Using simulation-based interprofessional education to change attitudes towards collaboration among higher specialty trainee physicians and registered nurses: a mixed methods pilot study

ABSTRACT

Interprofessional collaboration (IPC) is important for delivering safe patient care and can be enhanced through interprofessional education (IPE). In postgraduate medical education, the most effective model for delivering IPE remains unclear. A multi-site non-randomized mixed methods study was undertaken to investigate the effectiveness of a simulation-based IPE (SB-IPE) intervention on changing attitudes among higher specialty trainee (HST) physicians in general internal medicine and registered nurses (RNs). The intervention, underpinned by intergroup contact theory, is comprised of paired participants (HSTs:RNs) undertaking six simulated scenarios. The Jefferson Scale of Attitudes toward Interprofessional Collaboration (JeffSATIC) was administered pre-and-post intervention. Focus groups were conducted to explore participants’ perceptions of IPC and the SB-IPE intervention. Fifty-six participants attended the SB-IPE intervention and 37 completed focus group interviews. Overall, attitudes toward IPC changed positively (p < .001), with greater change among HSTs (p = .001) compared to RNs (p = .12). Attitudes to “working relationships” significantly increased for HSTs (p < .001) but not RNs (p = .047). Focus group analysis identified three processes by which SB-IPE led to attitudinal change: 1) Shared vulnerability, 2) Positive affirmation, and 3) Negotiating professional hierarchies, mainly through relationship building. Further research is needed to investigate the long-term impact of attitudinal change, including the extent to which benefits transfer into practice.

KEYWORDS:

• Interprofessional collaboration
• interprofessional education
• physicians
• registered nurses
• simulation

Acknowledgments

This research formed the basis of a thesis submitted by PE and supervised by RP for award of MMedSci in Medical Education. The authors would like to thank the participants who volunteered for this research and the faculty (simulation center staff and volunteer educators) at NUH and NGH.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authorship contributions

Conceived study and designed simulation model: PE, NW, BB. Designed scenarios, recruited participants, and facilitated SB-IPE pilot delivery: PE, NW, AD, VO, LY, FP. Collected data and transcribed focus group recordings: PE. Analyzed, interpreted, and discussed results: PE, AD, NW, CM, RP. Drafted the manuscript: PE, RP. Critically revised the manuscript: PE, RP, CM, NW, AD, BB. All authors read and approved the final manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/13561820.2022.2137481

Additional information

Funding

This research was conducted as part of an SB-IPE project funded by Health Education England (HEE) East Midlands.

Notes on contributors

Patience Ifeoma Ehilawa

Patience Ehilawa, BSc, MBChB, MRCP UK (Respiratory) is a consultant physician in respiratory medicine and general internal medicine. She holds an MMedSci in medical education and has interests in undergraduate and postgraduate simulation-based IPE.

Nicholas Woodier

Nicholas Woodier is a qualified medical doctor who moved from clinical medicine into medical education. He now works in a national role undertaking patient safety investigations. He holds an MSc in human factors and is undertaking a PhD in patient safety. He is also an Honorary Assistant Professor with the University of Nottingham where he delivers education around patient safety and human factors to healthcare students.

Alison Dinning

Alison Dinning is an International recruitment manager for NHS England (Midlands). She previously worked as a Clinical Lead for Education at Nottingham University Hospitals NHS Trust. She has designed and facilitated training programmes for healthcare staff working across integrated care systems. She is passionate about networking, sharing ideas and best practice both locally and nationally.

Vicky O’Neil

Vicky O'Neil is a qualified ODP (Operating Department Practitioner) with 28 years of healthcare service. A highly self-motivated, senior level manager with extensive clinical and strategic leadership experience in acute settings. She has expertise in clinical and non-clinical medical education, simulation, resuscitation and quality improvement.

Fiona Poyner

Fiona Poyner, MA BMBCh, FRCP FRCEM is an Emergency Medicine Consultant at Northampton General Hospital. She is the clinical lead for simulation and appraisals and is interested in interprofessional communication.

Lisa Yates

Lisa Yates graduated from the University of Leicester in 2010. Following completion of core medical training in the East Midlands, she commenced a year as a simulation fellow at Northampton General Hospital. She is now a senior clinical fellow working in critical care and has an interest in multidisciplinary education.

Bryn Baxendale

Bryn Baxendale is a Consultant Anaesthetist and Director, Trent Simulation and Clinical Skills Centre at Nottingham University Hospitals NHS Trust. Honorary Professor of Clinical Simulation, School of Psychology, University of Nottingham, Clinical Lead for MSc in Quality and Patient Safety Improvement, University of Nottingham. Past President of the Association for Simulated Practice in Healthcare (ASPiH), and currently a clinical advisor to Health Education England Technology Enhanced Learning (HEE TEL) and the national lead for the HEE TEL Simulation and Immersive Learning Technologies programme.

Christopher Madan

Christopher Madan, PhD, FPsyS, is Assistant Professor in the School of Psychology at the University of Nottingham; Nottingham, UK. He has extensive expertise across a variety of behavioural research methods.

Rakesh Patel

Rakesh Patel currently works as a Clinical Associate Professor in Medical Education at the University of Nottingham and Honorary Consultant Nephrologist at Nottingham University Hospitals NHS Trust. In his academic role, Rakesh is Course Director for the MMedSci in Medical Education and is Academic Programme Director for Medical Education Research in the School of Medicine. In his clinical role, Rakesh is dual-trained in Nephrology and General (Internal) Medicine.