Development of a Simulation-Based Interprofessional Teamwork Assessment Tool.
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ABSTRACT: Background
The Accreditation Council for Graduate Medical Education (ACGME) Milestone projects required each specialty to identify essential skills and develop means of assessment with supporting validity evidence for trainees. Several specialties rate trainees on a milestone subcompetency related to working in interprofessional teams. A tool to assess trainee competence in any role on an interprofessional team in a variety of scenarios would be valuable and suitable for simulation-based assessment.Objective
We developed a tool for simulation settings that assesses interprofessional teamwork in trainees.Methods
In 2015, existing tools that assess teamwork or interprofessionalism using direct observation were systematically reviewed for appropriateness, generalizability, adaptability, ease of use, and resources required. Items from these tools were included in a Delphi method with multidisciplinary pediatrics experts using an iterative process from June 2016 to January 2017 to develop an assessment tool.Results
Thirty-one unique tools were identified. A 2-stage review narrowed this list to 5 tools, and 81 items were extracted. Twenty-two pediatrics experts participated in 4 rounds of Delphi surveys, with response rates ranging from 82% to 100%. Sixteen items reached consensus for inclusion in the final tool. A global 4-point rating scale from novice to proficient was developed.Conclusions
A novel tool to assess interprofessional teamwork for individual trainees in a simulated setting was developed using a systematic review and Delphi methodology. This is the first step to establish the validity evidence necessary to use this tool for competency-based assessment.
SUBMITTER: Bismilla Z
PROVIDER: S-EPMC6476092 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background:This study explores how interprofessional simulation-based education (IPSE) can contribute to a change in students' understanding of teamwork and professional roles. A series of 1-day training sessions was arranged involving undergraduate nursing and medical students. Scenarios were designed for practicing teamwork principles and interprofessional communication skills by endorsing active participation by all team members. Methods:Four focus groups occurred 2-4 weeks after the training. Thematic analysis of the transcribed focus groups was applied, guided by questions on what changes in students' understanding of teamwork and professional roles were identified and how such changes had been achieved. Results:The first question, aiming to identify changes in students' understanding of teamwork, resulted in three categories: realizing and embracing teamwork fundamentals, reconsidering professional roles, and achieving increased confidence. The second question, regarding how participation in IPSE could support the transformation of students' understanding of teamwork and of professional roles, embraced another three categories: feeling confident in the learning environment, embodying experiences, and obtaining an outside perspective. Conclusions:This study showed the potential of IPSE to transform students' understanding of others' professional roles and responsibilities. Students displayed extensive knowledge on fundamental teamwork principles and what these meant in the midst of participating in the scenarios. A critical prerequisite for the development of these new insights was to feel confident in the learning environment. The significance of how the environment was set up calls for further research on the design of IPSE in influencing role understanding and communicative skills in significant ways.
| S-EPMC5806292 | biostudies-literature
Project description:INTRODUCTION:Interprofessional learning (IPL) is increasingly recognized as a promising strategy in addressing the burgeoning challenges in healthcare. Its assessment remains to be perplexing and requires accurate measurements. Thus, this study intended to develop a valid and reliable reflective tool in assessing IPL as a Continuing Professional Development (CPD) outcome. METHODS:A one-group post-posttest pre-experimental design with tool development was employed to establish the validity and reliability of the "Inventory of Reflective Vignette-Interprofessional Learning" (IRV-IPL). This tool was developed from an extensive literature review and designed with three segments to assess interprofessional competencies before, after, and what if scenarios using vignettes. After it was validated by education experts (n = 5) and written consent forms were signed by the participants, the IRV-IPL was pilot tested among healthcare professionals (n = 10) for analysis and improvement. During the actual implementation, it was administered to healthcare professionals (n = 45) who participated in a university-provided CPD event. Collected data underwent validity and reliability testing. RESULTS:IRV-IPL generated excellent internal consistency (? = 0.98), and across all segments of collaboration (? = 0.96), coordination (? = 0.96), cooperation (? = 0.96), communication (? = 0.97), and commendation (? = 0.98). Items exhibited significantly positive large correlations (r > 0.35, p < 0.05) in all segments showing beneficial measures for postdictive validity in recalling prior interprofessional competencies, and predictive validity in estimating interprofessional learning as an outcome of CPD and alternative interventions. CONCLUSION:This study provided a piece of groundwork evidence on the use of IRV-IPL as a reflective assessment tool for interprofessional learning in CPD contexts. Further studies are essential to explore the educational utility of IRV framework in crafting relevant assessments and to establish construct validity of IRV-IPL using exploratory and confirmatory factor analyses.
| S-EPMC6347297 | biostudies-literature
Project description:Simulation-based teamwork trainings are considered a powerful training method to advance teamwork, which becomes more relevant in medical education. The measurement of teamwork is of high importance and several instruments have been developed for various medical domains to meet this need. To our knowledge, no theoretically-based and easy-to-use measurement instrument has been published nor developed specifically for simulation-based teamwork trainings of medical students. Internist ward-rounds function as an important example of teamwork in medicine.The purpose of this study was to provide a validated, theoretically-based instrument that is easy-to-use. Furthermore, this study aimed to identify if and when rater scores relate to performance.Based on a theoretical framework for teamwork behaviour, items regarding four teamwork components (Team Coordination, Team Cooperation, Information Exchange, Team Adjustment Behaviours) were developed. In study one, three ward-round scenarios, simulated by 69 students, were videotaped and rated independently by four trained raters. The instrument was tested for the embedded psychometric properties and factorial structure. In study two, the instrument was tested for construct validity with an external criterion with a second set of 100 students and four raters.In study one, the factorial structure matched the theoretical components but was unable to separate Information Exchange and Team Cooperation. The preliminary version showed adequate psychometric properties (Cronbach's ?=.75). In study two, the instrument showed physician rater scores were more reliable in measurement than those of student raters. Furthermore, a close correlation between the scale and clinical performance as an external criteria was shown (r=.64) and the sufficient psychometric properties were replicated (Cronbach's ?=.78).The validation allows for use of the simulated teamwork assessment scale in undergraduate medical ward-round trainings to reliably measure teamwork by physicians. Further studies are needed to verify the applicability of the instrument.
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| S-EPMC5863499 | biostudies-literature
Project description:Background: The so called ABCDE approach (Airway-Breathing-Circulation-Disability-Exposure) is a golden standard of patient assessment. The efficacy of using cognitive aids (CA) in resuscitation and peri-arrest situations remains an important knowledge gap. This work aims to develop an ABCDE CA tool (CAT) and study its potential benefits in patient condition assessment.Methods: The development of the ABCDE CAT was done by 3 rounds of modified Delphi method performed by the members of the Advanced Life Support Science and Education Committee of the European Resuscitation Council. A pilot multicentre study on 48 paramedic students performing patient assessment in pre-post cohorts (without and with the ABCDA CAT) was made in order to validate and evaluate the impact of the tool in simulated clinical scenarios. The cumulative number and proper order of steps in clinical assessment in simulated scenarios were recorded and the time of the assessment was measured.Results: The Delphi method resulted in the ABCDE CAT. The use of ABCDE CAT was associated with more performed assessment steps (804: 868; OR?=?1.17, 95% CI: 1.02 to 1.35, p?=?0.023) which were significantly more frequently performed in proper order (220: 338; OR?=?1.68, 95% CI: 1.40 to 2.02, p?<?0.0001). The use of ABCDE CAT did not prolong the time of patient assessment.Conclusion: The cognitive aid for ABCDE assessment was developed. The use of this cognitive aid for ABCDE helps paramedics to perform more procedures, more frequently in the right order and did not prolong the patient assessment in advanced life support and peri-arrest care.
| S-EPMC7718686 | biostudies-literature
Project description:BACKGROUND: Health professions education programs use simulation for teaching and maintaining clinical procedural skills. Simulated learning activities are also becoming useful methods of instruction for interprofessional education. The simulation environment for interprofessional training allows participants to explore collaborative ways of improving communicative aspects of clinical care. Simulation has shown communication improvement within and between health care professions, but the impacts of teamwork simulation on perceptions of others' interprofessional practices and one's own attitudes toward teamwork are largely unknown. METHODS: A single-arm intervention study tested the association between simulated team practice and measures of interprofessional collaboration, nurse-physician relationships, and attitudes toward health care teams. Participants were 154 post-licensure nurses, allied health professionals, and physicians. Self- and proxy-report survey measurements were taken before simulation training and two and six weeks after. RESULTS: Multilevel modeling revealed little change over the study period. Variation in interprofessional collaboration and attitudes was largely attributable to between-person characteristics. A constructed categorical variable indexing 'leadership capacity' found that participants with highest and lowest values were more likely to endorse shared team leadership over physician centrality. CONCLUSION: Results from this study indicate that focusing interprofessional simulation education on shared leadership may provide the most leverage to improve interprofessional care.
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Project description:'Background: Large-scale sequencing of cDNA (RNA-seq) has been a boon to the quantitative analysis of transcriptomes. A notable application of significant biomedical relevance is the detection of changes in transcript usage between experimental conditions. For example, discovery of pathological alternative splicing may allow the development of new treatments or better management of patients. From an analysis perspective, there are several ways to represent RNA-seq data to unravel differential transcript usage, such as annotation-based exon-level counting, differential analysis of the `percent spliced in'' measure or quantitative analysis of assembled transcripts. The goal of this research is to compare and contrast current state-of-the-art methods, as well as to suggest improvements to commonly used workflows. Results: We assess the performance of representative workflows using synthetic data, and explore the effect of using non-standard counting bin definitions as input to a state-of-the-art inference engine (DEXSeq). Although the canonical counting provided the best results overall, several non-canonical approaches were as good or better in specific aspects, and most counting approaches outperformed the evaluated event- and assembly-based methods. We show that an incomplete annotation catalog can have a detrimental effect on the ability to detect differential transcript usage in transcriptomes with few isoforms per gene, and that isoform-level pre-filtering can considerably improve the false discovery rate (FDR) control. Conclusion: Count-based methods generally perform well in detection of differential transcript usage. Controlling the FDR at the imposed threshold is difficult, mainly in complex organisms, but can be improved by pre-filtering of the annotation catalog.'
2015-07-23 | E-MTAB-3766 | biostudies-arrayexpress
Project description:IntroductionSubstance misuse is a critical social and health care issue, and learning how to effectively screen for misuse and perform a brief intervention is useful for all health care professions. As an intercollegiate, interprofessional group, we developed a mechanism for delivering interprofessional education (IPE) using SBIRT (screening, brief intervention, and referral for treatment) as a tool to identify potential substance misuse.MethodsA total of 1,255 students from nursing, pharmacy, medicine, physician assistant, social work, dietetics, and occupational therapy programs participated in the training and evaluation of this IPE experience over 2 academic years. The training incorporated asynchronous SBIRT training, in-person student role-plays, and a standardized patient (SP) interaction.ResultsA significant majority of participants indicated that this IPE experience enhanced their interprofessional skills (91%), was useful for interprofessional development (79%), was relevant to their career (92%), and would benefit their clients (93%). Faculty debrief sessions supported the efficacy of SBIRT as a platform for IPE.DiscussionStudents believed that utilizing SBIRT as an interprofessional learning experience enhanced their overall educational experience and assisted with developing interprofessional relationships and that team-based care would lead to improved patient outcomes. Faculty found this learning activity to be effective in developing student insight regarding future professional peers and patient interview skill development through role-plays with peers and SPs.
| S-EPMC7485913 | biostudies-literature
Project description:To reduce the incidence of hypoxic brain injuries among newborns a national cardiotocography (CTG) education program was implemented in Denmark. A multiple-choice question test was integrated as part of the program. The aim of this article was to describe and discuss the test development process and to introduce a feasible method for written test development in general.The test development was based on the unitary approach to validity. The process involved national consensus on learning objectives, standardized item writing, pilot testing, sensitivity analyses, standard setting and evaluation of psychometric properties using Item Response Theory models. Test responses and feedback from midwives, specialists and residents in obstetrics and gynecology, and medical and midwifery students were used in the process (proofreaders n?=?6, pilot test participants n?=?118, CTG course participants n?=?1679).The final test included 30 items and the passing score was established at 25 correct answers. All items fitted a loglinear Rasch model and the test was able to discriminate levels of competence. Seven items revealed differential item functioning in relation to profession and geographical regions, which means the test is not suitable for measuring differences between midwives and physicians or differences across regions. In the setting of pilot testing Cronbach's alpha equaled 0.79, whereas Cronbach's alpha equaled 0.63 in the setting of the CTG education program. This indicates a need for more items and items with a higher degree of difficulty in the test, and illuminates the importance of context when discussing validity.Test development is a complex and time-consuming process. The unitary approach to validity was a useful and applicable tool for development of a CTG written assessment. The process and findings supported our proposed interpretation of the assessment as measuring CTG knowledge and interpretive skills. However, for the test to function as a high-stake assessment a higher reliability is required.
| S-EPMC5437628 | biostudies-literature
Project description:AimThe aim of the study reported here was to address the need to assess and train teamwork and non-technical skills in the context of Resuscitation. Specifically, we sought to develop a tool that is feasible to use and psychometrically sound to assess team behaviours during cardiac arrest resuscitation attempts.MethodsTo ensure validity, reliability, and feasibility, the Observational Skill based Clinical Assessment tool for Resuscitation (OSCAR) was developed in 3 phases. A review of the literature leading to initial tool development was followed by an assessment of face and content validity, and finally a thorough reliability assessment, using Cronbach's α to assess internal consistency and intraclass correlation to assess inter-rater reliability.ResultsOSCAR was developed methodically, and tested for face and content validity. Cronbach's α results ranged from 0.736 to 0.965 demonstrating high internal consistency, and intraclass correlation results ranged from 0.652 to 0.911, all of which are strongly significant and indicate good inter-rater reliability.ConclusionOn the basis of our results, we conclude that OSCAR is psychometrically robust, scientifically sound, and clinically relevant. We have developed the Observational Skill-based Clinical Assessment tool for Resuscitation (OSCAR) for the assessment of non-technical skills in Resuscitation teams. We propose the use of this tool in simulation and real Cardiac Arrest Resuscitation attempts to assess, guide and train non-technical skills to team members, to improve patient safety and maximise the chances of successful resuscitation.
| S-EPMC3121958 | biostudies-literature