Healthcare students benefit from inter-disciplinary learning opportunities, including the practice of communication and collaborative strategies essential for real-world patient care.1 Faculty are increasingly using simulation-based inter-professional education (IPE) experiences to enhance inter-disciplinary practice. As students of rurally-located educational programs have specific barriers to IPE participation, an innovative solution may be the use of telehealth tools.2 Telehealth is remote healthcare provision to patients at distant sites using technology-based tools.3 A simulation-based IPE experience using these tools not only provides students the opportunity to work with the technology, but addresses issues inherent in providing IPE experiences to rurally-located students. The purpose of this project was to examine the feasibility and acceptability of a simulation-based IPE experience for pre-licensure nursing, pharmacy, and medical students on a rurally-located campus.
Methods
Using a mixed-methods, explanatory sequential approach,4 this project: 1) examined the feasibility of implementing a simulation-based IPE experience using telehealth tools; and 2) evaluated student perceptions of inter-professional teamwork, roles and responsibilities, and patient outcomes for collaborative practice, both pre- and post-scenario. Twenty-nine participants included fourth year nursing (n=16), third year medical (n=8), and fourth year pharmacy (n=5) students. The students first completed a questionnaire regarding knowledge of and attitudes toward IPE, and were then randomly assigned to one of five IPE groups consisting of 5-7 students. Each group completed an advanced cardiac simulation scenario in which the nursing and pharmacy students were in the simulation lab, and the medical students “remoted in” using a telehealth robot. The scenario concluded with a video-recorded debriefing session; subsequently, the students completed post-surveys.
Results
Quantitative data were analyzed using SPSS. Results revealed 94% agreed/strongly agreed the IPE experience resembled a real-life situation. 100% of nursing/medical students and 80% of the pharmacy students indicated they would recommend this experience to their peers. Significant positive changes in attitudes towards using an inter-professional team approach were noted for pharmacy students, especially in regards to patient outcomes, reduced costs, and improved patient-centered care.
Qualitative data were transcribed and analyzed using thematic analysis. Four themes emerged: 1) better understanding of technology; 2) improved communication among team members; 3) benefit of true to life experience; and 4) increased knowledge level and confidence.
Participant suggestions for improvement included: 1) improve the simulation/telehealth equipment orientation; 2) consider a grand round-type simulation; and 3) address technical challenges with the robot, e.g., volume control.
Conclusion
Complex healthcare now requires a collaborative and team approach to patient care. A simulation-based IPE approach using “remote in” technology allows for the development and mastery of these competencies. Although limited by a small sample size, this project confirmed it is feasible and acceptable to offer simulation-based IPE in a rural setting facilitated by the use of telehealth tools, and collaborative teamwork is enhanced by using “remote in” technology during a simulation-based IPE activity. Future work will incorporate student suggestions to improve the experience, as well as integrate students from other healthcare disciplines, such as physician assistant students.
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