The Efficacy of Simulation-Based Learning and Self-Reflection for Enhancement of Respiratory Therapy Students’ SBAR Handover Competency

Abstract

Background:

The basis for the knowledge of a patient’s condition begins with verbal handover from another respiratory therapist (RT). This handover includes vital information that plays an integral role in patient safety and outcomes. Despite including the Situation-Background:-Assessment-Recommendation (SBAR) communication technique in courses and classroom labs, often students lack confidence and struggle to give thorough handovers. High-fidelity simulations have been found to be an effective technique in training health care providers in targeted skills. Reflective practice is also recognized as core to professionalism and skill development. The purpose of this study was to develop and analyze the effectiveness of a high-fidelity simulation experience with self-reflection on SBAR handover skill development.

Methods:

Eighteen first-year RT students participated in this IRB approved pilot study. The simulation experience was an endotracheal intubation scenario in the operating room where students gathered clinical information throughout the experience. SBAR handover was video recorded and both an expert (faculty) and students used a rubric to rate SBAR and communication effectiveness post-simulation and post-skill check-off. An online survey instrument also measured pre and post-simulation self-efficacy and student satisfaction. Data analysis included descriptive statistics and paired t-tests.

Results:

Expert ratings showed a statistically significant improvement in all SBAR categories, along with communication and mean total handover score (P <.001) from post-simulation to post-checkoff. Students’ self-ratings also demonstrated a statistically significant increase in the “Situation” (P = .048), “Recommendations” (P = .009) categories, as well as communication ratings (P = .02), and mean overall score (P = .005). Self-efficacy for identifying landmarks for intubation improved and students rated the simulation environment to be more realistic than the low-fidelity lab.

Conclusions:

Participation in a simulation-based experience with self-reflection requirements gives students the opportunity to enhance SBAR communication skills before entering the clinical environment. Significant improvements were made in handover skills including student self-efficacy. The simulation structure developed in this study could be adopted to enhance interpersonal communication competence in RT students.