Development of a pilot interprofessional education workshop for healthcare students and assessment of interprofessional collaborative competency attainment.

We describe the development and student evaluation of a collaborative health service provider and higher education institution initiative designed to deliver an Interprofessional Education (IPE) pilot workshop program for healthcare students. The aim was to investigate whether an IPE workshop would result in improved student confidence in self-reported interprofessional competencies using the Interprofessional Collaborative Competency Attainment Scale (ICCAS) tool. The workshops involved interprofessional student groups working on a patient case followed by a facilitator-led discussion and patient representative interaction. There were three different voluntary, extra-curricular workshops. A total of 99 students registered, from 3rd to 5th year undergraduate and 2nd year graduate entry healthcare programs at a single Irish university in February 2022. Ninety-three post-workshop survey responses showed statistically significant improvements in the ICCAS subscales of Communication, Collaboration, Roles and Responsibilities, Collaborative Patient/Family-Centered Approach, and Team Functioning; Conflict Management showed less change. Students reported positively on the benefit of the patient representative, the workshop format, and the opportunity to collaborate with students from other professions. Our findings indicate that this was a beneficial and effective way to deliver IPE across a range of healthcare professions that led to improvements in self-reported interprofessional competencies.

Effectiveness of a proficiency-based progression e-learning approach to training in communication in the context of clinically deteriorating patients: a multi-arm randomised controlled trial.

OBJECTIVE: To determine the effectiveness of proficiency-based progression (PBP) e-learning in training in communication concerning clinically deteriorating patients. DESIGN: Single-centre multi-arm randomised double-blind controlled trial with three parallel arms. RANDOMISATION, SETTING AND PARTICIPANTS: A computer-generated program randomised and allocated 120 final year medical students in an Irish University into three trial groups. INTERVENTION: Each group completed the standard Identification, Situation, Background, Assessment, Recommendation communication e-learning; group 1 Heath Service Executive course group (HSE) performed this alone; group 2 (PBP) performed additional e-learning using PBP scenarios with expert-determined proficiency benchmarks composed of weighted marking schemes of steps, errors and critical errors cut-offs; group 3 (S) (self-directed, no PBP) performed additional e-learning with identical scenarios to (PBP) without PBP. MAIN OUTCOME MEASURES: Primary analysis was based on 114 students, comparing ability to reach expert-determined predefined proficiency benchmark in standardised low-fidelity simulation assessment, before and after completion of each group's e-learning requirements. Performance was recorded and scored by two independent blinded assessors. RESULTS: Post-intervention, proficiency in each group in the low-fidelity simulation environment improved with statistically significant difference in proficiency between groups (p<0.001). Proficiency was highest in (PBP) (81.1%, 30/37). Post hoc pairwise comparisons revealed statistically significant differences between (PBP) and self-directed (S) (p<0.001) and (HSE) (p<0.001). No statistically significant difference existed between (S) and (HSE) (p=0.479). Changes in proficiency from pre-intervention to post-intervention were significantly different between the three groups (p=0.001). Post-intervention, an extra 67.6% (25/37) in (PBP) achieved proficiency in the low-fidelity simulation. Post hoc pairwise comparisons revealed statistically significant differences between (PBP) and both (S) (p=0.020) and (HSE) (p<0.001). No statistically significant difference was found between (S) and (HSE) (p=0.156). CONCLUSIONS: PBP e-learning is a more effective way to train in communication concerning clinically deteriorating patients than standard e-learning or e-learning without PBP. TRIAL REGISTRATION NUMBER: NCT02937597.

Effect of a proficiency-based progression simulation programme on clinical communication for the deteriorating patient: a randomised controlled trial.

OBJECTIVE: This study aimed to determine the effectiveness of a proficiency-based progression (PBP) training approach to clinical communication in the context of a clinically deteriorating patient. DESIGN: This is a randomised controlled trial with three parallel arms. SETTING: This study was conducted in a university in Ireland. PARTICIPANTS: This study included 45 third year nursing and 45 final year medical undergraduates scheduled to undertake interdisciplinary National Early Warning Score (NEWS) training over a 3-day period in September 2016. INTERVENTIONS: Participants were prospectively randomised to one of three groups before undertaking a performance assessment of the ISBAR (Identification, Situation, Background, Assessment, Recommendation) communication tool relevant to a deteriorating patient in a high-fidelity simulation facility. The groups were as follows: (i) E, the Irish Health Service national NEWS e-learning programme only; (ii) E+S, the national e-learning programme plus standard simulation; and (iii) E+PBP, the national e-learning programme plus PBP simulation. MAIN OUTCOME MEASURES: The primary outcome was the proportion in each group reaching a predefined proficiency benchmark comprising a series of predefined steps, errors and critical errors during the performance of a standardised, high-fidelity simulation assessment case which was recorded and scored by two independent blinded assessors. RESULTS: 6.9% (2/29) of the E group and 13% (3/23) of the E+S group demonstrated proficiency in comparison to 60% (15/25) of the E+PBP group. The difference between the E and the E+S groups was not statistically significant (χ2=0.55, 99% CI 0.63 to 0.66, p=0.63) but was significant for the difference between the E and the E+PBP groups (χ2=22.25, CI 0.00 to 0.00, p<0.000) and between the E+S and the E+PBP groups (χ2=11.04, CI 0.00 to 0.00, p=0.001). CONCLUSIONS: PBP is a more effective way to teach clinical communication in the context of the deteriorating patient than e-learning either alone or in combination with standard simulation. TRIAL REGISTRATION NUMBER: NCT02886754; Results.

Near field communications technology and the potential to reduce medication errors through multidisciplinary application.

BACKGROUND: Patient safety requires optimal management of medications. Electronic systems are encouraged to reduce medication errors. Near field communications (NFC) is an emerging technology that may be used to develop novel medication management systems. METHODS: An NFC-based system was designed to facilitate prescribing, administration and review of medications commonly used on surgical wards. Final year medical, nursing, and pharmacy students were recruited to test the electronic system in a cross-over observational setting on a simulated ward. Medication errors were compared against errors recorded using a paper-based system. RESULTS: A significant difference in the commission of medication errors was seen when NFC and paper-based medication systems were compared. Paper use resulted in a mean of 4.09 errors per prescribing round while NFC prescribing resulted in a mean of 0.22 errors per simulated prescribing round (P=0.000). Likewise, medication administration errors were reduced from a mean of 2.30 per drug round with a Paper system to a mean of 0.80 errors per round using NFC (P<0.015). A mean satisfaction score of 2.30 was reported by users, (rated on seven-point scale with 1 denoting total satisfaction with system use and 7 denoting total dissatisfaction). CONCLUSIONS: An NFC based medication system may be used to effectively reduce medication errors in a simulated ward environment.

Evaluation of the educational impact of a special study module on maritime medicine for medical undergraduate students.

BACKGROUND: The hazardous occupation of seafaring brings many unique medical challenges. Despite its international nature, maritime medicine does not typically form a part of undergraduate medical studies. A unique and innovative, optional student-selected module (SSM) 'maritime medicine' was offered to medical students. A key objective was to develop students' attitudes to maritime medicine and increase their awareness of the discipline and its specialised nature. AIM: The aim of this study was to assess qualitatively and quantitatively the educational impact of the maritime medicine SSM and to improve the module content and design for future academic years. MATERIALS AND METHODS: Students' perceived relevance and knowledge before and after the module was assessed using a Likert-based questionnaire. Comparison was made with controls in the post module100 multiple choice question (MCQ) paper. Qualitative feedback was obtained from semi-structured focus student discussion groups and the questionnaire's free comments section. RESULTS: A significant increase in perceived knowledge was seen between pre and post module p < 3.45 × 10-10, matched with the module students performing significantly better than controls in the end-of-module MCQ paper (p < 8.99 × 10-20). Qualitative analysis revealed 5 main themes: teaching methods, appreciation of non-academic instructors, appreciation of maritime medicine unique requirements, timetabling and enjoyment. CONCLUSIONS: This unique and innovative maritime medicine module harnessed local expertise and raised the awareness and profile of maritime medicine among undergraduate medical students. It was very well received and had a significant educational impact. Practical teaching methods were highly valued by students, with these areas also performing best in quantitative analysis.