Enhancing Communication Competencies Through Complex Simulation and Health Technology

Background:
As healthcare becomes more technologically complex, clinicians are using electronic health records (EHR) to optimize communication among interprofessional teams, in addition to a repository for patient data. Despite near ubiquitous use of EHRs in clinical settings, few clinical students utilize this technology during their training. In this study, we integrated students from administrative and non-clinical disciplines into traditional clinical simulations, with complex patient safety errors embedded in EHR technology and measured the effect on communication and teamwork.

Methods:
From July 2017-July 2018, 408 students from five schools (medicine, nursing, dentistry, public health, and informatics) participated in one of eight, 3-hour IPE clinical simulations with Standardized Patients and electronic health record technologies. Data was gathered using a pretest-posttest interventional Interprofessional Collaborative Competency Attainment Survey (ICCAS), and also through qualitative evaluations from Standardized Patients.

Results:
Of the total 408 students, 386 (94.6%) had matched pre- and posttest results from the surveys. There was a 15.9% improvement in overall collaboration between the pre- and post-tests. ICCAS competencies showed improvement in teamwork, communication, collaboration, and conflict management, with an average change from 5.26 to 6.10 (t=35.16; p Conclusion).

By integrating non-clinical public health and informatics students into IPE, we found students were able to enhance their interprofessional team competencies, by sharing and learning from one another.

Reflections:
Adding informatics students to the team allowed clinical students to ask questions about usability, design, and workflow. During the debriefing, many of the nursing and medical students expressed an interest in using the EHR for communication and a desire for greater access and training. Although the teaching was through simulation and not in a clinical setting, the implementation and post-simulation debrief provided a level of faculty role-modeling which is not evident elsewhere in the curriculum. The use of the faculty team, representing broad expertise, allowed students to witness and learn from expert, interprofessional role models.