Student Reflection of Team-Based Simulation to Facilitate Interprofessional Education Compentencies

Background and Purpose: Simulation-based education has proven to foster team-based decision making in health professions education. Health professions students were provided a simulation opportunity to develop and practice interprofessional skills in ethics/professionalism, communication, roles/responsibilities, and teams/teamwork while navigating the nuances of these behaviors in an observed and mentored setting. The objectives are to describe the simulation development in its first semester based on students’ reflections. Student responses were used to evaluate perception of team learning, and how the experience affects the students’ perception of individual and overall team performance.

 

Methods: Students were asked to reflect on their simulation experience after debriefing using an anonymous web-based evaluation. All 320 students from Social Work, Medicine, Pharmacy, Nursing, and Dentistry enrolled in a team-based decision making course in the winter semester 2017 were included. A total of 75 students responded (response rate= 23. 4%).

 

Results: Student feedback was insightful and promoted further adaptation of an acute care simulated patient scenario. Salient points focused on inclusion of all team members, student self-criticism and discomfort based on their performance, and the importance of communication, delegation and leadership. Approximately half (52. 0%, 39/75) expressed the experience as “stressful” or “intimidating” or “overwhelming” yet students equally expressed it was “interesting” or “thought-provoking” or “valuable” (50. 7%, 38/75). Most students reported no previous clinical simulation experience (85. 3%, 64/75).

Conclusions and Implications: Despite known challenges, these findings support simulation as a proven strategy for positive team learning. This simulation promoted practice of interprofessional education competencies in a clinically stressful scenario. Based on student feedback, unique lessons learned included an expected response to the cognitive and emotional load of managing a seriously ill patient. As a result, we modified the final team debrief to include content on self-care, including dual management of the cognitive and emotional load, stress response leading to either a good or bad outcome (compassion fatigue, burnout or resilience) types of coping mechanisms (active versus avoidance), and finding balance.  It would be important to consider the complexity and challenge of the simulation scenario to match the level of the student learners, as student experiences in the clinical environment was limited and varied with this group.  Of particular relevance, health professions students may benefit from training in self-care, resilience and coping strategies in acute patient care scenarios. Additional simulation experiences may relieve intimidation factors.