A systematic review of the use of simulation and reflection as summative assessment tools to evaluate student outcomes following interprofessional education activities

Figures & data

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Table 1. Characteristics of included studies.

Study	Sabus, et al. J Allied Health /2011	Machin, et al. Nurse Educ Today/2013	Tan, et al. Med Educ Online/2014	Root, et al. Pharm Educ/ 2015	MacKenzie, et al. J interprof Care/2017
Country	United States	UK	Malaysia	UK	Canada
Course involved (total number of students)	Concurrent courses within the first-year curriculum of physical therapy and occupational therapy program (n = 69)	An interprofessional module within the final year curriculum during their practice placement setting (n = 420). Assignments analyzed (n = 150).	Comprehensive healthcare module (2 credits) Second year medical students (compulsory) and third year pharmacy students (elective) (n = 252)	A course within first year curriculum (n = 165)	Skills-based course for pre-licensure student (n = 302)
IPE topic	Clinical assessment and interventions in home environment (Home assessment)	Service improvement theory, patient safety and understanding students’ complementary roles in a service improvement, systems context.	Interprofessional home visits to patients’ homes and to community-based organizations.	Teamwork and communication skills.	Stroke care
IPE activity	Simulation (virtual): Introductory lecture on home assessment concept and a review of The International Classification of Functioning, Disability and Health. Students were then divided into IPE teams and interviewed a virtual patient. Student then formulated goals and home modification recommendations and reviewed these with the instructor.	Students participated in an interprofessional core day. Students were linked with an interprofessional buddy group, and if feasible planned and implemented a small scale service improvement project within their practice placement setting.	The module was developed to introduce pre-clinical medical and pharmacy students to the concept of interprofessional comprehensive healthcare	Team building exercises and discussion of specific patient cases. The exercises were designed to encourage students to demonstrate the potential for each professional group to work together to contribute to improved patient outcomes.	Simulated team encounter for a complex neurological patient with stroke. Students met in their IPE teams to review and discuss patient case.
Observation period IPE activity duration	Two 2-hour classroom sessions	Experiential learning (variation in length and timing).	16 weeks	Two 3-hour IPE events	90 min low acuity simulation and active discussion. Teams then prepared a 2-week, collaborative, care plan.
Professions involved	Two: Physiotherapy (n = 34) Occupational therapy (n = 35)	Eight: Learning disability nursing (n = 2) Midwifery (n = 12) Mental health nursing (n = 9) Children’s nursing (n = 12) Adult nursing (n = 50) Social work (n = 25) Physiotherapy (n = 20) Occupational therapy (n = 20)	Two: Pharmacy (n = 50) Medicine (n = 202)	Four*: Medicine Nursing Social work Pharmacy	Four*: Occupational therapy Physiotherapy Pharmacy Medicine
Assessment used	Group assignment	Written reflection Oral poster project presentation	Written reflection	Written reflection	Collaborative care plan
Assignment details	Following the simulation session, groups were provided with additional information. patient information and analysis of modifications in place. The required group assignment was developed based on the content learning objectives. students will formulate patient-centered environmental recommendations through an interprofessional, collaborative effort; students will appreciate the influence of contextual factors including patient values, patient roles, and environmental barriers on functional and occupational performance; Students will evaluate recommendations to appreciate unintended consequences of environmental modifications.	Summative assessment A short written individual reflection (one single page) post presentation on the key learning achieved during the module. Oral poster project presentation.	A short written individual reflection (300–500 words) contributing to 25% of final grade on their experiences regarding working with other professions. Focused on knowledge and skills of collaborative teamwork. In addition to supervisor’s assessment on individual/ team performance, peer evaluation, case reports and case presentations.	A short (650–750 words) summative written individual reflection about an IPE experience which is marked against seven outcomes.	Teams prepared a 2-week, collaborative, care plan including prioritized patient’s key concerns, issues and developing collaborative goals and plans.
IPE Competencies included	Interprofessional collaboration, Patient-centered decision-making	Reflective practice Interprofessional communication Team work Role clarification and understanding Patient safety	Role clarification Interprofessional collaboration Teamwork	Reflective practice Interprofessional Communication Teamwork	The Canadian Interprofessional Health Collaborative competencies; interprofessional communication, collaboration, role clarification, collaborative patient/family-centered approach, conflict management/resolution, team functioning
Grading Tool	A rubric for written assignment based on simulation. Performance ratings were based on the complexity of decision-making consistent with the International Classification of Functioning, Disability, and Health Model of Functioning and Disability. Criteria included patient-centered environmental recommendations, interprofessional collaborative effort.	Not explicitly indicated; students were assessed if they met the intended learning outcomes which included a critical appreciation of service improvement tools such as the PDSA cycle.	NI A rubric based on scoring system in reflective writing	A rubric using three outcomes specifically related to reflective practice: Analysis and Evaluation Identification of personal learning Action plan for personal development. Each outcome is graded as “Beginning,” “Developing,” “Competent” or “Proficient.”	A rubric to evaluate stroke knowledge and application across individual and IPP competencies. Team members received the same grade which contributed to their respective profession’s course mark
Graded by	Each group assignment was scored independently by the physical and occupational therapy investigators. Scoring discrepancies were discussed until consensus was reached.	Academic staff and Service users provided formative feedback	Facilitators from academic staff, clinical and pre-clinical medicine, pharmacy and nursing staff	Academic staff	NI
Scores	Maximum possible score was 12 points.	NI	Maximum score: 25%	“Pass” or “Fail”	Excellent, very good, good, satisfactory, and fail.
Quality (CCAT)	28%	43%	78%	60%	78%

NI: Not indicated; PDSA: Plan, do, study, act; IPP: Interprofessional Practice

*Sample size of individual professions were not clearly defined.