Collaborative behaviours and professional culture traits in real-time interprofessional clinical simulation

Interprofessional education (IPE) has been proposed as a method of creating a collaborative practice ready workforce in healthcare. Postulated benefits of the technique include improving communication between professional groups, which in turn should help to prevent serious untoward events and ultimately improve patient outcomes. Critics of the method have cited poorly designed IPE as a method of reinforcing physician power, and argued there is a paucity of data linking undergraduate IPE to tangible benefits in a patient-facing setting. Simulation has been increasingly used as a method for delivery of IPE, with positive outcomes cited by students and educators alike. Virtual Patients and avatars have been recently used as a delivery method for healthcare education, but there is a paucity of data regarding their use in IPE. Simulation is not a panacea for IPE, many simulations focus on the acute phase of care naturally excluding healthcare professions who are not involved in those situations. Findings from acute simulations may not apply to sub-acute scenarios. Method A sub-acute real-time virtual patient simulation was designed then delivered to educators (n=6) and undergraduate students (n=33) from the professions of medicine, nursing, pharmacy and physiotherapy. Qualitative data was gathered according to a constructivist paradigm using unstructured observation of in-simulation behaviour, focus groups and semi-structured interviews. Results Data was analysed according to Braun and Clarke’s method of thematic analysis. Five themes were identified: technology, education, collaboration, intrinsic behaviours and stereotyping. The simulation was educationally successful with participants citing improved recognition of the skills of other professional groups, and improved physiological and pharmacological knowledge. The real-time aspect of the simulation improved clinical reasoning and forced students to make prescribing decisions, which was cited as beneficial for future practice. The sub-acute nature of the simulation resulted in participants hyper-observing their VP to the detriment of patient care. Good levels of collaboration, team working and appropriate communication were facilitated but students were observed to subconsciously selfstereotype. Conclusions Sub-acute real-time virtual patient simulation appears to be a valid method of enabling students to learn with and from one another. It conveys benefit over traditional educational methods such as classroom-based, problem-based and experiential learning as students are given full responsibility for patient care with little supervision. Self-stereotyping amongst students suggests that students convey stereotypical messages about their own profession to others. This may aid team-building in the undergraduate setting, but if these stereotypical views are transferred to advanced practice, there may be detrimental consequences for team formation and patient care