He lping Stude nts L e arn Ab o ut I nte rdisc iplinary T e ams - - PowerPoint PPT Presentation

He lping Stude nts L e arn Ab o ut I nte rdisc iplinary T e ams T hro ug h Simulatio n.

 Jo a n Nie de rrite r, PhD, MSN, CMSRN, RN-BC- fro m CSU  Susa n Ha ze le tt, MS, RN, Summa He a lth  Je nnife r Dro st, DO, MPH, Summa He a lth

 T

his pro je c t is/ wa s suppo rte d b y the He a lth Re so urc e s a nd Se rvic e s Administra tio n (HRSA) o f the U.S. De pa rtme nt o f He a lth a nd Huma n Se rvic e s (HHS) unde r g ra nt numb e r U1QHP28707 e ntitle d Ge ria tric s Wo rkfo rc e E nha nc e me nt Pro g ra m fo r $666,830.00 ye a r

• ne . T

his info rma tio n o r c o nte nt a nd c o nc lusio ns a re tho se o f the a utho r a nd sho uld no t b e c o nstrue d a s the o ffic ia l po sitio n o r po lic y o f, no r sho uld a ny e ndo rse me nts b e infe rre d b y HRSA, HHS o r the U.S. Go ve rnme nt.

 Pre se nte rs ha ve no c o nflic ts o f inte re st to disc lo se

Othe r Me mb e rs o f the T e a m

Summa He a lth



Sue F

• snig ht RPh, CGP, BCPS

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Cra ig B. Sisa k, MSPT

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Re v. Sha nno n M. Blo we r, MA, MAR

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Bria n T ritc hle r

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Ra mi Ahme d, MD

Unive rsity o f Akro n

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Dia ne Bro wn PhDc , MSN, RN, CCRN

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Me lissa K . Mc Co lliste r, MSW, Ph.D.

No rthe a st Ohio Me dic a l Unive rsity

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Ba rb a ra Pa lmisa no , BSN, MA

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Ma rg a re t B. Sa nde rs, M.A., L .S.W.

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Ca ssa ndra K

• ne n, M.A., L

PC

Dire c tio n Ho me : Akro n Ca nto n Are a Ag e nc y o n Ag ing

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Ab ig a il Mo rg a n

Cle ve la nd Sta te Univ.



Che ryl De lg a do

Wha t do e s the Re se a rc h Sa y Ab o ut I nte rdisc iplina ry T e a ms?

 I

nstitute o f Me dic ine Re po rt, T

• E

rr is Huma n (2000)

 44,000+ pa tie nts die in ho spita ls e ve ry ye a r a s a re sult o f

me dic a l e rro rs

 E

rro rs a lso c o st the syste m >$19 b illio n a ye a r

 De c e ntra liza tio n/ fra g me nta tio n o f the he a lthc a re syste m  Mis/ no nc o mmunic a tio n b e twe e n he a lthc a re pro vide rs

 Co mmunic a tio n b re a kdo wn le a ds to ine ffe c tive a nd

unsa fe he a lth a nd so c ia l c a re ma na g e me nt

 Hig h F

unc tio ning I DT suppo rts pa tie nt-c e nte re d , c o o rdina te d a nd e ffe c tive a nd mo re e ffic ie nt he a lthc a re de live ry I OM (2000) WHO (2010)

I nte rdisc iplina ry Simula tio n

 E

duc a tio n, like he a lthc a re pra c tic e still o pe ra te s in silo s

 Inte rdisc iplina ry e duc a tio n is re q uire d a c ro ss a c c re diting

b o die s

 Inte rdisc iplina ry e duc a tio n fo c use s o n e q uipping stude nts

with c o lla b o ra tive skills

 Simula tio n a llo ws he a lth c a re pro fe ssio na ls to pra c tic e

skills a nd stra te g ie s in a sa fe le a rning e nviro nme nt

 Simula tio n inc lude s

 Ro le pla y  Huma n pa tie nt simula tio n  Sta nd a rd ize d pa tie nts

 Inte rdisc iplina ry simula tio n e nha nc e s se lf-e ffic a c y in

c linic a l situa tio ns

Wa lte rs BMJ Ope n 2015;5:e 005472 Ab u-Rish Jo urn Inte rpro f Ca re 2012, 26. AACN 2010

I nte rdisc iplina ry Simula tio n

 Pa tie nt o r he a lthc a re a dvo c a te a s pa rt o f the I

DT

 F

a mily me mb e rs pro vide 90% o f c a re to de pe nde nt c o mmunity dwe lling o lde r a dults

 Spo use , pa rtne r, c hildre n, g ra ndc hildre n, sib ling s, frie nds  30+ millio n pe o ple >18 ye a rs o ld a re c a re g ive rs

 Ca re g ive rs a re a n inte g ra l pa rt o f the he a lthc a re

syste m

 Ofte n o ve rlo o ke d, unde r va lue d  Pro vide info rma tio n, c o ntinuity, a nd dire c t c a re

Mitnic k J Ge n Inte rn Me d .; DOI 10.1007/ s11606-009-1206-3.

HRSA GRANT

 T

hre e ye a r g ra nt

 F

• c us is o n inte rdisc iplina ry te a ms wo rking with the

g e ria tric po pula tio n

 F

• ur g o a ls fo r the g ra nt

 We will fo c us o n the stude nt e duc a tio n pie c e using

simula tio n to te a c h a b o ut inte rdisc iplina ry te a ms

Purpo se o f the Simula tio n E xpe rie nc e

 He lp stude nts unde rsta nd the ir ro le a s a me mb e r o f a n

inte rdisc iplina ry te a m

 He lp stude nts unde rsta nd o the r te a m me mb e rs ro le o n

the inte rdisc iplina ry te a m

 He lp stude nts unde rsta nd ho w a n inte rdisc iplina ry

te a m func tio ns

 He lp stude nts unde rsta nd the impo rta nc e o f

c o mmunic a tio n in a n inte rdisc iplina ry te a m

 He lp stude nts unde rsta nd tha t the fo c us o f the te a m is

the c lie nt a nd the ir fa mily

Pla nning

 Sc e na rio s

 F

• c us o n situa tio ns tha t c a n b e use d with multiple d isc ipline s

 Input wa s g ive n b y a ll te a m me mb e rs to ma ke sure tha t a ll

d isc ipline s info rma tio n wa s a c c ura te

 Online e duc a tio n pie c e

 F

• c us o n b a sic info rma tio n tha t a ll d isc ipline s c o uld

und e rsta nd

 Info rma tio n wa s re la te d to the c a se tha t the stud e nts wo uld

b e using in the simula tio n

 All we re re q uire d to c o mple te the o n line tra ining a nd c o uld

b e tra c ke d

 L

ink wa s se nt via the ir e ma il a d d re ss, Skypre pApp

F a c ilita to rs

 Gra nt g o a l: to e duc a te a nd tra in fa c ulty  F

a c ilita to r tra ining o c c urs e a c h se me ste r

 6-ho ur c la ss o n de b rie fing skills  F

a c ilita to rs c o mple te the o n line tra ining

 F

a c ilita to rs a ssist in mo nito ring the simula tio n se ssio n a nd de b rie fing the se ssio n a fte r the simula tio n

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a c ilita to r fe e db a c k is use d to he lp with twe a king the simula tio n e xpe rie nc e s

Online e duc a tio na l pie c e

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Ho ste d thro ug h we b -b a se d L e a rning Ma na g e me nt Syste m

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Stud e nts se nt lo g in via e ma il/ re g istra tio n

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1.5 hr a nno ta te d Po we rpo int pre se nta tio n

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Ge ria tric Co re Co nc e pts  Ag ing Myths  Impo rta nc e o f func tio n  Go a l & Va lue o f the inte rdisc iplina ry te a m  Pha rma c y b a sic s  Adva nc e Ca re Pla nning  F

a mily Ca re g iving & Co mmunity Re so urc e s

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Ca se spe c ific ma te ria ls  De pre ssio n & Grie f  Inso mnia e va lua tio n a nd tre a tme nt  E

mo tio na l inte llig e nc e

https:/ / summa -he a lth-syste m.skypre pa pp.c o m/

T he Simula tio n E xpe rie nc e

 Stude nts fro m diffe re nt disc ipline s a re a ssig ne d to te a ms  Re c ruitme nt wa s fro m unde rg ra dua te so pho mo re

nursing stude nts to g ra dua te stude nts in so c ia l wo rk, PT , OT a nd spe e c h.

 F

irst se me ste r wa s ma inly vo lunte e rs

 Afte r the first se ssio n, sta rte d g e tting c a lls fro m stude nts

who he a rd a b o ut the simula tio n a nd wa nte d to pa rtic ipa te

 Se c o nd se me ste r, PT

, OT a nd nursing ma de it a re q uire me nt fo r so me o f the c o urse s, SW g a ve e xtra c re dit

 Aske d fo r vo lunte e rs fo r o the r disc ipline s

Pa rtic ipa nts

 F

a ll se me ste r a b o ut 130 stude nts a nd 10 fa c ilita to rs pa rtic ipa te d

 Spring se me ste r a b o ut 210 stude nts a nd 15 fa c ilita to rs

pa rtic ipa te d (two mo re se ssio ns le ft)

 Pa rtic ipa nts we re fro m:

 Nursing - so pho mo re a nd se nio rs stud e nts  OT

/ PT

• pre pro g ra m stud e nts a nd g ra d ua te stud e nts

 SW- g ra d ua te stud e nts  Pha rma c y- g ra d ua te stud e nts  Spe e c h- g ra d ua te stud e nts  Cle rg y- g ra d ua te stud e nts  He a lth sc ie nc e ma jo rs- und e rg ra d ua te stud e nts  Me d ic a l- und e rg ra d ua te pre me d stud e nts

Pro c e ss

 Stude nts a re ra ndo mly a ssig ne d to a te a m tha t will ha ve

so me o ne fro m e a c h o f the disc ipline s (va rie s b a se d o n stude nt mix)

 Assig nme nt is b a se d o n the ir disc ipline b ut so me ma y

ha ve a diffe re nt ro le tha n the ir e duc a tio na l b a c kg ro und- try to ke e p to a minimum

 T

he te a m is g ive n a c o py o f so me b a sic info rma tio n a b o ut the c lie nt

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a c h disc ipline re c e ive s disc ipline a sse ssme nt info rma tio n

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he te a m me e ts fo r a b o ut 10-15 minute s to sha re info rma tio n a nd pull the ir pla n to g e the r

 T

e a m ne e ds to ide ntify le a de r b ut so me time s fa c ilita to r just will a ssig n o ne

E xa mple o f I nfo rma tio n Give n to Stude nts

 SW

 Ho using:

 Mr. Be nne t o wns his ho me . I

t is a 2 sto ry ho me with 2nd flo o r b e d and b ath. T he re is a railing o nly o n o ne side

• f the ste ps. T

he re are 3 ste ps that do no t have a railing into the ho use . T he laundry is in the b ase me nt.

So c ia l Wo rk

 So c ial

 Mr. Be nne t was wido we d appro ximate ly 6 mo nths ag o .

His wife had b e e n diag no se d with lung c anc e r and de spite ag g re ssive tre atme nts the dise ase pro g re sse d. Nine mo nths ag o she was e nro lle d in ho spic e . She mo ve d to the ir c hild’ s ho use b e c ause the re was spac e o n the first flo o r fo r a ho spital b e d and a first flo o r b athro o m. Mr. Be nne t spe nt e ve ryday with he r the re . He has 1 living c hild. He has o ne so n that is de c e ase d due to panc re atic c anc e r. T his happe ne d ab o ut 3 ye ars ag o . His c hild live s ab o ut 20 minute s away, trie s to he lp o ut b ut afte r taking time o ff to c are fo r Mrs. Be nne t has b e e n trying to c atc h up with wo rk and family ac tivitie s. I t has b e e n 3-4 we e ks sinc e Mr. Be nne t has se e n the m. T he y do talk o n the pho ne se ve ral time s a we e k.

Physic a l T he ra py Pie c e

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F unc tio nal ac tivitie s:

 Supine <-> sit with CGA d/t Rig ht wrist/hand splint  Sit <-> stand with supe rvisio n fo r safe ty  Stand pivo t transfe r with SBA

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Ambulatio n:

 supe rvisio n to SBA witho ut assistive de vic e x 25 fe e t; de c re ase d

arm swing b ilate ral, rig ht to e o ut, de c re ase d ste p le ng th L L E , unste ady with turning le ft, c /o fatig ue and re q ue ste d to sit do wn, b e c ame mo re unste ady the furthe r he walke d

 T

UG: 14.5 se c o nds

 T

ine tti: 18/28

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Safe ty:

 fair, do e s no t push o ff c hair, do e s no t re ac h b ac k fo r c hair to sit

do wn, impulsive at time s

Simula te d F a mily Me mb e r

 Sta nda rdize d pa tie nt tra ining

 De mo g ra phic s g ive n to the m b e fo re ha nd  Re vie w the c linic a l info rma tio n with tra ine rs, pra c tic e

 Spe c ific c o nc e rns a re disc usse d with the m tha t the y

sho uld b ring o ut in the te a m me e ting

 E

a c h simula tio n is diffe re nt a s simula te d fa mily me mb e rs will re a c t b a se d o n wha t the te a m sa ys in the me e ting so no simula tio n e xpe rie nc e is the sa me

Simula te d F a mily Me mb e r I nfo rma tio n

 Ag e  So c io e c o no mic  Ma rita l  Childre n  Oc c upa tio n  Pre se nta tio n: ho w do e s the fa mily me mb e r a ppe a r

Ope ning Sta te me nt

 He / she doe s not intr

• duc e he r

se lf/ himse lf, r athe r imme diate ly state s, “I am he r e today be c ause I am ve r y upse t by Dad’s ac c ide nt! He should not be dr iving and is not taking c ar e of himse lf; doe sn’t e at r ight and I don’t think he ge ts muc h sle e p. You c an se e that he ge ts e asily c onfuse d and shouldn’t be living by himse lf.”



He has not be e n the same sinc e Mom die d. He doe sn’t c all, doe sn’t want to c ome ove r whe n I invite

• him. He just sits in that house and br
• ods. It’s be e n
• ve r

a month sinc e I have se e n him. He looks te r r ible !

 Afte r a b o ut 15 minute s, a fa mily me mb e r (a c to r)

c o me s in to disc uss the ir fa mily me mb e r

 T

he disc iplina ry te a m a nswe rs q ue stio ns a nd liste ns to the fa mily me mb e r to he lp c o me up with a pla n tha t inc lude s the ir c o nc e rns b ut a lso ma ke s se nse fo r the c lie nt

 T

he te a m a nd fa mily me mb e r spe nd a b o ut 30 minute s disc ussing the b e st c a re fo r the c lie nt b a se d o n the te a ms finding s

 T

he te a m a ddre sse s the fa mily me mb e rs c o nc e rns re la te d to the ir fa mily me mb e r

De b rie fing

 Spe nd se ve ra l minute s de b rie fing with the fa mily

me mb e r (a c to r)

 Ha ve the fa mily me mb e r disc uss wha t thing s the te a m

did we ll

 Ha ve fa mily me mb e r disc uss a nything tha t c o uld ha ve

g o ne b e tte r

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a c ilita to r turns to te a m a nd a sks wha t we nt we ll

 F

a c ilita to r a sks wha t c o uld ha ve g o ne b e tte r

 T

e a m ha s b e e n ve ry g o o d a nd po inting o ut stre ng ths a nd a re a fo r impro ve me nt

De b rie fing

 At the e nd o f the te a m de b rie fing se ssio n, the who le

g ro up me e ts a ll to g e the r to ha ve a n o ve ra ll de b rie fing se ssio n

 Disc uss wha t stude nts ha ve le a rne d fro m the ir

e xpe rie nc e

 Disc uss ho w the te a m the y we re in func tio ne d  Disc uss wha t thing s we nt we ll  Disc uss wha t thing s c o uld ha ve g o ne b e tte r

Stude nt E va lua tio ns

• Students were given surveys post simulation experience
• A Likert scale was used from 1-5 with 5 being the highest

There were 49 students that strongly agreed that the simulation was a valuable learning experience (mean 4.94) 30 students strongly agreed and 16 students agreed that they were more confident to practice in an actual clinical team (mean 4.49)

 26 students felt that working in a team with multiple disciplines was the most effective thing about the sim  15 students felt that the debriefing and facilitator feedback was the most effective thing about the sim  17 students felt that the lack of prep time before the sim was the least effective part of the educational sim

Re c o mme nda tio ns

 Co ntinue to wo rk with

e duc a to rs in the va rio us disc ipline s to e nc o ura g e stude nt invo lve me nt

 As c la ss a ssig nme nt  As e xtra c re dit  As a n e duc a tio na l a c tivity

 Co ntinue to tra in fa c ilita to rs  Co ntinue to de ve lo p simula tio n

e xpe rie nc e s tha t a llo w fo r invo lve me nt o f a ll disc ipline s

L ite ra ture

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Re c o mme nd e d Ba c c a la ure a te Co mpe te nc ie s a nd Curric ula r Guid e line s fo r Nursing Ca re o f Old e r Ad ults (2010). Ha rfo rd Institute fo r Ge ria tric Nursing , AACN.

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F ra me wo rk fo r a c tio n o n inte rpro fe ssio na l e d uc a tio n & c o lla b o ra tive pra c tic e . Ge ne va : Wo rld He a lth Org a niza tio n (WHO) 2010.



Ab u-Rish E ., K im S., Cho e L ., e t a l., (2012). Curre nt tre nds in inte rpro fe ssio nal e duc atio n o f he alth sc ie nc e s stude nts: A lite rature re vie w. Jo urna l o f Inte rpro fe ssio na l Ca re , 26: 444-451.



Institute o f Me d ic ine , T

• E

rr is Huma n, Build ing a Sa fe r He a lth Syste m, 2000



Wa tte rs C., Re e d y G., Ro ss A., e t a l. (2015). Do e s inte rpro fe ssio na l simula tio n inc re a se se lf-e ffic a c y: a c o mpa ra tive stud y. BMJ Ope n 2015; 5:e 005472. Do i:10.1136/ b mjo pe n-2014-005472.

L ite ra ture Co ntinue d….



Mitnic k S, L e ffle r, C, a nd Ho o d VL (2010). F

• r the Ame ric a n Co lle g e o f Physic ia ns

E thic s, Pro fe ssio na lism a nd Huma n Rig hts Co mmitte e . F a mily c a re g ive rs, pa tie nts a nd physic ia ns:e thic a l g uid a nc e to o ptimize re la tio nships. J Ge n Inte rn Me d .; DOI 10.1007/ s11606-009-1206-3. Ava ila b le o n Spring e rL ink a t: http :/ / www.spring e rlink.c o m/ o pe nurl.a sp? g e nre =a rtic le &id =d o i:10.1007/ s11606- 009-1206-3.