Purpose:
This Sim-enhanced IPE toolkit is a collaboration between the University of Illinois, Chicago and Villanova University. The toolkit aims to:
- Guide faculty and staff to develop, implement, and evaluate a Sim-Enhanced IPE.
- Provide faculty with the resources needed such as budget, training materials, personnel, equipment, and supplies needed for simulation implementation
This toolkit provides faculty with the resources needed to:
- introduce healthcare professional students to simulations focused on underserved communities and social determinants of health.
- promote the collaborative practice behaviors required to work in an interprofessional team.
- promote the employment and collaborations with individuals with intellectual and developmental disabilities and theatre students as simulated participants.
This toolkit is made possible through a collaboration among Villanova University's M. Louise Fitzpatrick College of Nursing and the University of Illinois Chicago Colleges of Dentistry, and Nursing, and the Department of Disability and Human Development. See faculty and staff contact information at the end of the toolkit.
Overview:
- Current literature emphasizes the importance of interprofessional collaboration in healthcare. However, the most effective approach for preparing collaboration-ready healthcare professionals remains uncertain
- Purposeful healthcare student curriculum focuses on introducing interprofessional student teams to underserved communities, such as individuals with intellectual and developmental disabilities (IDD) and those with challenging social determinants of health (SDOH), is lacking.
- SIM-IPE is an effective method for interprofessional student teams to gain experience working with patient populations who are not readily accessible during their student training, such as people in underserved communities
Video Overview : Implementation of the Patient Voices Project (IPE / IDD Sims)
Research Article: Utilizing simulation-enhanced interprofessional education to identify differences in healthcare students' collaborative practice behaviors: A mixed- method study.
Faculty Training and Resources:
Case Development: Faculty members from three health science colleges, including nursing, dentistry, and pharmacy met over a 6-month period to develop interprofessional primary care scenarios. Scenarios focus on medication-centric cases in patients with IDD who presented with oral health concerns. Will / Wendy Tobias and Daniel / Dana Cortez
Debriefing Learning Modules: Facilitators complete a learning module on how to conduct debriefing sessions, which was posted on the University Blackboard Learning Management System portal. The module consists of three lessons with embedded videos and quiz questions designed to teach multiple debriefing methods, including Promoting Excellence and Reflective Learning through Simulation (PEARLS). We have included the learning modules quiz, IPE simulation example, and PEARLS debriefing of the IPE simulation example below.
- Pre / Post Debriefing Quiz
- IPE Simulation Example (14 min)
- PEARLS Introduction (2 min)
- Debriefing Learning Modules - PEARLS (22 min)
PEARLS debriefing guide: PEARLS includes the following: (1) setting the scene to create a safe space for learning; (2) creating a safe space to share initial reactions and feelings; (3) describing the simulation to ensure all learners have a shared understanding of the scenario; (4) providing analysis for learners to self-assess and discuss their performance gaps and positive behaviors exhibited during the scenario; and (5) providing a student summary that identifies take-aways, and any outstanding issues and concerns. Each debriefing session includes all five phases of PEARLS. However, an emphasis is placed on the analysis phase, during which students discussed their interprofessional CPBs and perceptions of caring for individuals with IDD and SDOH. Adapted PEARLS Debriefing Guide
Facilitation Workshops: Facilitators were invited to SP workshops to learn the cases and practice case implementation with SPs.
Budget:
Below are examples of logistics and costs for simulated participants and sim lab rental. These examples are frameworks for planning as costs and fee structures can be adapted per your organization.
Simulated Participants - responsibilities and pay rate for SPs.
Simulation Lab Logistics - Students - Students time and expectations.
Budget Example - Sample budget to run both in-person and telehealth simulations.
Simulated Participants Training and Resources:
SP Recruitment and Training: The education and recruitment of SPs focuses on the diversity seen in underserved communities, and their training occurred over a 4-month period. Individuals with IDD were initially chosen and trained as SPs. Training consists of three in-person or telehealth workshops followed by 1–2 individual sessions with the SP educator. SPs also receive detailed, structured techniques to use in their role as simulated participants with IDD to achieve more range, authenticity, and "higher stakes" within their SP work. To further support SPs, two healthcare coaches are also trained in each of the two scenarios; each SP had the option of including the healthcare coach in the SIM-IPE they were performing. Utilizing a healthcare coach also aligns with best practices for working with individuals with IDDs.
Theatre Students: Due to the large number of SIM-IPE scheduled, a second group of SPs were recruited from the university's theatre department. Theatre students portrayed patients from underserved communities with SDOH who had challenges with employment, transportation, finances, and lack of support systems. Theatre students attended an abbreviated version of SP training: one Zoom workshop and one individual session with the SP educator. Theatre students were selected by the Director of the UIC Theatre Department, interviewed, oriented and trained by the Sim Team.
Simulation Cases:
Wendy / Will Tobias - Patient Report: A 28-year-old patient (Will / Wendy) Tobias has requested a visit with the nurse practitioner - run telehealth clinic due to prolonged episodes of bleeding gums. Patient is asking to see the provider as soon as possible as he is on his lunch break and needs to get back to work.
Dana / Daniel Cortez - Patient Report: (Dana / Daniel) Cortez is a 25-year-old who requested a visit at this nurse practitioner run telehealth clinic due to prolonged episodes of facial pain. Patient is asking to see the provider soon as he / she is in pain. This is his/her first time to the community clinic so there is no chart or lab values to review.
Video 1: Daniel / Dana Cortez (1)
Video 2: Daniel / Dana Cortez (2)
Video 3: Will / Wendy Tobias (1)
Video 4: Will / Wendy Tobias (2)
Student Resources:
Pre- Work: Students complete two hours of online pre-work before participating in their Simulation experiences. One week before attending the simulation experiences students view an online learning health advocacy with an overview of issues impacting people with disability's access to accessible and acceptable healthcare. Students also complete reflection questions before attending the simulation experiences.
- Health Advocacy Training (TM): Structurally Competent Healthcare for People with Disability
- Health Advocacy: Reflection Questionnaire
Orientation Worksheets: Students were emailed an introductory letter and an Orientation worksheet one week before the simulation experience. These documents provided instructions and preliminary information.
Simulation Day Orientation: Faculty utilized orientation sheets to inform students of learning objectives, timing, and tasks involved in the IPE simulations. Orientation sheets are below.
Implementation & Logistics:
Student Recruitment: DNP, dentist, and pharmacy students were grouped into interprofessional teams of three. The SIM-IPE replaced eight DNP project hours for students (2 h of online pre-work and 6 h of SIM-IPE) as well as ten clinical hours for dentistry and pharmacy students.
Student Scheduling: Dentistry and Pharmacy students were assigned to the interprofessional team based on their clinical rotation day and DNP students self-selected on to a team based on their work and class schedule.
SP / Facilitator Scheduling: SPs and facilitators were then assigned to and IPE simulation experience based on their availability and case. Below is an example of schedule.
Student Evaluations: The SIM-IPE lasted 3 hours and was composed of a student prebrief, patient encounter, care plan development, patient education, and student debriefing. Students participated in SIM-IPE either over Zoom for telehealth experiences or in-person for clinic experiences. Each step of Sim-IPE was outlined, then methods of students' evaluation included: completion of a pre-test survey on self-competency in CPBs; answering embedded quizzes throughout learning modules, participating in recorded debriefing sessions based on the IPEC Competencies and care for underserved communities; and completion of a post-test survey on post-self-competency in CPBs.
Future Goals:
Expand healthcare professions: Future iterations plan to include nutrition, physical therapy, and social work students. We would also like to measure CPBs over time, which could inform us whether CPBs are transferred to clinical practice.
Expand Implementation: Suggestions for future implementations includes financial support from each professions' department chair, accounting for facilitators' time in workload and calculating the cost for the SIM-IPE on a per student basis with funding following each student from their respective healthcare programs.
Expand number of cases: As more professions join the simulations the simulation cases will be broadened to represent the range of healthcare experienced by underserved communities, including people with disabilities.
Expand SP employment opportunities: Employment of SPs is a major goal of the IPE Simulations. We aim to expand the number of SPs employed as well as the number of times the program is run each year.
Faculty and Staff Contact Information
Dr. Susan Kilroy PhD, RN, CHSE: Endowed Professor for Healthcare Simulation and Innovation. Villanova University, M. Louise Fitzpatrick College of Nursing (susan.l.kilroy@villanova.edu)
Dr. Blase Brown MS, DDS: Director, Small Group Facilitation, Clinical Associate Professor, Oral Medicine and Diagnostic Sciences. University of Illinois Chicago, College of Dentistry (bpbrown@uic.edu)
Dr. Beth Marks PhD, RN, FAAN: Research Associate Professor, Disability and Human Development. University of Illinois Chicago, College of Applied Health Sciences (bmarks1@uic.edu)
Chris Karczmar MFA: Program Coordinator University of Illinois Chicago, College of Nursing. (karczmar@uic.edu)
Dr. Khatija Noorullah MPH, MS, MEd: Clinical Assistant Professor, Division of Prevention and Public Health Sciences. University of Illinois Chicago (knoorula@uic.edu)
Questions:
If you have questions or would like more information on the IPE Simulation project you can fill out this survey and post questions / comments.
Funding
Funding for this project is ongoing and provided by:
- University of Illinois Chicago IPE Steering Committee Research Grant, Interprofessional Practice and Education Funding.
- University of Illinois Chicago Dean's Faculty Catalyst Award.
- UIC College of Dentistry’s Division of Prevention & Public Health Sciences.
- Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion, The Healthy Brain Initiative Award #1 NU58DP006782-01-00 supported the development of this website. Contents are solely the responsibility of the authors and do not represent the official views of CDC.
- Partnering to Transform Health Outcomes With Persons With Intellectual and Developmental Disabilities (PATH-PWIDD) Funded by the U.S. Department of Health and Human Services, Administration for Community Living.
- Villanova University, Fitzpatrick College of Nursing. Kreider Endowed Professor Funding.