Mitigating Misinformation Toolkit: Online Simulation and Standardized Patient Cases for Interprofessional Students to Address Vaccine Hesitancy and Misinformation.

Introduction: Medical misinformation, which contributes to vaccine hesitancy, poses challenges to health professionals. Health professions students, while capable of addressing and advocating for vaccination, may lack the confidence to engage with vaccine-hesitant individuals influenced by medical misinformation. Methods: An interprofessional in-person simulation activity (90 minutes) using standardized patients was developed and instituted for students in medicine, nursing, pharmacy, and public health programs. Student volunteers were recruited from classes approximately halfway through their respective degree programs (i.e., second or third year of a 4-year program). Online simulation was used as a method to prepare for in-person simulation. Impact on students was assessed primarily through a postprogram student self-assessment. Results: A total of 220 students participated in the program; 206 (94%) had paired data available to analyze. Following program participation, self-assessed abilities increased from pre to post, from 2.8 out of 5 (good) to 3.9 out of 5 (very good; p < .001). Ninety-eight percent of students felt that their ability to address medical misinformation was somewhat/much better after the activity, compared to before, and that their ability to address vaccine hesitancy was somewhat/much better. The overall program was rated highly, with mean scores for each program evaluation item >4 out of 5 (very good). Discussion: An interprofessional cohort of students demonstrated improvement in self-assessed skills to participate in a conversation with an individual with hesitancy to receive vaccines and/or beliefs informed by misinformation. Students felt that this program was relevant and important to their professional development.

Educating Nurses in Sleep Screening, Brief Intervention, and Referral for Treatment.

BACKGROUND: Poor sleep is an unrecognized problem among cancer survivors that affects quality of life. However, screening for sleep disorders is not routine in cancer care. To fill this gap, a self-paced online training program was designed for RNs to screen patients for sleep disturbance and provide brief intervention or referral for treatment (Sleep-SBIRT). METHOD: A three-phase evaluation pilot study included the following steps: (a) develop an online training program with in situ simulation; (b) implement the program with RNs at a comprehensive cancer center; and (c) evaluate module and quiz completion rates and focus group thematic analysis. RESULTS: Of the 22 RNs participating, 17 completed online modules and in situ simulation. The RNs were satisfied (M = 4.74/5, SD = 0.42) and self-confident (M = 4.45/5, SD = 0.45) with the learning. Focus group themes were learning new knowledge, learning online effectively, applying learning to in situ simulation, and intending to implement. CONCLUSION: The RNs gained knowledge applying Sleep-SBIRT, but future larger studies are warranted. [J Contin Educ Nurs. 2024;55(8):387-392.].

Utilizing an Ecomap to Visualize the Impact of Social Determinants of Health in an Interprofessional Forum.

INTRODUCTION: Graphical representations of a case study can help learners recognize how systems and institutions impact health. The impact of the social determinants of health (SDoH) on individual and community health is well established, yet it may be challenging for students to visualize the impact of these components within a case study. PURPOSE: This study explored the use of ecomaps in an interprofessional forum and examined the perceptions from students and faculty regarding use of this educational tool. METHODS: This tool was assessed over two semesters, Fall 2021 (n=968) and Fall 2022 (n= 835) to evaluate student and faculty perceptions of the use of the tool along with faculty's assessment of student completion of the tool within a rubric. RESULTS: Nearly all students (99%) came prepared to the forum and presented their ecomaps to others during the small group discussion to facilitate conversation as they explored the role of SDoH related to the case study. Both students and faculty rated the use of this tool favorably. DISCUSSION: In conclusion, ecomaps were viewed favorably by both students and faculty. This visual exploration of SDoH helps students to visualize both positive and negative factors that impact a patient's experience.

Educational game improves systems thinking, socialization, and teamwork among students of 13 health professions programs.

Systems thinking and interprofessional collaborative practice competencies are critical to inculcate in students of health professions programs. The purpose of this study was to evaluate the impact that an interprofessional education (IPE) experience consisting of an educational game, Friday Night at the ER (FNER), and structured debriefing had on students' systems thinking and self-assessed interprofessional socialization and teamwork skills. Systems thinking was evaluated using the Systems Thinking Scale (STS), and interprofessional socialization and teamwork were evaluated using a modified Interprofessional Socialization and Valuing Scale-9 (ISVS-9) and Interprofessional Collaboration Competency Attainment Scale (ICCAS) question #21. This single-center study targeted students in 13 health professions programs. In the cohort (N of 626), Systems thinking increased significantly. Interprofessional socialization increased significantly, with a large effect size, and 485 (78%) students indicated their interprofessional collaborative practice competencies improved. Program evaluation data revealed students highly valued the experience and would recommend it to their peers. Based on our findings, an IPE experience consisting of FNER gameplay and structured debriefing can improve systems thinking and interprofessional socialization and teamwork in a large, diverse group of students of health professions programs.

Interprofessional Simulation Learning Game Increases Socialization and Teamwork Among Students of Health Professions Programs.

BACKGROUND: Interprofessional (IP) socialization is important to develop early in the training of health professions students. PURPOSE: This study compared changes in health professions students' IP socialization and readiness to function in IP teams and sought to understand students' participation experiences using a simulation learning game ( Friday Night at the ER [FNER]). METHODS: The single-center study targeted students in 13 health professions programs using a mixed-methods design. Student teams engaged in open discussion, played the game, and participated in team debriefing. RESULTS: IP socialization increased from fairly great to great extent among all students. Qualitative analyses revealed 3 overarching themes supporting the development of IP communication and systems-based thinking. Program evaluation data revealed that students highly valued this experience as being effective and important to their professional development. CONCLUSIONS: An IP experience consisting of FNER gameplay and structured debriefing can improve IP socialization and lay the foundation for the development of IP skills among early health professions students.

Virtual escape room paired with simulation improves health professions students' readiness to function in interprofessional teams.

BACKGROUND: This project investigated the change in nursing, pharmacy, and physical therapy students' interprofessional socialization after participation in a virtual interprofessional escape room and case conference simulation. INTERPROFESSIONAL EDUCATION ACTIVITY: Interprofessional teams of nursing (n = 93), pharmacy (n = 75) and physical therapy (n = 33) students completed asynchronous, online learning (sepsis recognition and total hip replacement post-operative precautions) followed by a virtual escape room and a virtual simulated patient case conference. During the case conference, interprofessional student teams developed a discharge plan for an individual after a hip replacement complicated by post-operative sepsis. Before and after the experience, students completed a knowledge test and a validated survey instrument that assessed their interprofessional socialization (Interprofessional Socialization and Valuing Scale-21). During the simulated patient case conference, faculty assessed student performance using a standardized rubric. After the experience students completed a program evaluation. DISCUSSION: Interprofessional socialization significantly increased (5.5 ± 0.9 vs. 6.0 ± 0.9) among all students with a medium effect size (Cohen's d = 0.56). Faculty assessment of individual student's team performance during the virtual simulation revealed a moderate rate meeting competency, with good interrater reliability. Students highly valued this learning experience as being both effective and important to their professional development, as indicated on the program evaluation. IMPLICATIONS: A virtual interprofessional experience consisting of asynchronous online learning, a virtual escape room, and a virtual case conference positively influenced students' interprofessional socialization. Students valued the experience and recognized its importance in their development as student health professionals.

Experiential Education About Patient Death Designed for Undergraduate Nursing Students.

ABSTRACT: New graduate nurses are unprepared for patient death, leading to a potential negative impact on patient care and an increase in turnover. This study investigated the use of high-fidelity simulation to teach about patient death. Senior nursing students ( n = 124) were randomly assigned to rescue or failure-to-rescue scenarios. Outcomes included knowledge and emotional affect. Data analyses included comparative statistics, t -tests, and two-way analysis of variance. Both groups had equal knowledge gain. The failure-to-rescue group had significantly lower emotional affect following simulation but was equal to the rescue group following debriefing.

An Interprofessional Escape Room Experience to Improve Knowledge and Collaboration Among Health Professions Students.

Objective. The purpose of this study was to extend our understanding of escape room pedagogical design by investigating the impact of escape room puzzle content on changes in students' immediate recall knowledge and demonstration of interprofessional skills during a subsequent simulation.Methods. Students from nursing, pharmacy, and physical therapy programs were randomized to complete an escape room themed around acute management of sepsis (intervention group; n=133) or general acute care (control group; n=129) prior to participating in a simulated patient discharge case conference. Students completed a knowledge assessment before the escape room, immediately after the escape room, and immediately after the simulation. Additionally, students completed the Interprofessional Socialization and Valuing Scale (ISVS-21) before and after the experience along with a post-program evaluation. Faculty rated student achievement of interprofessional learning objectives during the simulation using a standardized rubric.Results. Students in the intervention group had higher scores on the knowledge test administered immediately after the escape room. All participants' ISVS-21 scores increased from before to after the activity. Interprofessional learning objectives, as evaluated by faculty, were met by 248 (94.7%) students.Conclusion. Participating in an interprofessional escape room activity with specific puzzle content improved students' immediate recall knowledge. In both groups, self-assessed interprofessional socialization improved, and a high percentage of students achieved the interprofessional learning objectives in a subsequent simulation. Escape rooms can be an innovative pedagogical tool that can positively impact immediate recall knowledge and interprofessional collaborative skills of health professions students.

Saving patient x: A quasi-experimental study of teamwork and performance in simulation following an interprofessional escape room.

Graduates of health professions programs are required to work collaboratively as part of interprofessional healthcare teams. The purpose of this study was to create and test the use of an interprofessional escape room, as a method to improve teamwork, prior to interprofessional simulation. The study evaluated performance in simulation with the Observed Interprofessional Collaboration tool and self-reported attitudes toward teamwork using the Interprofessional Socialization and Valuing Scale. A total of 233 students from professional nursing (n of 118) and pharmacy students (n of 115) were split into groups of four (two nursing, two pharmacy students). Groups were randomized to participate in the escape room first followed by simulation, or simulation first followed by the escape room. Results indicated median scores in simulation performance were higher for students who participated in an escape room before simulation compared to an escape room after simulation. There was no difference in the mean change in perceptions of teamwork from pre to post between students who participated in an escape room before simulation. Escape rooms can, in a brief period of time, improve teamwork and consequently performance during simulation. Findings support the use of escape rooms in interprofessional education curriculum as a method to promote teamwork.

Impact of Pharmacy Student Observation Versus Active Participation in an Interprofessional Simulation.

Objective. To compare the change in pharmacy students' self-reported competence toward interprofessional collaboration between those that were active participants in or observers of an interprofessional simulation. Methods. Second- and third-year (P2 and P3) pharmacy students and senior nursing students participated in an interprofessional simulation. Third-year pharmacy students and senior nursing students were divided into teams of four (two from each profession) and were active participants. Second-year pharmacy students were observers. All pharmacy students were asked to complete a brief demographic survey and the Interprofessional Collaborative Competency Attainment Survey (ICCAS) after the simulation. Mean retrospective pretest and posttest ICCAS scores for each group of learners were compared using paired sample t tests. To examine the difference in the change in mean total ICCAS score between observers and active participants, repeated measures analysis of variance was completed. Results. One hundred thirty (95%) P2 pharmacy students and 121 (92%) P3 pharmacy students participated in the interprofessional simulation experience as observers and active participants, respectively, and completed the ICCAS for an overall response rate of 94%. The active participants' mean ICCAS scores were significantly higher than those of the observers on both the retrospective pretest (M=4.9, SD=1.0 vs M=5.2, SD=1.0) and the posttest (M=5.9, SD=0.7 vs M=6.2, SD=0.7). The mean change in scores from retrospective pretest to posttest was not significantly different between observer and active participant pharmacy students. Conclusion. Both observation and active participation in an interprofessional simulation experience may increase pharmacy students' self-reported competence in interprofessional collaboration.

Pharmacy Students' Standardized Self-Assessment of Interprofessional Skills During an Objective Structured Clinical Examination.

Objective. To examine pharmacy students' self-assessment and evaluator assessment of the global performance of skills required for effective interprofessional collaborative practice during an objective structured clinical examination (OSCE). Methods. Third-year pharmacy students completed three cases designed to evaluate the skills they would need to engage in effective interprofessional collaborative practice as part of a capstone objective structured clinical examination (OSCE). Students then also completed a brief survey regarding the quality of the cases and the Interprofessional Collaborative Competency Attainment Survey (ICCAS). Student performance on each of the three cases was assessed using the Global Rating Scale (GRS). Paired sample t tests were conducted to compare differences in mean change in ICCAS scores. Correlations between the GRS ratings and ICCAS pre- and post-assessment scores and changes in scores were examined. Results. One hundred twenty-four students participated in the study. The majority of students reported that the OSCE cases were realistic and of high quality. The average total ICCAS score (out of 7) was 5.1 (SD=0.8) at pre-assessment and 5.9 (SD=0.6) at post-assessment; the difference in scores was significant. The mean GRS scores (out of 5 points) for the three cases were 4.2 (SD=0.5), 4.5 (SD=0.6), and 4.6 (SD=0.5); and the mean score for the three cases combined was 4.4 (SD=0.3). A weak relationship was found between the total GRS and ICCAS post-assessment scores. Conclusion. Presenting pharmacy students with OSCE cases that focused on skills important to effective interprofessional collaborative practice was an effective means of assessing their skills and improving their self-assessment of interprofessional collaborative behaviors.

Measuring changes in pharmacy and nursing students' perceptions following an interprofessional high-fidelity simulation experience.

The purpose of this study was to evaluate the effects of interprofessional high-fidelity simulation-based learning (SBL) on third-year pharmacy and senior nursing students' perceptions of interprofessional care. Students participated in an interprofessional high-fidelity SBL experience consisting of two hospital-based scenarios followed by a debriefing. The "Student Perceptions of Interprofessional Clinical Education-Revised" (SPICE-R) instrument was administered pre- and post-SBL. The "Student Satisfaction and Self-Confidence in Learning" (SSSCL) instrument, which uses a 5-point Likert scale, was administered post-SBL. A total of 104 (78%) pharmacy and 93 (77%) nursing students completed both the pre- and post-survey instruments. Baseline differences between pharmacy and nursing students included number of clinical hours completed [200 (190-240) vs. 210 (209-210); p < 0.001] and previous/current experiencing working directly with other healthcare professionals [71 (53%) vs. 88 (73%); p < 0.001]. Median score increases were observed for all SPICE-R items (p < 0.01) for pharmacy students and nine of ten SPICE-R items (p < 0.01) for nursing students. All students rated both the experience and their confidence highly on the SSSCL; however, nursing scores were higher than pharmacy scores for 7 of 13 items (p < 0.05). An interprofessional high-fidelity SBL experience increased pharmacy and nursing students' perceptions of interprofessional care.

Nursing teams: behind the charts.

AIMS: To examine the nature and characteristics of both received and provided mutual support in a social network within an acute care hospital unit. BACKGROUND: Current evidence regarding the social network in the health care workforce reveals the nature of social ties. Most studies of social network-related support that measured the characteristics of social support used self-reported perception from workers receiving support. There is a gap in studies that focus on back-up behaviour. METHODS: The evaluation included a social network analysis of a nursing unit employing 54 staff members. A 12 item electronic survey was administered. Descriptive statistics were calculated using the Statistical Package for the Social Sciences. Social network analyses were carried out using ucinet, r 3.2.3 and gephi. RESULTS: Based on the study findings, as providers of mutual support the nursing staff claimed to give their peers more help than these peers gave them credit for. Those who worked overtime provided more mutual support. CONCLUSION: Mutual support is a key teamwork characteristic, essential to quality and safety in hospital nursing teams that can be evaluated using social network analysis. IMPLICATIONS FOR NURSING MANAGEMENT: Because of a discrepancy regarding receiving and providing help, examining both receiver and provider networks is a superior approach to understanding mutual support.

Evaluating Simulation Methodologies to Determine Best Strategies to Maximize Student Learning.

Limited evidence exists as to the most effective ways to provide simulation experiences to maximize student learning. This quasi-experimental study investigated 2 different strategies repeated versus 1 exposure and participation versus observation on student outcomes following exposure to a high-fidelity acute asthma exacerbation of asthma scenario. Immediate repeated exposure resulted in significantly higher scores on knowledge, student satisfaction and self-confidence, and clinical performance measures than a single exposure. Significant intergroup differences were found on participants' satisfaction and self-confidence as compared with observers. Implications for nurse educators include expanding the observer role when designing repeated exposure to simulations and integrating technical, cognitive, and behavioral outcomes as a way for faculty to evaluate students' clinical performance.

Nursing control over practice and teamwork.

Nurses' control over practice is essential to nursing care quality and fosters teamwork at the point of care delivery. This article describes a study to measure the impact of nurses' control over their practice from the perspective of teamwork. The purpose of this study was to measure the relationship of control over practice to the five following dimensions of teamwork: team structure, leadership, situation monitoring, mutual support, and communication. The study method was a secondary analysis of 456 surveys from registered nurses working in a five-hospital system. Study results demonstrated that the global measure of teamwork correlated with control over practice and nursing experience, but not with teamwork training. All five individual dimensions of teamwork were perceived as better for those who had a high level of control over practice compared to those who did not. In the discussion section, we consider situation monitoring since this dimension demonstrated an interaction effect between teamwork training and control over practice. Nursing control over practice demonstrates a positive relationship with teamwork and should be considered in future education, policy, and research efforts. Further study is needed to understand control over practice as a potential moderator or mediator of other predecessors of effective teamwork.

A leadership challenge: staff nurse perceptions after an organizational TeamSTEPPS initiative.

The purpose of this study was to measure RNs' perceptions of teamwork skills and behaviors in their work environment during a multiphase multisite nursing organizational teamwork development initiative. Teamwork is essential for patient safety in healthcare organizations and nursing teams. Organizational development supporting effective teamwork should include a just culture, engaged leadership, and teamwork training. A cross-sectional survey study of bedside RNs was conducted in one 5-hospital healthcare system after a TeamSTEPPS teamwork training initiative. TeamSTEPPS teamwork training related to improved RN perceptions of leadership. Initiatives to align the perspectives and teamwork efforts of leaders and bedside nurses are indicated and should involve charge nurses in the design.

Strengthening communication to overcome lateral violence.

AIM: This quality improvement project aims to reduce nurse-to-nurse lateral violence and create a more respectful workplace culture through a series of workshops. BACKGROUND: Lateral violence is common and pervasive in nursing, with detrimental physical, psychological and organizational consequences. METHODS: This project describes the organization-wide pre- and post-intervention survey of registered nurses' perception of lateral violence and turnover. RESULTS: After the workshop series, nurses who reported experiencing verbal abuse fell from 90 to 76%. A greater percentage of nurses perceived a workplace that was respectful to others and in which it was safe to express opinions. After the workshop series, a greater percentage of nurses felt determined to solve the problem after an incident of lateral violence, while a smaller percentage felt powerless. Nursing turnover and vacancy rates dropped. CONCLUSIONS: Educational workshops that enhanced awareness of lateral violence and improved assertive communication resulted in a better working environment, reduction in turnover and vacancy rates, and reduced incidence of lateral violence. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers must raise awareness of lateral violence with individual and organizational consequences. Nursing leadership can effect organizational change to lesson lateral violence and enhance a healthy workplace culture by replicating our intervention or components of our workshops.