Abstract:

Background: An estimated 44,000 to 98,000 hospital deaths can be attributed to preventable medical error. A recurring feature of preventable medical error is decentralized and fragmented care delivery. Educational institutions that are producing future healthcare practitioners have an obligation to produce graduates that enter the workforce with effective decision-making skills and experience in collaborative practice. The use of high-quality technology, including high-fidelity human patient simulation (HPS), in an inter-professional setting can provide students with realistic scenarios that they will encounter in the workplace. It is expected that the integration of high-quality technology in an inter-professional curriculum will further reduce the chance of medical error and, therefore, positively impact the resulting emotional and economic costs of these preventable errors in society. To assess the benefits of inter-professional labs with high-fidelity HPS we developed an inter-professional practice lab that integrated high-fidelity HPS for 5th year (P3) Doctor of Pharmacy students enrolled in PHP 515, Professional Practice Laboratory, and Senior Bachelor of Science Nursing students enrolled in NUR 464, Advanced Medical/Surgical Clinical Rotations.

Methods: Third professional year (P3) pharmacy students and fourth year (Senior) nursing students, together in the inter-professional practice laboratory, were assigned to groups (1:1) pharmacy/ nursing. Students were given a pre-lab presentation reviewing interpretation of clinical lab values pertinent to patient care. Each group of six students then work on a standard interactive simulated training case using a high-fidelity patient simulator. After finishing the training exercise the students were allowed to participate in a survey. The focus of the survey was to examine student’s attitudes and confidence after participation in their inter-professional practice lab using high-fidelity HPS.

Results: Students assigned to the inter-professional practice lab had better learning outcomes when compared to a control group of pharmacy students alone. Improved understanding of patient care and confidence in decision making was also improved in students assigned to the inter-professional practice lab. Both groups reported benefits in decision making skills, understanding of lab values and overall confidence after case-based learning using the high-fidelity HPS. Students’ comments reported a desire for more simulation exercises/ cases. Students viewed working with the patient simulator as “real-life” practice in a safe environment. All students also reported a strong desire for additional patient simulation labs.

Conclusions: The integration of high-fidelity HPS into the professional practice lab for Doctor of Pharmacy students improved understanding of patient care and student confidence. The inter-professional practice lab encouraged Doctor of Pharmacy students and Bachelor of Nursing students to actively integrate knowledge of their disciplines and practice cooperative decision making. Based on this experience, we plan to develop and implement additional inter-professional practice labs that will use high-fidelity HPS to facilitate active learning, enhancing team-building and improve inter-professional clinical decision making.