Purpose:
The purpose of this study was to compare two IPE simulation teaching methods, examining the outcome of teamwork skills, and to determine if there are predictive factors for teamwork skills.
Methods:
Interprofessional Collaborative competency, consisting of sub-competency outcomes in knowledge, skill and attitude (KSA), were identified by an international team of experts (Interprofessional Education Collaborative, 2016). We used the sub-competency KSAs to guide our education design and outcome evaluation for a group of pre-licensure students from nursing, medicine, and respiratory therapy (n=161) at a single academic institution and practice setting partner.
We randomly assigned interprofessional teams (n=19 teams) and delivered either high dose, low frequency teamwork instruction in a single session immediately preceding a mock code simulation, or alternatively teams received small dose, high frequency instruction over four weeks leading to the simulation. Trained observers using video rated teamwork skills with a revised version of the Teamwork Performance Observation Tool (TPOT); a 20-item five-point Likert scale (Baker, Capella, Hawkes, Gallo, & Clinic, 2009).
Results:
We chose to compare team scores rather than individuals to capture the cumulative team effort. The total TPOT score comparison between groups revealed the high dose same day training groups were associated with higher team skill scores when compared to low-dose high-frequency delivery groups (M difference 8.32, 90% CI [16.03, .62] p = .08, small effect size d =.09).
Multiple regression analysis was used to determine if teamwork skills could be predicted by measures taken pre-simulation including levels of anxiety, feelings of preparation, and baseline teamwork attitude. Results demonstrated statistically significant prediction of team skills for anxiety (p= .06) and preparation (p = 0.04), but pre-simulation attitude was the least predictive of teamwork skills (p = .70).
Conclusions:
The ultimate purpose of IPE with simulation is to prepare students to transition their learning into practice. The high team skill scores in both teaching method groups demonstrated successful training that can transfer to practice (Hayden, Smiley, Alexander, Kardong-Edgren & Jeffries, 2014). Similar studies using same day preparation also demonstrated effective team skill outcomes (Brock et. al, 2013, Sawyer et al., 2013). This study design contributes to the IPE and team training research literature in two ways that have been under-studied: 1) as a model for collecting data at the team unit level as opposed to the individual level, and 2) comparison of pre-simulation education time-delivery. Teams function as a unit, and to measure at the individual level may misrepresent the effect of collective teamwork skill. The small difference in teamwork skills between groups may suggest that either method is effective, allowing the educator to choose what works best for their curriculum.