Sammendrag
Background
Primary healthcare providers are responsible for patients with increasingly complex problems. Introducing interprofessional collaboration in healthcare curricula prepares students to meet these challenges. Simulation-based learning may be a powerful facilitator for active and safe learning, but is mostly used in acute clinical situations. We explore simulation as a strategy to train students in interprofessional collaboration in sub-acute clinical scenarios in primary healthcare.
Summary of work
We tested two low-fidelity simulation scenarios with common, sub-acute patient situations from primary healthcare: An older patient stays at a nursing home after having a hip fracture and surgery, and he develops a urinary tract infection or a pneumonia. Healthcare students (n=27) in their final stage of education (medical students, master students in advanced geriatric nursing and bachelor students in nursing) were allocated to ten groups. The groups were assigned to do a clinical assessment, agree on a probable diagnosis and develop a treatment plan during both scenarios. The facilitators guided the groups from briefing through to debriefing with focus on collaboration and communication. The study is an exploratory, qualitative study with interaction analysis of segments from video recordings of the simulations.
Summary of results
Different forms of interaction and communication affected interprofessional collaboration, especially during the development of a care plan. The content and structure of the care plan and the team’s efficiency in settling a plan as a team depended on 1) the ability to recognize each other’s contribution, 2) mutual knowledge development and 3) the awareness of setting and roles. This emerged through dialogue, gestures, gaze and body language. During debriefing, several groups reflected on clarifying concepts such as close monitoring and deterioration of the patient.
Discussion and conclusions
The sub-acute scenarios show potential to identify interactions and communication affecting collaboration. Using the scenarios in healthcare education may help students to develop productive interactions strengthening interprofessional collaboration. Furthermore, the simulation scenarios are feasible to use on-site in an education facility with minimal technical equipment.
Take home message
Low-fidelity, on-site simulation scenarios based on common, sub-acute clinical situations shows promise in training students in interprofessional collaboration preparing for the complexity of primary healthcare.
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