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      Effectiveness of an interprofessional patient safety team-based learning simulation experience on healthcare professional trainees

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          Abstract

          Background

          Although the American Council of Graduate Medical Education (ACGME) mandates formal education in patient safety, there is a lack of standardized educational practice on how to conduct patient safety training. Traditionally, patient safety is taught utilizing instructional strategies that promote passive learning such as self-directed online learning modules or didactic lectures that result in suboptimal learning and satisfaction.

          Methods

          During the summer of 2015, 76 trainees consisting of internal medicine interns and senior-level nursing students participated in an interactive patient safety workshop that used a flipped classroom approach integrating team based learning (TBL) and interprofessional simulated application exercises.

          Results

          Workshop trainees demonstrated an increase in knowledge specifically related to patient safety core concepts on the Team Readiness Assurance Test (TRAT) compared to the Individual Readiness Assurance Test (IRAT) ( p = 0.001). Completion rates on the simulation application exercises checklists were high except for a few critical action items such as hand-washing, identifying barriers to care, and making efforts to clarify code status with patient. The Readiness for Interprofessional Learning Scale (RIPLS) subscale scores for Teamwork and Collaboration and Professional Identity were higher on the post-workshop survey compared to the pre-workshop survey, however only the difference in the Positive Professional Identity subscale was statistically significant ( p = 0.03). A majority (90%) of the trainees either agreed that the safety concepts they learned would likely improve the quality of care they provide to future patients.

          Conclusions

          This novel approach to safety training expanded teaching outside of the classroom and integrated simulation and engagement in error reduction strategies. Next steps include direct observation of trainees in the clinical setting for team-based competency when it comes to patient safety and recognition of system errors.

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          Most cited references9

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          The development of a questionnaire to assess the readiness of health care students for interprofessional learning (RIPLS).

          Although shared learning activities are gradually being introduced to health care undergraduates, it has not been possible to measure the effects of educational interventions on students' attitudes. The main objective of this study was to develop a rating scale using items based on the desired outcomes of shared learning, to assess the 'readiness' of health care students for shared learning activities. A questionnaire study of 120 undergraduate students in 8 health care professions. Principal components analysis resulted a 3-factor scale with 19 items and having an internal consistency of 0.9. The factors have been initially named 'team-working and collaboration', 'professional-identity' and 'professional roles'. The new scale may be used to explore differences in students' perception and attitudes towards multi-professional learning. Further work is necessary to validate the scale amongst a larger population.
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            The Readiness for Interprofessional Learning Scale: a possible more stable sub-scale model for the original version of RIPLS.

            The original version of the Readiness for Interprofessional Learning Scale (RIPLS) was published by Parsell and Bligh (1999). Three sub-scales with acceptable or high internal consistencies were suggested, however two publications suggested different sub-scales. An investigation into how to improve the reliability for use of the RIPLS instrument with undergraduate health-care students commenced. Content analysis on the original 19 items involving experienced health-care staff resulted in four sub-scales. These sub-scales were then used to formulate a possible model within a structural equation model. The goodness of fit was assessed using a sample (n = 308) of new first year undergraduate students from 8 different health and social care programmes. The same data was fitted to each of the two original sub-scale models suggested by Parsell and Bligh (1999) and the results compared. The fit of the new four sub-scale model appears superior to either of the original models. The new four factor model was then tested on subsequent data (n = 247) obtained from the same students at the end of their first year. The fit was seen to be even better at the end of the academic year.
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              A critical appraisal of instruments to measure outcomes of interprofessional education.

              Interprofessional education (IPE) is believed to prepare health professional graduates for successful collaborative practice. A range of instruments have been developed to measure the outcomes of IPE. An understanding of the psychometric properties of these instruments is important if they are to be used to measure the effectiveness of IPE.
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                Author and article information

                Contributors
                nirvani.goolsarran@stonybrookmedicine.edu
                carine.hamo@stonybrookmedicine.edu
                susan.lane@stonybrookmedicine.edu
                Stacey.Frawley@stonybrook.edu
                (631) 444-8316 , wei-hsin.lu@stonybrookmedicine.edu
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                8 August 2018
                8 August 2018
                2018
                : 18
                : 192
                Affiliations
                [1 ]ISNI 0000 0004 0437 5731, GRID grid.412695.d, Department of Medicine, , Stony Brook University Hospital, ;
                [2 ]ISNI 0000 0004 0437 5731, GRID grid.412695.d, School of Nursing, , Stony Brook University Hospital, ; 101 Nicolls Road, Stony Brook, 11794 NY USA
                [3 ]ISNI 0000 0004 0437 5731, GRID grid.412695.d, Department of Preventative Medicine, , Stony Brook University Hospital, ; 101 Nicolls Road, Stony Brook, 11794 NY USA
                [4 ]ISNI 0000 0001 2216 9681, GRID grid.36425.36, Stony Brook University School of Medicine, ; 101 Nicolls Road, HSC Level 4 Room 148, Stony Brook, NY 11794-8430 USA
                Article
                1301
                10.1186/s12909-018-1301-4
                6083611
                30089502
                da826c6d-c4ba-483f-b518-4d1ccdf321b3
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 September 2017
                : 27 July 2018
                Funding
                Funded by: Team-Based Learning Collaborative
                Award ID: We did not receive a grant number from the funding body. Also the funding body did not play a role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Education
                patient safety training,team-based learning,simulation-based education,interprofessional education

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