Reflections of Student Nurses With Managing a Clinical Crisis: Sim-IPE

Friday, 26 July 2019: 1:35 PM

Rebecca K. Aulbach, PhD, RN-BC, ACNS-BC, CPHQ
Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX, USA, Texas Woman's University, Houston, TX, USA
Rita Ann Dello Stritto, PhD, RN, CNS, ENP, ACNP-BC, FAANP
College of Nursing, Texas Woman's University, Houston, TX, USA
Peggy A. Landrum, PhD, MS, RN, CS
Nelda C. Stark College of Nursing, Texas Woman's University, Houston, TX, USA

Purpose: Miscommunication between healthcare providers is directly linked to poor patient outcomes and is a root cause in sentinel events. The importance of interprofessional education (IPE) is recognized internationally as important in preparing nurses, physicians and other healthcare professionals to providing safe care. Increasingly IPE is being required by academic accreditation organizations and incorporated into required content of nursing, medicine and pharmacy programs.

Methods: Senior level students from colleges of nursing, medicine and pharmacy participated in a simulation IPE using a clinical crisis scenario. The scenario was jointly developed by faculty in each of the colleges of nursing, medicine and pharmacy. The student only knew they would participate in a sim-IPE but did not know any specifics of the scenario. Following the sim-IPE debriefing, the nursing students were asked to write a reflection paper that addressed their sim-IPE experience, interprofessional communication, and how the sim-IPE met the course objectives for their final semester nursing course. A narrative approach was used to analyze the 25 student nurse reflection papers.

Results: The nursing students (SN) definitely identified the different communication styles of the three disciplines of nursing, medicine and pharmacy described by Foronda, MacWilliams and McArthur (2016) which is an article they were asked to read after their sim-IPE. Examples of the SN reflections include:

  • “Speaking out loud and utilizing ‘closed loop communication’ ensures that all health care providers are fully aware of what is happening in this extremely urgent setting.”
  • “Inter-professional experiences assist nurses with gaining their ‘voice’ and gaining confidence to communicate effectively with physicians and other healthcare personnel. This contributes to a nurse gaining the confidence and strategy to develop leadership skills and the ability to advocate effectively for the patient.”
  • “We learned it is important to remain calm, but also speak loudly so anyone in the room can hear what is being said. If everyone in the room cannot hear, a medication error could occur.”
  • “The simulation helped us to have independence, which encourages even more personal accountability. My actions were not influenced by a preceptor or instructor. I was truly alone in my role, which does not occur many times in the hospital. Of course, we were not truly alone in the scenario, as there were other healthcare professionals to collaborate with, but I was the only one with nursing expertise on our team. This means that every thought I had and did not voice, or every thought I could have had, but did not, is on me and me alone.”

The SN felt the clinical crisis sim-IPE met most the course objectives for the last semester course in their baccalaureate nursing program. They also felt it was an appropriate and valuable clinical experience activity.

Conclusion: Incorporation of IPE simulations into the educational curriculum enhances the interdisciplinary teamwork, collaboration, communication, and understanding each other’s roles. The goal of an IPE of having participants walk away with new knowledge and understanding of how to work as a team with other disciplines in the healthcare field was met according to the reflections of the nursing students.

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