SPECIAL SESSION: Save Stan Turns Five: A Large-Scale Interprofessional Practice and Academe Innovation

Description/Overview: Description of the Event: The Interdisciplinary Health Education Partnership (IHEP) is an inter-institutional, interprofessional team comprised of healthcare simulation specialists and interprofessional education experts from both clinical practice and academic settings in Edmonton, Alberta Canada. Over the past seven years, IHEP members have successfully developed, implemented, and evaluated multi-modal interprofessional simulations (SIM-IPE) for pre-licensure learners at HELP! Save Stan Saturday (SSS). This annual IPE event offers learners a full day of interprofessional team-based scenarios focused on increasing interprofessional competence. IHEP, through the implementation of SSS, has developed capacity for SIM-IPE in faculty and clinical instructors and successfully provided pre-licensure health science students the opportunity to increase IP competence. Moreover, this partnership has resulted in significant enrichment of SIM-IPE in the nursing and non-nursing simulation practice communities locally and across Canada. On March 14, 2015, the IHEP development team will implement the 5th HELP! Save Stan Saturday! Strong interprofessional partnerships are not simply a “nice to have’, they are pivotal to the advancement of team development in nursing and other professions. Inter-institutional partnerships also promote the development of strong, collaborative communities of practice whose collective efforts have the power to shift healthcare culture for safer patient care. Collective findings support that SIM-IPE and IP competency attainment, is positively correlated with improved care outcomes and increased patient safety (Jeffries & Battin, 2011; Lemoine, Chauvin, Broussard & Oberleitner, 2015). The five-member partnership, formally established in 2009, is a collaborative between Alberta Health Services e-SIM (the Provincial Health Authority simulation team), MacEwan University, Northern Alberta Institute of Technology (NAIT), NorQuest College, and the University of Alberta to develop capacity in faculty and students, where three of the post-secondary institutions offer pre-licensure programs in nursing that range from practical nursing to baccalaureate nursing degrees. To date, IHEP has developed, delivered and evaluated relevant interprofessional simulation experiences for pre-licensure students from over 20 disciplines in certificate, diploma and degree programs. To date, nearly 1000 students from the 4 post-secondary institutions have participated in a series of SIM-IPE offerings representing the full continuum of care. This full day event requires the involvement of over 100 specifically trained IP simulation educators who collaborate to deliver upwards of 30 evidence-based interprofessional simulations to pre-licensure students from across all health disciplines. The educators come from both academe and clinical practice settings. Capacity building among educators unfolds through engagement in the coordination, development, and facilitation of interprofessional simulations. Continuing faculty development activities comprise of workshops in debriefing and scenario development for IPE and a 3 day educator training curriculum and course entitled, Sim ETC (Simulation Educator Training Course) that has been offered in 3 Western Canadian provinces. Overcoming Challenges to the Collaboration: Challenges and barriers to the implementation of IPE include: 1) unique, discipline-specific cultures; 2) physical distances that make timetabling and logistics difficult, contributing to the inadequate socialization of undergraduate students from different disciplines; 3) differences in curricular goals and foci, as well as; 4) variations in areas such as workload, reward systems, research expectations, and varied teaching approaches using simulation within and across institutions for faculty members (Thibault, 2011). The benefits of adopting an inter-institutional collaborative model include; 1) enhanced individual and collective abilities to enact strategic goals in IPE toward transforming clinical education and ultimately improve patient care; and 2) provision of a platform for socialization, and networking with other educators/administrators to overcome common barriers (King et al, 2013). The IHEP team planned for these challenges by: 1) developing infrastructure and governance processes comprised of an oversight committee with representation and voting power from each partner and key stakeholder groups; 2) building a unified vision for SIM-IPE based on common goals; 3) creating a web-based repository for sharing IPE scenarios and resources; 4) employing SIM-IPE ‘best practice’ as the basis for program and partnership development; 5) creating a SIM-IPE community of practice by promoting collaborative learning, research development and establishing multiple opportunities for building cross-institutional relationships; and 5) creating and delivering relevant, well-designed IPE experiences that mirror students’ future practice (Bridges, Davidson, Soule et al., 2011; Greenstock, Brooks, & Bingham, 2013; INACSL, 2011, 2013; Jeffries & Rizzolo, 2013; Lemoine et al., 2015; Thibault, 2011). Identifying a unified approach to curriculum development and delivery of SIM-IPE proved crucial to successful outcomes. The faculty development team, therefore, articulated a shared vision to offer simulation that promoted high levels of realism and interactivity for the learners. Each of the 30+ simulations offered at SSS are grounded in simulation and educational best practices. Therefore, best practice provides a foundation for SIM-IPE design and incorporates, 1) the Simulation Education Framework (Jeffries, 2007); 2) the Canadian Interprofessional Health Collaborative Framework for IPE, (CIHC, 2010); 3) Standards of Best Practice: Simulation by the International Association for Clinical Simulation and Learning (INACSL) (2011; 2013); and 4) an approach to debriefing developed through the Center for Medical Simulation (CMS) at Harvard (Rudolph et al, 2006; 2007; 2008). All SIM-IPE experiences comprised: 1) pre-briefing/briefing; 2) simulation scenario development using a common IHEP template; and 3) a plan for assessment and debriefing grounded in learning objectives for team-based competency acquisition. Only trained faculty facilitate SIM-IPE delivery where debriefing focuses on team competencies in healthcare. Simulation typologies are selected based on their capacity to optimize engagement and interaction for the learner. Low fidelity partial task trainers, medium and hi-fidelity simulators, standardized patients, embedded actors (confederates), virtual reality, and hybrid simulations are all simulation modalities utilized in SSS. A survey by Adamson (2010, as cited in Jeffries & Battin, 2011), reported antecedents to excellence in faculty development within simulation consortia as; 1) collaborative learning for faculty; 2) support for learning from colleagues and administrators, and; 3) encouragement through the use of varied incentives. Additionally, deliberate efforts to network and reflect on shared experiences, created a capacity building environment for simulationists from the various disciplines. The IHEP team continues to replicate a synergistic phenomenon born of uniting innovative thinkers, life-long learners, and movers and shakers that are impassioned by a shared vision; that of employing SIM-IPE to effect cultural change in healthcare and increase patient safety. Tipping Points: The IHEP team collaborated for the duration of the project funding. New funding proved elusive and the team faced the largest challenge it had encountered to that point: should the partnership fold or should we find a way to continue? Two years have passed since the official closing of the project and the energy, commitment, enthusiasm from all partner sites has not diminished. The team found ways to cut expenses and seek funding from each of the partner sites and vendors to cover the cost of implementation and ensure no charge for students. Resource Allocation: The catalyst for the partnership’s work was government funding. The partnership developed principles to guide our initial collaborative work. Each partner had an equal voice at the table, regardless of the size of the institution. The SSS event rotated among institutions to ensure equity. Faculty development debriefing workshops were co-instructed by people from all institutions and the hosting responsibilities were shared equally across institutions. The fact that the partnership still thrives after leadership turnovers and lack of base funding is a testament to the value of the activities and outcomes. Next year, the SSS event will be integrated into a required course for students from one institution. Measurable Positive Student Outcomes: Evidence of positive student outcomes gathered through three sources: 1) survey results; 2) student interviews; and 3) reflections with digital storytelling. The University of West England Questionnaire (Pollard et al, 2004) was used pre and post simulation experience to determine the change in communication and teamwork. Overall, students’ perceptions of their communication and teamwork skills increased after completing either simulation. Placing students in teams that are relevant for practice, rather than defaulting to grouping them by academic credentials, provided positive learning experiences for all participants, as demonstrated by these results. Results from student interviews indicated that 3-6 months post-SSS, students still felt confident to share their ideas, felt they had a better understanding of other disciplines’ roles and understood the value of collaboration for better patient care. The digital storytelling narratives revealed that students and faculty appreciated learning in a psychologically safe environment. Moreover, the participants’ stories spoke highly of reflective team debriefing strategies that resulted in transformational learning experiences with self-reported increases self-efficacy in IP competencies and skill transferability to team practice for enhanced patient care. Future research is planned to explore point-of-care outcomes for patients and teams. HELP! Save Stan lives on!