Simulation-based Interprofessional Team training APPD Annual Meeting

Sandrijn van Schaik, MD PhD Jennifer Plant, MD

Chicago, April 2010

Glenn Rosenbluth, MD

Simulation-based Interprofessional Team Training: Developing an effective and sustainable program utilizing 360o evaluation of teamwork and communication skills

2

Workshop Objectives: • Understand the components of a needs assessment for an interprofessional team training program • Link a needs assessment to specific goals and objectives focusing on teamwork and communication skills • Identify stakeholders and resources at your institution to aide in implementation of the program • Understand how to utilize debriefing for 360o evaluation of teamwork and communication skills

3

Workshop Outline • Introduction • Principles of curriculum development and needs assessment • Identify learning objectives (exercise) • Our experience • Stakeholders and barriers (group discussion) • Debriefing and 360o evaluation

4

Introduction • Who we all are • What is interprofessional team training? • Why should you care? • Why simulation?

5

We are…. • Sandrijn van Schaik – [email protected]

• Jennifer Plant – [email protected]

• Glenn Rosenbluth – [email protected] And we have nothing to disclose

6

Our Program: • An interprofessional team training program – Simulation-based – Pediatric Emergencies – Focus on Teamwork and Crisis Resource Management skills – In situ training – Multiple professions participate: MD, RN, RCP, PharmD

7

Interprofessional Education? • What is it? – Learning with, from and about other health care professionals

8

Interprofessional Education • What is it not? – Learners from different disciplines learning the same thing without reflection or interaction (multidisciplinary education) – A Pharm D teaching RN students about the role of pharmacists in a clinical team (interdisciplinary education)

9

Learning with, from and about – why? 1999 Institute of Medicine report “To err is human” • Communication failures are the root of the majority of medical errors • Team training is advocated to as a means to improve communication

10

Learning with, from and about – why? ACGME competencies: • Interpersonal and Communication Skills – “Communicate effectively with physicians, other health professionals, and health related agencies” – “Work effectively as a member or leader of a health care team or other professional group”

• Systems-based practice – “Work in interprofessional teams to enhance patient safety and improve patient care quality”

11

Interprofessional Education • Simulation – “Safe” re-creation of real-life situations in which team work is essential • Safe for the patients • Safe for the learners

– Allows for identification of errors in systems, environment and processes – Creates room to practice: make mistakes and learn from mistakes – ACGME has embraced simulation for teaching and assessment of competencies

12

Team training: Developing a Program Kern’s 6 steps to curriculum development 1. Problem identification 2. Needs Assessment 3. Goals and Objectives 4. Education Strategies 5. Implementation 6. Evaluation and Feedback

13

Problem Identification • What problem are you trying to solve and for whom? For example: – Residency competency training – Nurse credentialing – Respiratory therapist familiarity with pediatric codes – Patient Safety

14

Needs Assessment • General and targeted: – What do learners from different backgrounds need to learn? – How do they learn it best? – What common learning needs do learners from different backgrounds have?

• How do you find out? – Training requirements – Credentialing criteria from professional organizations – Ask the learners, ask their teachers: surveys, focus groups, (informal) interviews – Pretests, direct observation of performance

15

Learning Objectives • Follow from the needs assessment • What is it that learners need to be able to do after completion of the program? • Attainable and measurable • Find the ones with overlap (common learning objectives) & address those with team training • Identify the ones that are profession-specific & design different learning modules for those

16

Small Group Exercise • Describe to the rest of your group a program that you would like to set up. – What is the problem identification? – Who are the learners and what do they need to learn? – Identify common learning objectives among your learners from different professions – How would you go about a formal needs assessment?

17

Defining Learning Objectives and Developing a Program: Our Experience • We started small: 2 groups (residents and nurses), one unit (PICU)

18

Common Learning Objectives

19

Specific Learning Objectives • MD: procedural competency – Procedural skills lab as separate sessions

• RN: defibrillator competency – Extra hour for RNs only

• Medical knowledge – handouts

20

21

Stakeholders Discussion points: • Who are the stakeholders at your institution for the interprofessional team training program you are proposing? • How can you capitalize on those stakeholders?

22

Barriers Discussion point: • What are the barriers you perceive?

23

Our Barriers • No money • No space • No time • Not the culture

24

Interprofessional Team Training Changing the culture through debriefing and 360o feedback and evaluation • Do it together: – program leadership – Debriefing

• Make it safe • Make it the norm

25

Video Examples

26

Our Debriefing & Peer Evaluation Tools • Based on learning objectives: – Common learning objectives – Scenario-specific learning objectives

• Check list for team training facilitators • Assessment form for facilitators and participants: – Team leadership – Teamwork

27

28

29

30

Tips to Start • Start small • Identify stakeholders and their needs, incorporate those into your program – Examples: defibrillator competency for nurses, ACGME competency assessment for residents

• Use available resources – TeamSTEPPS, scenario books – School of Nursing/ School of Medicine

www.ahrq.gov

31

Tips to Sustain • Agree on best time, and don’t cancel • Emphasize respect during debriefing to create a culture for interprofessional feedback • Collect data and use these to gain further support • Train others early on to become champions • Create a shared (on-line) forum

32