, to their daily collaboration with professionals in all aspects of the healthcare environment. Social workers can work with individuals, families, and the larger systems that impact the individual. In order to produce an effective intervention, social workers must develop a holistic and comprehensive understanding of the individual client. Interprofessional collaboration allows social workers to recognize the complex and dynamic factors that impact an individual client beyond the traditional biopsychosocial assessment. Competency is a core professional value requiring social workers to continually expand their knowledge base and to practice within their areas of expertise (National Association of Social Workers, 2008). For social work practitioners today, competency no longer applies