Utilizing Simulation to Improve Communication and Collaboration in Intraprofessional Nursing Teams

Experts agree that effective inter-disciplinary collaboration is a complex issue that, when achieved, positively impacts patient outcomes. During an acute patient emergency, inter-disciplinary teams commonly struggle to reach a consensus regarding the patient’s plan of care. While a successful patient outcome is, without a doubt, the overarching goal of the team, each individual member has a different vision of what success looks like and varied strategies for achieving that success. A focus on collaboration and teamwork translates to an approach in which each team member is cognizant of and integrates the needs and often-competing goals of the other disciplines into his or her roadmap of success (Weller et al., 2014).

Research has shown that groups are more open to information sharing when: the team is made up of similar roles, necessary information is not unique among the group, and members can make decisions independently. Conversely, teams are least likely to share information when the group is heterogeneous and the information that needs to be shared is specific to certain members (Mesmer-Magnus & DeChurch, 2009). This effect “reflects a divergence in what teams actually do and what they should do in order to be maximally effective, and it has particularly meaningful implications for expert decision-making teams, like those employed for emergency response and medical decision-making” (Mesmer-Magnus & DeChurch, 2009, p. 543). Nurses are not immune to this flaw. In US hospitals, it is not uncommon for a team to be comprised entirely of nurses with varying levels of training and perspective.

Although most nurses would agree that effective communication is necessary for successful outcomes, it is often considered a soft skill, of lesser importance than technical skill or education. Communication and interpersonal skills are rarely, if ever, formally taught and practiced, yet, it has been well documented that failures in communication are a common factor in sentinel events (The Joint Commission, 2016).

Simulation exercises have been noted to be an effective means of teaching and practicing communication skills (Saaranen et al., 2015). Many published observations of simulation have focused on inter-disciplinary teams, comprised of nurses, physicians, and allied health staff. As previously mentioned, teams acutely assembled for an emergency can be comprised entirely of nurses: bedside nurses, managers or coordinators, and various advanced practice nurses. These inter-disciplinary nursing teams often struggle with the ability to effectively communicate with each other. A simulation exercise was designed in an effort to strengthen the relationship between nursing students of varying levels with the goal of bridging the gap that may facilitate miscommunication. The simulation centers around four distinct groups of nursing students.

Junior level undergraduate nursing students, senior level undergraduate nursing students, nurse practitioner students, and student registered nurse anesthetists must collaborate to work through an acute patient emergency. The pilot has been shown to be highly effective with an overwhelmingly positive response from the students.