Findings from a Multidisciplinary Hospital Classroom Simulation: A Pilot Study

Background and Purpose: Simulation is an educational pedagogy integrating theoretical knowledge and applied learning, allowing students to enhance their work-readiness skills in real-world settings. Simulation allows students to participate in real time while building their competence and confidence. Embedded in simulated learning modules are provisions for attempts, errors, and reception of essential feedback. The aims of this multidisciplinary (Social Work, Nursing, and Theatre Departments) pilot simulation project was threefold: to assess social work student learning of Council on Social Work Education (CSWE), Educational Policies and Standards (EPAS); to assess nursing student acquisition of National Patient Safety Goals (NPSG) and Quality and Safety in Nursing Education (QSEN); and to address “silo-based” learning through multidisciplinary collaboration. This study hypothesizes statistical differences between the professional rater assessments and students’ self-assessments.

Methods: Simulation took place with a total of 40 nursing and social work students, professional raters from both disciplines, in four hospital classrooms that were prepared in advance to ensure fidelity. Simulations occurred in two cycles, lasting three hours, commencing with nursing students demonstrating their acquisition of NPSG requirements, including social worker referrals. Two types of patients were used: 1) high fidelity– programmable mannequins–that exhibit medical conditions; and 2) standardized patients–student actors performing the role of sick patients. Students were observed, by professional raters, through a one-way window. Raters were equipped with headphones to hear the dialogue. Students, faculty, and raters participated in a 45 minute debrief. Immediately following simulation, social work students completed a 22-item multidimensional assessment that centered on five CSWE EPAS standards: 1) ethical and professional behavior, 2) diversity and difference in practice, 3) practice-informed research and research-informed practice, 4) engagement and 5) assessment. Bivariate analyses were conducted to test differences between student-self assessment and rater assessment. Nursing students were evaluated on NPSG performance, which assessed the nursing students’ ability to identify patient correctly, communicate effectively, ensure medication safety, prevent infection, and assess the safety risk. A measurement error was estimated for each individual category and all categories were combined for the NPSG. QSEN assessed patient-centered care, work in inter/intra-disciplinary teams, evidence-based practice, and utilization of information from a variety of sources. The analyses also included dichotomous data evaluation using binomial-based statistics.

Findings: MSW students rated themselves higher in engagement skills practiced in class and field practicum and lower in technical skills. Professional raters scored MSW students higher in technical categories and lower soft skills, like empowerment and empathy. Cumulative scores situate student and rater means in the average range, concluding need for increased knowledge and improved engagement skills.

 

Conclusions and Implications: A larger social work student sample size and interrater reliability mechanisms would provide more consistent social work results. Nursing student errors will likely improve with continued interprofessional collaboration. As a result, the three Departments are committed to continued collaboration and involving additional allied professionals from education, psychology, and sociology. Future activities, including expanding the quantity and types of simulation scenarios, comparative studies about student and instructor demographics, and long-term effects of interprofessional collaboration will be discussed.