Establishing trust within interprofessional teams with a novel simulation activity in the pediatric clerkship

ABSTRACT

Interprofessional trust is essential for effective team-based care. Medical students are transient members of clinical teams during clerkship rotations and there may be limited focus on developing competency in interprofessional collaboration. Within a pediatric clerkship rotation, we developed a novel simulation activity involving an interprofessional conflict, aiming to foster trusting interprofessional relationships. Active participants included a nurse educator and a medical student participant, with additional students using a checklist to actively observe. The debrief focused on teaching points related to interprofessional competencies and conflict resolution. Students completed a written evaluation immediately following the simulation. Descriptive statistics were used to analyze Likert-type scale questions. Conventional content analysis was used to analyze open-ended responses. Two hundred and fourteen students participated in the simulation between June 2018-June 2019. Most students indicated that the simulation was effective (86%) and improved their confidence to constructively manage disagreements about patient care (88%). Students described anticipated changes in practice including developing their role on the interprofessional team as a medical student, developing a shared mental model, and establishing a shared goal. Our findings suggest that simulation-based learning may present an opportunity for developing interprofessional trust in academic health centers.

KEYWORDS:

• Simulation
• interprofessional education
• interprofessional trust
• pediatrics
• undergraduate medical education

Acknowledgments

The authors would like to thank the Harvard Medical School Pediatrics Core Clerkship program, the Boston Children’s Hospital Simulator Program, the health professionals who contributed to the simulation content, and all of the students who have participated in the simulation.

Declaration of interest

The authors have no conflicts of interest to disclose. This research has been presented in part at the Harvard Macy Institute Professional Development Course 2018, Boston, MA and Harvard Medical Education Day 2018, Boston, MA.

Supplementary material

Supplemental data for this article can be accessed on the publisher’s website

Additional information

Funding

We acknowledge the generous support of the Macy Faculty Scholars Program that helped to make this work possible.

Notes on contributors

Kathleen Huth

Kathleen Huth, MD, MMSc is a pediatrician in the Complex Care Service at Boston Children's Hospital; Instructor of Pediatrics at Harvard Medical School; and Faculty Development Lead in the Boston Children's Hospital Simulator Program.

Amanda S. Growdon

Amanda Growdon, MD is a pediatric hospitalist at Boston Children’s Hospital, Assistant Professor of Pediatrics at Harvard Medical School, and Associate Clerkship Director for Pediatrics at Boston Children’s Hospital. 

Leah S. Stockman

Leah Stockman, MA is a Research Project Manager with the Department of Medical Oncology in the Division of Population Sciences at Dana-Farber Cancer Institute.

Marisa Brett-Fleegler

Marisa Brett-Fleegler, MD is an attending in pediatric emergency medicine at Boston Children's Hospital, Assistant Professor of Pediatrics and Emergency Medicine, Harvard Medical School.

M. Teresa Shannon

M. Teresa Shannon MSN, RN, CPN is a Nurse Education Coordinator for Patient Medical Service's Inpatient Nursing program at Boston Children's Hospital; SIMPeds-Nursing Associate Clinical Director at Boston Children's Hospital.

Matthew Taylor

Matthew Taylor, BA, RN is the Curriculum Development Manager in the Boston Children’s Hospital Simulator Program.

Edward S. Hundert

Edward M. Hundert, MD is Dean for Medical Education, Daniel D. Federman MD Professor in Residence of Global Health and Social Medicine and Medical Education, and Associate Director of the Center for Bioethics at Harvard Medical School.

Jennifer C. Kesselheim

Jennifer Kesselheim, MD, MEd is a pediatric hematologist-oncologist at Dana-Farber/Boston Children's Cancer and Blood Disorders Center; Director, Master of Medical Sciences (MMSc) in Medical Education, Associate Professor of Pediatrics, Harvard Medical School.