Factors correlating with interprofessional engagement in debriefing following pediatric simulation-based team training.

Document Type

Article

Publication Date

4-30-2020

Institution/Department

Maine Medical Center, Medical Education, Maine Medical Center Research Institute

MeSH Headings

Simulation Training, Interprofessional Relations, Child, Humans

Abstract

Peter W. Bates Award for Excellence in Health Professions Education Research- Trainee 1st Place Award - Scientific Talk Richard Byrnes, Student, Tufts University School of Medicine-MMC Maine Track Program, Medical Education, Maine Medical Center: Factors correlating with interprofessional engagement in debriefing following pediatric simulation-based team training (video presentation by Leah Mallory, Medical Director, The Hannaford Simulation Center, Maine Medical Center).

Background: Interprofessional (IP) teamwork is key to patient safety. Simulation provides a low risk, high fidelity tool to train and study IP collaboration. Debriefing following simulation is a critical component of simulation-based education. In debriefing following IP team training, underlying cultural and hierarchical barriers may prohibit balanced participation. Little data exist to suggest which factors or strategies contribute to robust IP engagement in debriefing. Objective: To analyze IP debriefing events and identify factors correlated with increased learner engagement

Design/Methods: This retrospective pilot study used 20 pre-recorded IP pediatric high fidelity simulation-based team training debriefings beween 5/25/18 and 6/28/19. Two or more reviewers observed each video using a modified STROBE tool (Fig 1) (1,2) to assess learner engagement and learner: facilitator (L:F) question ratios. Data related to the scenario, debriefing, learners and facilitators was entered into a RedCap database. Chi square or Fisher's exact test were used to compare number of utterances by learner profession and L: F question ratios. Spearman’s correlation was used to analyze association between factors of interest and average learner engagement scores (ALES) for each debrief.

Results: Our analysis included 20 educational events with a total of 175 learners. The mean learners per event were 11.8 (range 6-20). Physician learners comprised (38.3%), nurses (24.6%) other professionals (18.9%, mainly RT and Pharmacy), and students (18.2%). ALES was 3.19 (1-5 STROBE scale) and varied significantly between professions (Fig 2). There was a significant negative correlation between ALES and group size (Fig 3). Physicians spoke significantly more than any other group and physician facilitators spoke more than nurse co-facilitators. ALES was significantly correlated with higher L:F question ratios (Fig 4).

Conclusion(s): In our single center IP Team Training program physicians were most represented and spoke more than other professionals. Students of all kind were less engaged and least apt orally contribute, supporting that student level IP team training might be necessary to optimally engage this group. An inverse trend between ALES and facilitator utterances, and the significant relationship between ALES and higher L:F question ratio, suggest that inquiry-based probing by facilitators, allowing learners to orally contribute more may lead to optimal IP engagement.

References: 1. O'Malley, K. J., et al. (2003). 'Validation of an observation instrument for measuring student engagement in health professions settings.' Eval Health Prof 26(1): 86-103. 2. Alimoglu, M. K., et al. (2014). 'An observation tool for instructor and student behaviors to measure in-class learner engagement: a validation study.' Med Educ Online 19: 24037.

Comments

2020 Costas T. Lambrew Research Retreat, Peter W. Bates Award for Excellence in Health Professions Education Research Winner

Richard Byrnes- Resident

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