Designing SIM for interprofessionalism, diversity and inclusivity.

1. Designing SIM for interprofessionalism, diversity and inclusivity. Sharla King, University of Alberta Amy Nakajima, Bruyere Continuing Care & SIM-one Darin Abbey, Centre for Interprofessional Clinical Simulation Learning We have no financial conflicts of interest to disclosure. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/.

2. A Place of Mind We believe that participants in this workshop are: • Respectful of their colleagues • Open and committed to learning from, with, and about each other • Committed to ensuring a safe learning environment • Dedicated to excellence in healthcare Abbey, King & Nakajima

3. This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA. Abbey, King & Nakajima

4. Objectives By the end of this session, we hope that participants will: • be able to define Sim-IPE • be aware of frameworks, guidelines and competencies to develop and debrief Sim-IPE • be introduced to tools that evaluate Sim-IPE • have practiced writing and posing competency informed interprofessional questions Abbey, King & Nakajima

5. Introductions Who are you? • Are you a Simulationist? • Are you an Interprofessional Educator? • Are you a Quality Improvement/Quality Assurance person? • All of the above? • Other______________? Who are we? Abbey, King & Nakajima

6. What is IPE? "Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes" World Health Organization (WHO). (2010). Framework for action on interprofessional education & collaborative practice. Abbey, King & Nakajima

7. Canadian Interprofessional Competency Framework The Canadian Interprofessional Health Collaborative Abbey, King & Nakajima

8. Accessible… www.ipcontherun.ca Abbey, King & Nakajima

9. Simulation is… “An educational strategy in which a particular set of conditions are created or replicated to resemble authentic situations that are possible in real life. Simulation can incorporate one or more modalities to promote, improve, or validate participant’s performances.” Gaba, D. M. (2004). The future vision of simulation in healthcare. Quality and Safety in Healthcare, 13(supplement 1), i2-i10 Abbey, King & Nakajima

10. What is Simulation? Abbey, King & Nakajima

11. What is Sim-IPE? “Sim-IPE is designed for individuals to learn about, from, and with each other to enable effective collaboration and improve health outcomes.” INACSL Standards of Best Practice: Simulation-enhanced interprofessional education Abbey, King & Nakajima

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13. INACSL Sim- IPE Criteria • Conduct Sim-IPE based on a theoretical or a conceptual framework. • Utilize best practices in the design and development. • Recognize and address potential barriers. • Devise an appropriate evaluation plan. INACSL Standards of Best Practice: Simulation-enhanced interprofessional education Abbey, King & Nakajima

14. What is Simulation? Abbey, King & Nakajima

15. Prepare: Key Principles of Designing • Identify learning need • Determine professions • Identify co-lead(s) from all professions • Determine level of learners • Define learning objectives (uni and interprof) • Determine resources/sim modality • Check your baggage Abbey, King & Nakajima

16. Barriers and Enablers Barriers Enablers Support from leadership IPE ‘champions’ Knowledge/understanding of IPE Shared vision and equal status regardless of position Org structures to facilitate/coordinate IPE • Logistics – scheduling • Lack of buy-in • Rigid/condensed curriculum • Disparity in # of learners • Different assessment requirements Abbey, King & Nakajima

17. What is Simulation? Abbey, King & Nakajima

18. Canadian Interprofessional Competency Framework The Canadian Interprofessional Health Collaborative Abbey, King & Nakajima

19. Pre-brief • Ensure clarity regarding objectives • Identify roles and responsibilities • Review clinical resources • Introduce tools • Orientate participants to the facility and equipment • Articulate the ground rules • Discuss the social contract • Contribute to psychological safety Abbey, King & Nakajima

20. A Place of Mind We believe that participants in this workshop are: • Respectful of their colleagues • Open and committed to learning from, with, and about each other • Committed to ensuring a safe learning environment • Dedicated to excellence in healthcare Abbey, King & Nakajima

22. Psychological Safety “Most of us think that simulation and learning is a cognitive challenge, but when your skills are on display it can shift to an identity threat.” Jenny Rudolf http://simulationpodcast.com/2016/10/14/ep-4-safe-container-simulation/ Abbey, King & Nakajima

23. Psychological Safety is: • a person’s sense that the immediate environment is safe for interpersonal risk taking • that trying out new ways of talking or acting will not be ridiculed • that mistakes will be worked on together as a source of learning Edmondson A. Admin Sci Quart 1999; 44:350–383 Abbey, King & Nakajima

24. How do you buildPsychological Safety? Share and be true to logistics. Frame the work as a learning opportunity. Acknowledge and embrace shared fallibility. Model positive regard and genuine curiosity. Building a psychologically safe workplace: Amy Edmondson at TEDxHGSE http://simulationpodcast.com/2016/10/14/ep-4-safe-container-simulation/ Abbey, King & Nakajima

25. What is Simulation? Abbey, King & Nakajima

26. Canadian Interprofessional Competency Framework The Canadian Interprofessional Health Collaborative Abbey, King & Nakajima

27. Assessment of Team-based Competencies • Align with learning objectives • Assessment of performance by participants: • Individuals: • Knowledge • Technical skills • Team-based competencies • “The Team” as a collective • Team-based competencies Lingard, L. (2014, October). Collective Competence: Adapting our concept of competence to healthcare teams. Royal College of Physicians and Surgeons of Canada Abbey, King & Nakajima

28. What is Simulation? Abbey, King & Nakajima

29. What is Debriefing? Abbey, King & Nakajima

30. Advocacy-Inquiry Abbey, King & Nakajima

31. Let’s Practice:First just watch… Watch Abbey, King & Nakajima

32. IPE: Mission Possible Please watch the following scene again this time with an eye for interprofessional competencies.Listen with an ear for questions you might ask about role clarity, team functioning and collaborative leadership. Then please prepare and practice asking question competency informed interprofessional questions. Abbey, King & Nakajima

33. Canadian Interprofessional Competency Framework The Canadian Interprofessional Health Collaborative Abbey, King & Nakajima

34. Advocacy-Inquiry Abbey, King & Nakajima

35. Evaluation? Abbey, King & Nakajima

36. Evaluation: Kirkpatrick Adapted Level 1: Reaction Level 2a: Attitudes/Perceptions Level 2b: Knowledge/Skills Level 3: Behavioural Change Level 4a: Organizational Change Level 4b: Benefit to Patients Reeves, S. et. al (2015) . J Interprof Care, 2015; 29(4): 305–312. Abbey, King & Nakajima

37. Prelicensure Simulation-Enhanced Interprofessional Education:A Critical Review of the Research Literature The Kirkpatrick levels were reported in: 1) Learners’ reaction = 63% of studies 2a) Modification of attitudes and perceptions = 69% of studies 2b) Acquisition of knowledge/skill= 28% of studies 3) Change in behaviour = 6% of studies 4a) Change in organizational practice= 0% of studies 4b) Benefits to patients/clients= 0% of studies 5) Return on investment/system impact= 0% of studies Palaganas, J. et al.(2016) Sim Healthcare 11:404Y418. Abbey, King & Nakajima

38. Prelicensure Simulation-Enhanced Interprofessional Education:A Critical Review of the Research Literature “The quality and rigor of the existing literature is inadequate to confidently determine factors that affect learning through simulation enhanced IPE. We suggest that more rigorous research criteria be included in future studies.” Palaganas, J. et al.(2016) Sim Healthcare 11:404Y418. Abbey, King & Nakajima

39. Interprofessional Education and Practice Guide No. 3: EvaluatingInterprofessional Education • Think about evaluation early • Have a clear evaluation question • Be clear with the purpose • Consider the learning outcomes • Frame evaluation using theory • Employ an evaluation model • Select an evaluation design (i.e. quantitative, qualitative, mixed) Reeves, S. et. al (2015) . J Interprof Care, 2015; 29(4): 305–312. Abbey, King & Nakajima

40. How to evaluate self… www.ipcontherun.ca Abbey, King & Nakajima

41. How to evaluate self… www.ipcontherun.ca Abbey, King & Nakajima

42. Objectives Review At the end of this session, we hope that you: • can now define Sim-IPE • are aware of frameworks, guidelines and competencies to develop and debrief Sim-IPE • have been introduced to tools that evaluate Sim-IPE • have practiced writing and posing competency informed interprofessional questions. Abbey, King & Nakajima

43. Evaluation • Who are you? • Are you a Simulationist? • Are you an Interprofessional Educator? • Are you a Quality Improvement/Quality Assurance person? • All of the above? • Other______________? • What are your take away learning's and actions from attending this workshop? • What, if anything surprised you? Abbey, King & Nakajima

44. Thank you.We invite your questions, feedback and collaboration. Sharla King, University of Albertasjk1@ualberta.caAmy Nakajima, Bruyere Continuing Care & SIM-oneanakajima@sim-one.ca Darin Abbey, Centre for Interprofessional Clinical Simulation Learningdarin.abbey@viha.ca

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