Interprofessional healthcare simulation involves two or more disciplines collaborating on an interdepartmental scenario. Learners from each discipline participate as a team. How to facilitate inter-collaboration of teams in Healthcare Simulation follows the same rules that apply to any Clinical Simulation. This article by Kathy Sokol, RN, MSN will explore how to facilitate intercollaboration of healthcare teams in clinical simulation.
Clear learning objectives and adequate time to pre-brief, debrief, and run the clinical simulation scenario should be accounted for in a clinical simulation that involves multiple teams. Plan enough time to permit discussion and feedback after the scenario has occurred to improve for next time. Trained facilitators are essential, and since two or more disciplines participate in the healthcare simulation, all faculty members should review the scenario for accuracy and validity.
Medical and nurse simulation groups may collaborate with supportive services that work alongside other providers. Physical, occupational, and speech therapies have the ability to cooperate with medical or nursing personnel for interprofessional healthcare simulation experiences. Nutritionists, social service workers, pharmacists, and mental health professionals also provide the chance to learn more deeply in interprofessional clinical simulation.
Learners from unrelated disciplines can work together to achieve positive outcomes in a collaborative Healthcare Simulation. One Associate Degree nursing program joined forces with the College of Criminal Justice to explore this further. The result was a unique Clinical Simulation-based experience. Faculty from the Criminal Justice department were curious about activity in the nurse lab.
One instructor in the Criminal Justice program wanted to know how nurse faculty engaged the learners. Permission was obtained from the Program Director of Nursing for the criminal justice instructor to observe a scenario focused on assessment. Nurse faculty and participants gave their consent. Afterward, the criminal justice instructor asked to speak privately to the clinical simulation educator.
How to Keep Healthcare Simulation Learners Engaged
The criminal justice educator expressed concern that learners in the program seemed bored with practice of clinical cases presented in the lecture environment. Faculty wondered how to improve learner interest and help students understand the importance of observations and details in a criminal case. Foster (2023) wrote that an engaged learner gains knowledge from the experience. The Healthcare Simulation educator suggested an inter-collaborative experience in which nurses and criminal justice learners participated. The scenario took place in a hospital medical-surgical unit.
Guidelines published by the American Hospital Association (n.d.) state that hospital employees may release information to law enforcement for crimes against a hospitalized patient as long as this is in the individual’s best interests. The nurse learners, therefore, had permission to provide patient information to law enforcement to help with the case investigation. The scenario allowed nurses to collaborate with a discipline outside of the usual circle of professionals.
The Planned Learning Objectives for Nurse and Criminal Justice Participants Were:
- Learners will identify a crime scene and follow hospital protocol to notify law enforcement
- Learners will follow law enforcement policy and procedure to collect and label evidence from the crime scene
- All learners will collaborate to maintain the crime scene’s integrity and prevent contamination of evidence
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Two Independent Disciplines Participate in a Healthcare Simulation
Two nurse learners were assigned. One learner was the staff nurse role, and the other was the charge nurse. Three criminal justice learners acted in the role of investigators. The Clinical Simulation educator facilitated the scenario while the criminal justice faculty observed. The criminal justice instructor provided learners with the usual questions asked in a criminal investigation of this type.
The scenario found a patient deceased in their room. The patient had been scheduled for discharge later in the day. The patient’s condition had been stable for the last 24 hours. Poison was suspected when investigators found an empty vial of unidentified liquid in the trash can. The room had moulage applied as though someone recently visited the patient.
A coffee container sat on the floor beside a chair in the corner. A similar container with coffee residue at the bottom of the cup was on the patient’s bedside table. An emesis basin contained blue-tinted cloudy liquid on the patient’s bed. The manikin was positioned on their side in bed. The manikin’s mouth was tinged bluish-purple. The nurse learner could obtain no vital signs nor rouse the patient.
The learner investigators questioned the nurses to confirm the patient’s condition earlier. The nurse stated the patient was alive and well thirty minutes earlier on hourly rounds. One investigator asked the nurse about the vial in the trash.The nurse learner denied knowledge of the vial’s contents. Another learner investigator collected and labeled the empty coffee cups and vial and placed them in plastic bags.
A sample of the contents from the emesis basin was placed inside a specimen bottle labeled and bagged for transport to the crime lab. Since the patient suffered a suspicious and unexpected death, the body was shrouded with jewelry and the intravenous access device left in place.The learner staff nurse assisted one learner investigator to perform post-mortem care. The body was carefully handled, tagged per hospital protocol and legal guidelines, placed in a liquid impervious body bag, and left in the room to await the coroner’s van for transport to the morgue. This point marked the end of the scenario.
The learner nurses and investigators participated in a guided debrief facilitated by the Clinical Simulation educator in collaboration with the criminal justice instructor. The first comment learners made was how realistic the scenario seemed. All participants maintained a professional demeanor throughout. A few learners admitted a moment of anxiety at the start of the scenario. Once the activity was in full swing, learners felt wholly engaged, and the nurse learners were eager to provide complete and accurate information to the learner investigators.
The Challenge to Overcome Healthcare Simulation Bias
On the surface, this interprofessional clinical simulation was straightforward. The objectives covered basic knowledge of how to deal with a potential criminal case that involved a hospitalized patient. However, the scenario also revealed a need for keen clinical judgment on the part of the nurse when handling a potential criminal case. Criminal justice learners recognized the need for high level critical thought. All participants acknowledged the importance of thorough assessment, detailed information collection, and proper disposition of a crime scene.
While the criminal justice instructor saw the benefit of the collaboration, the curriculum dean did not pursue further clinical simulation-based experiences. Still, the joint effort of the two disciplines opened the door for collaboration with allied health programs on campus. Future healthcare simulations invited learners from the physical therapy and radiological assistant programs to collaborate with nurses and were very well received.
Interprofessional clinical simulation can benefit academic, hospital-based, and first-responder healthcare simulation programs. Collaboration helps improve healthcare delivery and bring awareness of the importance of teamwork for patient safety. Healthcare simulation allows healthcare professionals to work towards common patient care goals.
Incorporating Physical Therapy Into Interprofessional Education Clinical Simulation Experiences
References
- American Hospital Association, (n.d.). Guidelines for releasing patient information to law enforcement.
- Foster, S. (2023). Facilitating and assessing student engagement in the classroom. University of Colorado Boulder Center for Teaching and Learning.
