There is ongoing evidence that ineffective interprofessional collaboration and communication continue to compromise safety and quality of patient care. Interprofessional simulation-based team training (ISBTT) has gained popularity for cultivation of collaboration, yet despite widespread implementation, reports of ineffective interprofessional collaboration impeding patient safety remain frequent. One possible reason may be that current ISBTT programs are based on ?work-as-imagined? rather than ?work-as-done?, they aspire to an ideal rather than being grounded in the reality of actual teams. In every day work interprofessional collaboration is frequently hampered by conflict, power and hierarchy. Thus, to truly improve patient safety, ISBTT must recognize this reality and shift towards teaching about power dynamics and build skills such as perspective taking and conflict management to navigate these challenges. Debriefing after simulation is the element of ISBTT that has the greatest likelihood of creating change, since most learning from ISBTT is thought to occur as a result of reflection and discussion during the debriefing. Evidence-based guidelines for interprofessional debriefing are currently lacking. Our own data examining current practices in ISBTT programs indicate that debriefing most commonly focuses on knowledge and task performance by individual team members rather than on how and why collaboration occurs successfully. We propose a structured approach to debriefing after ISBTT that will help team members become aware of team processes and dynamics and develop essential teamwork skills that they will apply across different collaborative contexts. Such awareness and skills will result in a culture shift that will lead to improved interprofessional collaboration across clinical contexts, and hence, patient safety. Through a combination of qualitative and quantitative research methodologies we target the following specific aims: 1) To develop and test an innovative approach to debriefing after interprofessional team training that emphasizes team dynamics and processes and promotes development of collaborative skills, using design research methodology; 2) Evaluate the impact of the novel debriefing approach on team performance and attitudes towards teamwork among participants in ISBTT; and 3) Examine the effect of the novel debriefing approach on patient safety culture and communication-related patient safety events across our institution. We will measure the impact on team performance, attitudes towards teamwork, and perceptions of patient safety culture using previously validated instruments. In addition, we will examine whether frequency of patient safety events related to interprofessional collaboration decline after our intervention using existing event recording mechanisms. Our project will lead to evidence-based guidelines for debriefing interprofessional simulations that can be adapted to other training and practice contexts to improve interprofessional collaboration, and thereby patient safety. In addition, the studies in this proposal will further our understanding of interprofessional dynamics and how they influence the efficacy of team training.
There is ongoing evidence that ineffective interprofessional collaboration and communication continue to compromise safety and quality of patient care. Simulation-based team training has the potential to improve interprofessional collaboration, but thus far the reported impact of such training programs has been limited. Our project aims to create structured guidelines for debriefing interprofessional simulations to include learning about team dynamics and development of collaborative skills, thereby improving collaboration and decreasing patient safety events.
