Effective interprofessional simulation training for medical and midwifery students

Introduction Good interprofessional teamworking is essential for high quality, efficient and safe clinical care. Undergraduate interprofessional training has been advocated for many years to improve interprofessional working. However, few successful initiatives have been reported and even fewer have formally assessed their educational impact. Methods This was a prospective observational study of medical and midwifery students at a tertiary-level maternity unit. An interprofessional training module was developed and delivered by a multiprofessional faculty to medical and midwifery students, including short lectures, team-building exercises and practical simulation-based training for one obstetric (shoulder dystocia) and three generic emergencies (sepsis, haemorrhage, collapse). Outcome measures were interprofessional attitudes, assessed with a validated questionnaire (UWE Interprofessional Questionnaire) and clinical knowledge, measured with validated multiple-choice questions. Results Seventy-two students participated (34 medical, 38 midwifery). Following training median interprofessional attitude scores improved in all domains (p<0.0001), and more students responded in positive categories for communication and teamwork (69–89%, p=0.004), interprofessional interaction (3–16%, p=0.012) and interprofessional relationships (74–89%, p=0.006). Scores for knowledge improved following training for medical students (65.5% (61.8–70%) to 82.3% (79.1–84.5%) (median (IQR)) p<0.0001) and student midwives (70% (64.1–76.4%) to 81.8% (79.1–86.4%) p<0.0001), and in all subject areas (p<0.0001). Conclusions This training was associated with meaningful improvements in students’ attitudes to teamwork, and knowledge acquisition. Integrating practical tasks and teamwork training, in authentic clinical settings, with matched numbers of medical and non-medical students can facilitate learning of both why and how to work together. This type of training could be adopted widely in undergraduate healthcare education.

[1]  J. Ferris,et al.  Impact of introducing Practical Obstetric Multi‐Professional Training (PROMPT) into maternity units in Victoria, Australia , 2014, BJOG : an international journal of obstetrics and gynaecology.

[2]  D. Siassakos,et al.  Multiprofessional Team Simulation Training, Based on an Obstetric Model, Can Improve Teamwork in Other Areas of Health Care , 2014, American journal of medical quality : the official journal of the American College of Medical Quality.

[3]  S. Reeves,et al.  Interprofessional education: effects on professional practice and healthcare outcomes (update). , 2013, The Cochrane database of systematic reviews.

[4]  T. Timpka,et al.  Nurses' views of interprofessional education and collaboration: A comparative study of recent graduates from three universities , 2013, Journal of interprofessional care.

[5]  T. Levett-Jones,et al.  A systematic review of the effectiveness of interprofessional education in health professional programs. , 2013, Nurse education today.

[6]  K. Blondon,et al.  Interprofessional education in team communication: working together to improve patient safety , 2013, BMJ quality & safety.

[7]  R. MacKinnon,et al.  A review of undergraduate interprofessional simulation-based education (IPSE). , 2012, Collegian.

[8]  T. Clutton-Brock,et al.  Saving Mothers’ Lives: Reviewing Maternal Deaths to Make Motherhood Safer 2006-2008 A Review , 2012 .

[9]  Chao Zhang,et al.  A Review of Simulation-Based Interprofessional Education , 2011 .

[10]  C. Lockwood,et al.  A comprehensive obstetrics patient safety program improves safety climate and culture. , 2011, American journal of obstetrics and gynecology.

[11]  J. Neilson,et al.  Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006–2008 , 2011, BJOG : an international journal of obstetrics and gynaecology.

[12]  O. Pryds,et al.  Antenatal magnesium sulphate may prevent cerebral palsy in preterm infants—but are we convinced? Evaluation of an apparently conclusive meta‐analysis with trial sequential analysis , 2011, BJOG : an international journal of obstetrics and gynaecology.

[13]  H. Fineberg,et al.  Health professionals for a new century: transforming education to strengthen health systems in an interdependent world , 2010, The Lancet.

[14]  J. Medves,et al.  Evaluating an undergraduate interprofessional simulation-based educational module: communication, teamwork, and confidence performing cardiac resuscitation skills , 2010, Advances in medical education and practice.

[15]  J. Soar,et al.  European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. , 2010, Resuscitation.

[16]  J. Thistlethwaite,et al.  Learning outcomes for interprofessional education (IPE): Literature review and synthesis , 2010, Journal of interprofessional care.

[17]  S. Reeves,et al.  Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. , 2009, The Cochrane database of systematic reviews.

[18]  R. Fox,et al.  Retrospective cohort study of diagnosis–delivery interval with umbilical cord prolapse: the effect of team training , 2009, BJOG : an international journal of obstetrics and gynaecology.

[19]  D. Siassakos,et al.  The active components of effective training in obstetric emergencies , 2009, BJOG : an international journal of obstetrics and gynaecology.

[20]  D. Siassakos,et al.  Evaluation of a strategy to improve undergraduate experience in obstetrics and gynaecology , 2009, Medical education.

[21]  J. Thistlethwaite,et al.  Interprofessional developments in Australia – L-TIPP (Aus) and the Way Forward , 2009, Journal of interprofessional care.

[22]  Andrew Whitelaw,et al.  Improving Neonatal Outcome Through Practical Shoulder Dystocia Training , 2008, Obstetrics and gynecology.

[23]  T. Draycott,et al.  Change in knowledge of midwives and obstetricians following obstetric emergency training: a randomised controlled trial of local hospital, simulation centre and teamwork training , 2007, BJOG : an international journal of obstetrics and gynaecology.

[24]  S. Reeves,et al.  A best evidence systematic review of interprofessional education: BEME Guide no. 9 , 2007, Medical teacher.

[25]  A. Sayers,et al.  A comparison of interprofessional perceptions and working relationships among health and social care students: the results of a 3-year intervention. , 2006, Health & social care in the community.

[26]  Donovan A. McFarlane,et al.  Evaluating Training Programs: The Four Levels , 2006 .

[27]  Andrew Whitelaw,et al.  Does training in obstetric emergencies improve neonatal outcome? , 2006, BJOG : an international journal of obstetrics and gynaecology.

[28]  D. Fraser,et al.  Multiprofessional or interprofessional education in obstetrics and gynaecology , 2005 .

[29]  M. Gilchrist,et al.  Second year scepticism: Pre-qualifying health and social care students' midpoint self-assessment, attitudes and perceptions concerning interprofessional learning and working , 2005, Journal of interprofessional care.

[30]  Mollie Gilchrist,et al.  Collaborative learning for collaborative working? Initial findings from a longitudinal study of health and social care students. , 2004, Health & social care in the community.

[31]  J. Leaviss,et al.  Exploring the perceived effect of an undergraduate multiprofessional educational intervention , 2000, Medical education.

[32]  S. Reeves,et al.  Interprofessional education: effects on professional practice and health care outcomes. , 2008, The Cochrane database of systematic reviews.

[33]  Donald L. Kirkpatrick,et al.  Evaluating Training Programs. The Four Levels. Berrett-Koehler Organizational Performance Series. , 1994 .