Abstract:

Introduction:
Interdisciplinary communication gaps contribute significantly to medical malpractice cases. Despite recommendations to enhance interprofessional education (IPE) in healthcare, there needs to be more emphasis on this aspect in healthcare education. The challenges of fostering IPE have intensified in the post-pandemic era, where virtual settings dominate. Recognizing the need for virtual IPE improvement, three local medical institutions initiated a collaborative venture involving health professions representing 7 different disciplines. Collectively, they introduced an IPE Simulation Day with the primary emphasis on students collaborating in a virtual setting to address the difficulties faced by the standardized patient (SP) in resolving a complex case. The students also met with an SP representing the patient’s family member to explain disposition options and provide recommendations, emphasizing each student's discipline by recognizing the importance of the patient’s perspective. This study aims to evaluate student perceptions of the virtual simulation encounter and peer-led debrief through qualitative analysis and thematic review of student free-response answers in an online survey.

Methods:
Participants included 908 students from clinical nutrition, medicine, nursing, physical therapy, physician assistant, and social work schools. Students discussed the case with the SP from their disciplines’ unique perspectives as a collaborative team via a virtual platform. Following the encounter, each team underwent 10 minutes of peer debriefing using the scripted tool built on best-practice debriefing principles. A post-survey was administered to evaluate student perspectives on the simulation and peer-led debrief. Inductive content analysis was used for coding and elucidating themes in the data. Themes came from the Society for Simulation in Healthcare Simulation Dictionary and the Interprofessional Education Collaborative 2023 Draft Glossary of Terms. Themes were additionally differentiated as either promoters, where the student referred to the theme positively, or barriers, where the student referred to the theme negatively. Two coders established intercoder reliability by independently coding the first ten responses, then meeting to discuss thematic differences and come to an agreement. After this, the two coders independently coded the remaining responses and met again to alleviate non-alignments.

Results:
Person-centered care, shared mental models, and metacognition were, respectively, the most common of the 18 total promoters found. The most common of the 14 barriers to learning in the simulation included, respectively, no new skills learned, timeliness, and the importance of all team members. Overall, 1792 (91.1%) of the 1966 themes were promoters.

Discussion:
Our findings suggest that virtual interprofessional simulations were generally successful in aiding students in developing a shared mental model, practicing person-centered care, and facilitating individual self-reflection (metacognition). Thematic analysis further highlighted the significance of specific adjustments, such as a meticulous focus on including the appropriate number of students per discipline, which will be pivotal in enhancing the fidelity of future IPE simulations. Moreover, the thematic analysis unveiled a pervasive belief among learners across all professions that conducting IPE sessions virtually using a peer-led debriefing model was valuable.

Keywords:

Peer-led debrief, interprofessional education, virtual simulation, standardized patient.