Using Interprofessional Simulation to Improve Collaboration and Communication Amongst Nursing and Medical Students Brittney Mueller, RN, MSN, CEN Simulation Coordinator NDSU Nursing at Sanford Health Bismarck Nicole Hatzenbuhler, RN, MSN Simulation Faculty NDSU Nursing at Sanford Health Bismarck

Objectives Recognize the need for interprofessional education to promote the delivery of high-quality, patient-centered care Explore the use of interprofessional simulation to facilitate collaboration and communication between nursing and medical students Identify the value of using an experiential teaching strategy to improve communication and teamwork skills in health professions students

Background Lack of interprofessional cooperation and ineffective communication adversely affect both best practice and improved patient outcomes (IOM, 2010). Improving interprofessional efforts leads to improved patient safety (IOM, 2010). Effective nurse-physician collaboration promotes high-quality, patient-centered care. Interprofessional Education (IPE) fosters shared learning and assists students in adapting a collaborative model that embraces cooperation and effective communication (Angeline, 2011) Simulation has proven to be an effective experiential teaching strategy in both medical and nursing education (Simmones et al., 2010). In the delivery of health care services, numerous groups of health professionals work together to deliver patient centered care.

Purpose Determine if an interprofessional simulation experience for pre-professional medical and undergraduate nursing students is an effective learning strategy to improve communication and collaboration amongst the two professions. Questions Did students find interprofessional simulation helpful in improving their communication skills? Did students find the interprofessional simulation experience to be a valuable opportunity to communicate with students from another profession? Did both medical and nursing students find the interprofessional simulation experience helped them better understand how to work as a team member?

Method Multiple simulation scenarios using high-fidelity simulators Included: 3rd year medical students 2nd semester senior undergraduate nursing students 10 simulation sessions each semester 3 hours – simulation and debriefing 3-4 scenarios Ex: CHF exacerbation, Acute Asthma Attack, Elder Abuse/Neglect, Community Acquired Pneumonia/HIV, Pediatric DKA

Simulation Process and Roles Nursing Student(s) Initial assessment on the patient Report findings to physician Use nursing judgement to determine best time to collaborate with physician based on patient status. Medical Student Assess patient and order interventions as deemed necessary medications, labs, radiology, etc. Medical Student and Nursing Student(s) Work together to care for patient Active Observer(s) Bring key points noted during simulation to debriefing to discuss

Debriefing Facilitated by NDSU simulation faculty after each scenario Opportunity to discuss: Strengths Areas of improvement Communication techniques Collaboration Skills and concepts related to the scenario Post-simulation evaluations completed by all students at the end of each simulation session

Results Post evaluations collected to determine students’ view on the effectiveness of the simulation Data collected over 2 years/4 semesters 248 evaluations collected 119 medical students 129 nursing students

Results Did working in a collaborative simulation help improve your communication skills? 94% strongly agreed Did you feel the simulation experience provided a valuable opportunity to communicate with students from other professions? 97% strongly agreed Did the simulation experience help you to better understand how to work as a team member? 92% strongly agreed

Results Greatest benefit of collaborative learning: Collaboration “Learning to work with a different discipline.” “Learning how to effectively work with and collaborate with other professions to improve patient care.” Communication “It was great to get the opportunity to better understand the nursing profession and to get to communicate with future colleagues.” “I feel much more confident when addressing the physician and what information to include.” Teamwork “Learning more about how to work effectively as a team.” “I realized this is about team work and everyone respected each other.”

Results Greatest challenges working with an interdisciplinary partner: Knowing/Identifying others’ roles, scope of practice, knowledge “understanding what everyone's baseline is as far as knowledge and scope of practice” “It’s always challenging to know each other’s understanding level” “Knowing their scope” “Not having a big understanding of their role prior” Establishing Relationships/Rapport “Establishing rapport with new people” “Establishing communication with people you haven’t seen before” Communication – What and When to Share “Knowing what to communicate” “Not knowing exactly what to say to physician/suggestions” “Coming from different backgrounds -> what is important to show and communicating that” “Speaking up”

Results Suggestions for improvements/changes - Lessons Learned Not giving the nursing students prep work/pre-knowledge of diagnosis “then we would all be on same page” “would collaborate further to treat and diagnose” “would help us gather a better assessment and prioritize” Including other professions/disciplines More collaborative sims! Lessons Learned No UND Students during their first week in a new rotation Technology Challenges Simulator Education – educating on what it can and can’t do Pediatric simulator limited Lab/Radiology Results

Limitations/Future Areas of Study Questionable transfer of skills – will these skills in communication and collaboration as students transfer into their professional practice as nurses/physicians? Limited to two disciplines - Would adding more disciplines help even further to improve communication and teamwork amongst the different professions?

Conclusions Findings support the value of interprofessional simulation as an effective learning strategy to improve collaboration, communication, and teamwork between undergraduate nursing students and pre-professional medical students. Should be implemented/continued within pre-licensure nursing curricula to promote the delivery of safe, high-quality, patient- centered care.

References Angeline, D. J. (2011). Interdisciplinary and interprofessional education. What are the key issues and considerations for the future? Journal of Perinatal and Neonatal Nursing, 25(2), 175-179. Institute of Medicine (IOM). (2010). Health professions education: A bridge to quality. Retrieved 10/8/2018, from https://www.ncbi.nlm.nih.gov/books/NBK221528/pdf/Bookshelf_NBK221528.pdf Simmones, J., Wilcox, J., Scott, K., Gorden, D., Copley, D., Doetkock, R., & Kippley, M. (2010). Collaborative simulation project to teach scope of practice. Journal of Nursing Education, 49, 190-197.

Questions? Thank You