For this program, high-fidelity simulation scenarios were created to include physicians, nurses, nurse technicians, pharmacists, and respiratory therapists to focus on interdepartmental teamwork and collaboration and a positive work environment. The simulation scenarios and debriefing sessions were created in consultation with a representative who was considered an expert in the field. Learning outcomes were written at Bloom’s taxonomy level of analysis, synthesis, and evaluation, to account for the level of experience and clinical skills of participants. The professionals’ levels of experience ranged from competent, to proficient, to expert, according to Benner’s (1984) Novice-to-Expert Theory. Each of the six QSEN competencies were incorporated into each scenario (QSEN, 2018).
Participation from each discipline was supported by the hospital’s leadership team and time was given for clinicians to engage in simulation sessions. Simulation sessions were scheduled to accommodate clinical staff from both day and night shifts. A sign-up process was put in place to allow for each discipline to be represented in every scenario. Simulations were led by a simulation instructor who could facilitate interprofessional critical thinking and teamwork and collaboration. Scenarios included high acuity patients with deteriorating statuses. The scenarios allowed each discipline to play a role in critical thinking. Pre-briefing was completed with consideration for each discipline’s area of expertise. Interprofessional scenarios give teams the ability to anticipate actions (James, Page, & Sprague, 2016). During the simulation, each team member’s expertise was needed in order to manage the patient’s condition collaboratively.
Current literature recognizes the challenge to incorporating all professions into the scenario and creating a meaningful debrief for individual disciplines (Cheng et al., 2014; DeMarco et al., 2015; Holtschneider & Park, 2015). Understanding of scope and anticipation during simulation scenarios can yield bedside results of quicker response times, reduction of errors in communication, and create healthier relationships (Sexton & Baessler, 2016). Participants contemplated on how their role and scope of practice can affect effective teamwork and the quality of care provided.
Strategic debriefing sessions were used to reflect on the simulation experience. Structured debriefing questions can facilitate reflection of communication and teamwork skills (Cheng et al., 2014). The instructor influences thought process and open discussion around teamwork strategies and impact (Holtschneider & Park, 2015). The debriefing session also allowed participants to identify quality improvement opportunities and future teamwork development. Combining the reflection of clinical skills and interdepartmental collaboration can lead to healthy work environments and higher quality of care at the bedside (Jarzemsky, McCarthy, & Ellis, 2010). There is value in hearing the thought process of other departments during the debrief, as well as scope of practice.
Healthy work environments create higher-level communication and relationships that influence higher quality of care at the bedside (Jarzemsky, McCarthy, & Ellis, 2010). Interprofessional simulations create a safe environment for teams to build healthy relationships by understanding roles, communication, values, and teamwork (Holtschneider & Park, 2015). Scenarios and debriefing allowed peers to practice better communication skills and strengthen relationships within the teams. The understanding of scope of practice of each team member and anticipation of actions during scenarios yielded outcomes of quicker response times, reduction of errors in communication, higher quality of care and healthy interprofessional relationships. Participants reported that interprofessional simulations encouraged teamwork, collaboration, and cohesiveness. The collaboration of teams in a safe simulated environment created a milieu of trusting healthy relationships.