Abstract
Background:
Interprofessional education (IPE) among healthcare students provides a foundation for learning to work effectively as a team. Nursing and respiratory care students have cared for dying patients in the clinical setting with little experience. The purpose of this IPE was to give nursing and respiratory students the opportunity to work together in a simulated learning environment caring for a patient at end of life.
Methods:
Nursing and Respiratory Care students participated in an end of life simulation using a high fidelity manikin and ‘wife’ (instructor acting as) at the bedside. The scenario, by Gina Fieler, was developed from National League for Nursing and Laerdal Medical. A structured format for pre and debriefing was followed: the instructor gave a short pre-briefing report and directed all students to enter the simulation room to observe the patient and clinical scene. Students recorded their observations and returned to the debriefing classroom. Prebriefing continued as students shared their findings, discussed significance, identified further information needed, and developed a plan of care. Student caregivers (two nursing and two respiratory) were instructed to enter the patient room, assess and treat as ordered. Student observers remained in debriefing classroom and watched via video. Instructor ended simulation when objectives were met. Student caregivers returned for debriefing. Duration was approximately 2 hours. With prior Institutional Review Board approval, students were invited to complete a simulation effectiveness evaluation.
Results:
15 respiratory and 42 nursing students completed the survey (n = 57). The majority strongly agreed that the pre and debriefing (95% n = 54; both pre and debrief) were beneficial to learning. 87% (13) respiratory and 64% (27) nursing students strongly agreed they had the opportunity to practice clinical decision making skills. 93% (14) respiratory and 95% (40) nursing students strongly agreed that debriefing was valuable in helping improve their clinical judgment. 73% (11) respiratory and 76% (32) nursing strongly agreed they were more confident in reporting information to the team. Comments: value in role clarification; realistic; want more sims together; suggest different scenarios.
Conclusions:
Student responses reflect increased learning, confidence and desire for IPE simulation. Implementing IPE simulations of various patient scenarios is encouraged. A structured pre and debriefing format enhances learning.
Leighton, K, Ravert, P., Mudra, V., & Macintosh, C. (2018). Simulation Effectiveness Tool - Modified. Retrieved from https://sites.google.com/view/evaluatinghealthcaresimulation/set-m View all access options for this article.Simulation Effectiveness Tool - Modified (SET-M)
Strongly Agree - 3
Somewhat Agree - 2
Do Not Agree - 1
Prebriefing increased my confidence
Prebriefing was beneficial to my learning.
I am better prepared to respond to changes in my patient’s condition.
I developed a better understanding of the pathophysiology.
I am more confident of my nursing assessment skills.
I felt empowered to make clinical decisions.
I developed a better understanding of medications. (Leave blank if no medications in scenario)
I had the opportunity to practice my clinical decision making skills.
I am more confident in my ability to prioritize care and interventions
I am more confident in communicating with my patient.
I am more confident in my ability to teach patients about their illness and interventions.
I am more confident in my ability to report information to health care team.
I am more confident in providing interventions that foster patient safety.
I am more confident in using evidence-based practice to provide nursing care.
Debriefing contributed to my learning.
Debriefing allowed me to verbalize my feelings before focusing on the scenario
Debriefing was valuable in helping me improve my clinical judgment.
Debriefing provided opportunities to self-reflect on my performance during simulation.
Debriefing was a constructive evaluation of the simulation.
What else would you like to say about today’s simulated clinical experience?
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