Simulation as educational strategy: an interprofessional approach at the Faculty of Health Sciences, University of the Free State

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Date
2016-01
Authors
Van Wyk, Riaan
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University of the Free State
Abstract
English: With an ever-evolving and complex patient population, healthcare professionals need to adapt to these changes. A response to this challenge is to deliver patient care and management as an interprofessional healthcare team or collaborative practice. In order to deliver professionals that are ready for collaborative practice, education institutions need to enhance interprofessional education (IPE) amongst its students. Various strategies can be followed for effective IPE. These are didactic lessons, simulated experiences and community based education. The question arises as to the extent and techniques currently used by the Faculty of Health Sciences, UFS, to achieve IPE amongst its undergraduate students. Specific focus was given to addressing IPE utilising simulation. A quantitative descriptive study was performed and data was collected using structured interviews with 47 of 57 (82.5%) undergraduate module leaders of the Faculty of Health Sciences, UFS, covering 66 of 80 (82.5%) undergraduate modules. The research topics covered by the interview were interprofessional education, the use of and opinions on simulation and the possibility of utilising simulation to address IPE. The results were analysed and reported quantitatively. It was found that 36 out of 66 modules (56.1%) had no form of interprofessional education. In cases where interprofessional education was present, it was mostly addressed coincidentally (58.7%) and was not part of the formal outcomes of the module. The main platform utilised for interprofessional education is ward rounds in hospital and clinic visits during community based education. Simulation is used by 36 out of 66 (54.5%) modules and the most common type utilised is low-fidelity skills training. The module leaders’ opinions on simulation are positive, highlighting the advantages it holds for improved student learning. Some concerns were raised on the logistical challenges simulation could pose. The majority of module leaders (66.7%) indicated that simulation would not be a viable training tool to address interprofessional education in their module. The most common (84.1%) reason given was that there were no interprofessional activities in the relevant module to address. However, 21.7% did not see any disadvantages of its potential use to address interprofessional education where needed. Some challenges were highlighted and the biggest potential advantage mentioned (41.3%) was improved role clarification amongst the students. The conclusion was that although IPE does take place, it is mostly coincidental and not formalised in the modules. The majority of module leaders were positive about the possible use of simulation to address IPE, but various challenges and concerns were also reported and discussed. When using simulation to address interprofessional education, it is important to engage the students from all professions. In most cases the scenarios would be role-play using standardised (simulated) patients. These actors must be properly trained to ensure the authenticity of the scenario. The principles of interprofessional education (aspects such as collaboration, communication and professionalism) should be addressed in the outcomes and must be the focus during the debriefing phase of the simulation experience. Facilitators must be trained and competent in debriefing and reflection techniques.
Afrikaans: Pasiëntpopulasies is kompleks en verander voortdurend. Gesondheidsorgpersoneel moet hierby aanpas. Een manier is om die versorging en bestuur van pasiënte met ‘n interprofessionele gesondheidsorgspan en samewerkingpraktyk te benader. Opvoedkundige instansies moet interprofessionele opvoeding by studente versterk om hulle gereed te maak vir die samewerkingspraktyk. Verskillende strategieë vir doeltreffende interprofessionele opvoeding kan gevolg word: didaktiese lesings; gesimuleerde ervarings; en gemeenskapsgebaseerde onderrig. Die vraag is wat die huidige omvang en tegnieke van die Fakulteit Gesondheidswetenskappe, UV, is om interprofessionele opvoeding by voorgraadse student vas te lê, met die fokus op die gebruik van simulasie. ‘n Kwantitatiewe, beskrywende studie is uitgevoer en data is deur gestruktureerde onderhoude met 47 uit 57 (82.5%) voorgraadse moduleleiers van die Fakulteit Gesondheidswetenskappe, UV, ingewin. Die onderhoude het 66 uit 80 (82.5%) voorgraadse modules gedek. Die navorsingstemas wat deur die onderhoude gedek is, is interprofessionele opvoeding, die gebruik van en opinies oor simulasie en die moontlike gebruik van simulasie om interprofessionele opvoeding aan te spreek. Die resultate is kwantitatief geanaliseer en weergegee. Dit is bevind dat 36 uit 66 modules (56.1%) geen vorm van interprofessionele opvoeding bevat nie. Waar interprofessionele opvoeding wel plaasvind, is dit meestal toevallig van aard (58.7%) en nie deel van die formele uitkomste van die module nie. Die platform wat die meeste gebruik is vir interprofessionele opvoeding, was saalrondtes gedurende hospitaalbesoeke en kliniekbesoeke tydens gemeenskapsdiensonderrig. Simulasie word gebruik in 36 uit 66 (54.5%) van die modules en die algemeenste tipe is lae realisme, vaardigheidsopleiding. Die moduleleiers se menings oor simulasie is positief en die voordele wat dit vir studentopleiding inhou, word uitgelig. Sekere kwelpunte oor die logistieke uitdagings van simulasie is beklemtoon. Die meerderheid van moduleleiers (66.7%) het aangedui dat simulasie nie ‘n lewensvatbare opsie is vir interprofessionele opvoeding in ‘n spesifieke module nie. Die mees algemene (84.1%) rede hiervoor is dat interprofessionele opvoeding nie aangespreek word in ‘n betrokke module nie. Daar is egter aangedui deur 21.7% dat daar geen nadele is aan die potensiële gebruik van simulasie om interprofessionele opvoeding aan te spreek nie. Sommige uitdagings is uitgelig en die grootste (41.3%) voordeel wat genoem is, is die feit dat studente beter rolverheldering kry. Die gevolgtrekking was dat interprofessionele opvoeding wel plaasvind, maar dat dit toevallig is en nie in modules geformaliseer is nie. Die oorgrootte meerderheid moduleleiers was positief oor die moontlike gebruik van simulasie vir interprofessionele opvoeding, maar verskeie uitdagings en kwelpunte is ook meegedeel en bespreek. Wanneer simulasie gebruik word om interprofessionele opvoeding aan te spreek, is dit belangrik om studente van al die relevante professies te betrek. In die meeste gevalle sal die simulasie ‘n rolspel wees deur middel van gestandaardiseerde (gesimuleerde) pasiente. Om realisme te verbeter, moet hierdie akteurs opgelei word vir die rol. Die beginsels van interprofessionele opvoeding (aspekte soos spanwerk, kommunikasie en professionalisme) moet deur die simulasie se uitkomste aangespreek word. Hierdie beginels moet ook die fokus wees van die refleksiegedeelte van die simulasie ervaring. Fasiliteerders moet opgelei en bevoegd wees in refleksietegnieke.
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Keywords
Dissertation (M.HPE. (Health Professions Education))--University of the Free State, 2016, Undergraduate, Students, Curriculum, Medical, Nursing, Allied, Competencies, Quantitative, Structured interviews, Small-group learning, Collaborative practice, Clinical simulation, Interprofessional education
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