An Interprofessional Education Program Featuring Simulated Patient Encounters for Medical, Nursing, and Pharmacy Students: A Review of Significance within an Era Teamwork Training Models

Introduction: Based on research that revealed the poor state of patient safety in the U.S. health care system, the Institute of Medicine drafted a landmark report titled To Err is Human: Building a Safer Health System. Attention to the value of training providers to work effectively in teams as a strategy for increasing safety was a major theme in this report and in all the action that followed its publication. Training programs teaching teamwork and interprofessional or interdisciplinary understanding are now given the title Interprofessional Education (IPE), and early training in IPE is one of the most effective ways to make teamwork instrumental to improving patient safety. Objective: Can an IPE intervention for medical, nursing, and pharmacy students alter student attitudes, knowledge, skills, team performance, and/or team outcomes in a direction conducive to improving teamwork? Methods: Analysis of survey data gathered from students in University of North Carolina health affairs schools (medicine, nursing, and pharmacy), to evaluate the change in student attitudes toward their colleagues in other disciplines, students' knowledge of teamwork in the clinical setting, students' skills in teamwork activities, understanding of the teamwork process and the shared mental model, and team outcomes and performance following an IPE intervention by testing change over two simulated patient encounters Results: Survey data analysis revealed statistically significant changes in attitudes about other health care professionals in medical, nursing, and pharmacy students among almost all of the attitude variables assessed. The data regarding the knowledge of students about teamwork and how to run through a clinical scenario with respect to seven teamwork multiple choice questions was not conclusive. Surveys in which students assessed their teammates across disciplines after initial and second simulated patient encounters were also inconclusive, and appropriate statistical analysis to mine these data further was beyond the scope of this paper. Finally, survey data from observers of students' teamwork process skills, understanding of a shared mental model, and teamwork outcomes and performance show significant inter-encounter change in a few key areas after students had been exposed to IPE. Conclusion: This study's demonstration of statistically significant change in student attitudes following an IPE intervention suggest that this program may be a model for IPE to fulfill the goals of improved patient safety through improved teamwork. Although at present little evidence shows how IPE can be effectively incorporated into undergraduate health care curricula, the evidence presented in this paper will add to this growing field of research and, the investigators hope, will spur the implementation of more projects. Creating a cultural shift in the U.S. health care system can most efficiently and effectively be accomplished through starting to train the youngest members of that system to acquire a mindset that embraces the necessarily changing set of values and attitudes. This study is encouraging for advocates of supporting teamwork improvement through IPE, and for moving such training to an earlier point in the training of health care providers. Going forward, studies of program interventions should be more robust, including long-term evaluative studies to assess actual patient safety outcomes resulting from student training in IPE. This is the intended endpoint of these trainings, and currently it is very difficult to assess how trainings such as these are influencing the long term goals of improving patient safety, changing the health system culture, and making health care less fragmented.Master of Public Healt