The integration of simulation into healthcare education has been shown to enhance clinical performance and promote teamwork. This program was designed to bring together obstetrical and neonatal staff to provide an opportunity to practice the management of high-risk, low-occurrence events in a low stress environment without risk of patient harm.

Proposed change:

In emergency clinical situations staff from diverse backgrounds are expected to function as a cohesive team, but are rarely provided the opportunity to learn and practice together outside the clinical area. A primary goal of this program was to transition this silo education to an interprofessional approach. The planning team envisioned individual experts from different professions and departments practicing clinical skills and teamwork roles and behaviors as a team.

Implementation, outcomes and evaluation:

An interprofessional, interdepartmental planning team assembled to review the simulation literature, identify target participants, establish program goals and educational methodology, develop clinical scenarios, identify and obtain supplies and equipment, and test the process before program implementation.  Cognitive, technical and behavioral objectives were included. Simulations were videotaped to facilitate team debriefing, identified as a critical component of the learning process. To maximize participant comfort and learning, the planning team started each simulation recognizing the expertise of all participants, reinforcing the non-evaluative aspect of the sessions and emphasizing the opportunity to learn together in a safe environment.  Initially, medical and nursing administrative support for the simulation program ensured interprofessional staff attendance. Participation in a simulation cemented staff’s ongoing enthusiasm and desire to participate.  Participants completed evaluations and this evaluative feedback was reviewed with recommendations being incorporated into subsequent sessions.  As the simulation planning team worked to increase the complexity and realism of clinical scenarios, staff voiced increased satisfaction in their evaluations. Scenarios included precipitous birth, postpartum hemorrhage, maternal arrest, perimortem cesarean section, and term and preterm resuscitation.

Implications for nursing practice:

Interprofessional simulation provides an opportunity for nursing to take a leadership role in facilitating collegial relationships with-in the planning team as well as the teams participating in the simulations. Lessons learned in simulation regarding clinical management and team communication are used by participants in subsequent patient care situations. Simulation also provides an excellent forum for research as one explores creative, effective approaches to learning in a simulated environment and most importantly the translation of this learning to the patient care environment and its impact on decreasing patient harm.

Keywords:

Simulation, interprofessional, neonatal, obstetrics