A mixed-methods program evaluation of the Alda Healthcare Experience- a program to improve healthcare team communication.

BACKGROUND: Communication among interprofessional healthcare worker teams is critical to ensure a thriving and resilient workforce. We will evaluate the implementation and effectiveness of the Alda Healthcare Experience (AHE), a novel medical improvisation (improv) workshop designed to improve interprofessional communication skills among healthcare professionals. The AHE workshop includes a two-hour experiential training workshop led by an improv specialist and a clinical co-facilitator. In July 2022 we began implementing the AHE workshop by training 18 clinical co-facilitators who will co-facilitate the workshops for 550 healthcare workers from five hospital departments at Stony Brook University Hospital over the course of a year and a half. Using mixed-methods, we will conduct an Effectiveness-Implementation Hybrid Design project that includes an outcome evaluation (effectiveness) and a process evaluation (implementation). METHODS: Our outcome evaluation will assess the impact of the AHE workshop on short- and long-term improvement in interprofessional communication, stress, and professional fulfillment. The process evaluation component will examine programmatic, organizational, and individual facilitators or barriers to effective implementation of the AHE workshop. Qualitative methods will include dimensional analysis employing individual interviews of 20-40 AHE Project Participants, 5-10 Selected Informants, and all the clinical co-facilitators. Quantitative methods will use a quasi-experimental longitudinal design with an intervention group and surveillance of a control group (wait-list) and repeated assessments using validated instruments measuring communications skills, professional fulfillment, stress, burnout, uncertainty tolerance, and teamwork. DISCUSSION: Effective and efficient communication within healthcare teams is fundamental to building team cohesion that, in turn, supports individual resilience and builds positive organizational culture. The AHE program is an innovative approach to improve interprofessional healthcare communication and reduce healthcare worker burnout. In addition to institutional buy-in, rigorous evaluations of medical improv programs are necessary as a critical step in making such programs scalable. TRIAL REGISTRATION: N/A.

Process evaluation of a medical improvisation program for healthcare communication training.

BACKGROUND: Medical improvisation is an innovative approach to train healthcare professionals in effective communication. The success of this type of training depends on the active engagement of participants. METHOD: A total of 136 interprofessional healthcare workers completed surveys before and after a two-hour medical improvisation communication training session in October 2020. We investigated individual- and program-level contributors to participation outputs (e.g. engagement and experience). RESULTS: 97% of healthcare professionals in the participating department took part in the training. 82% described the training in positive terms or as a learning experience. Younger participants, medical doctors, and those who had difficulty tolerating uncertainty were less excited than others about training. Their engagement was associated with their excitement and group size. Uncertainty tolerance predicted engagement via a full mediation of excitement. CONCLUSIONS: Building excitement, reducing uncertainty about training, and capping group size are likely to improve participant's engagement and experience and will inform dissemination and implementation efforts.