Creating psychological safety in interprofessional simulation for health professional learners: a scoping review of the barriers and enablers

Lackie, Kelly; Hayward, Kathryn; Ayn, Caitlyn; Stilwell, Peter; Lane, Jennifer; Andrews, Cynthia; Dutton, Tanya; Ferkol, Doug; Harris, Jonathan; Houk, Shauna; Pendergast, Noel; Persaud, D. David; Thillaye, Jacquie; Mills, Jessica; Grant, Shannan; Munroe, Andrew

doi:10.1080/13561820.2022.2052269

Cited by 20 publications

(21 citation statements)

References 56 publications

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“…Participants worked through information gathering from a nurse, interviewing the parent, completing a feeding assessment and providing recommendations, and providing feedback to the otolaryngologist. The simulation was developed in line with the eleven criteria proposed in the Healthcare Simulation Standards of Best Practice for Simulation Design [ 21 ] (Table 1 ) and in consideration of the barriers and enablers of psychological safety in healthcare simulation [ 22 ]. Two of the research team members with expertise in pediatric feeding (Authors 1 and 2) collaborated to design the simulation.…”

Section: Methods and Resultsmentioning

confidence: 99%

Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study

et al. 2023

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Simulation enables learners to practice new skills in a supportive environment. Largely driven by the COVID-19 pandemic, simulation via telepractice, i.e., telesimulation, has emerged. Viable delivery of telesimulation requires consideration of the adaptations needed to conduct simulation via telepractice. The aim of this study was to design and pilot test the feasibility of using telesimulation to provide training in infant feeding management. An iterative process was used across four phases: (1) simulation design, (2) telesimulation adaptations, (3) user testing, feedback, and modifications, and (4) user testing of modified simulation, feedback, and final modifications. During Phases 1 and 2, team members worked together to design and test telepractice adaptations for a simulation experience. During Phases 3 and 4, the telesimulation was pilot tested with a group of speech pathologists, with feedback sought via open-ended survey questions and/or an optional focus group. Manifest content analysis was used to interpret user feedback. In Phase 2, several adaptations were explored to optimize telesimulation delivery and engagement, including Zoom® functions (e.g., ‘spotlighting,’ digital backgrounds) and supplementary video/auditory files. There were 11 participants across Phases 3 and 4. Specific feedback centered around simulation preparation and structure, session practicalities, supports for realism, Zoom® functions, group dynamics, participants’ experiences, and future enhancements. An overall list of recommendations for telesimulation was generated. Telesimulation for feeding management was considered feasible and participant feedback was favorable. Further research is required to investigate if the learner outcomes of telesimulation are comparable to in-person simulation for infant feeding management.

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Section: Methods and Resultsmentioning

confidence: 99%

Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study

et al. 2023

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“…A review by Lackie et al [ 32 ] discusses how to embed the psychological safety of participants into simulation activities. According to their findings, safety enablers include pre-briefing-debriefing by trained facilitators, no-blame culture and structured evidenced-based simulation designs, while barriers include hierarchy among/between professions, being observed, and fear of making mistakes [ 32 ]. As mentioned, patient actors were used in three studies in their simulation events [ 14 , 17 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of simulation-based cardiopulmonary and respiratory case training experiences on interprofessional teamwork: A systematic review

O’Brien¹,

Bevan²,

McCuaig³

et al. 2023

Can J Respir Ther

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Objective Simulation exercises are meant to provide an opportunity for health care workers to improve teamwork and develop clinical skills, among other goals. The objective of this systematic review was to determine whether simulated interdisciplinary activities in the health care or clinical setting improve interprofessional collaboration within health care teams that include respiratory therapists. Methods A systematic literature search of PubMed, EMBASE and CINAHL was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline to find relevant articles using both MeSH terms and free text. Filters were applied to include English-language studies; studies published within the last 10 years (2011–2021), and studies involving human participants. Studies were excluded if they did not assess the effects of simulation on aspects of teamwork, if participants were students, if teams did not include respiratory therapists, or if the training did not involve a simulated experience in a clinical setting. The search identified 312 articles, 75 of which were advanced to full-text review. Of those 75 articles, 62 were eliminated for not measuring teamwork in their outcomes. Two articles were excluded for being published before 2011, and one was eliminated for poor methodological quality. A risk of bias assessment using standardized qualitative and quantitative appraisal checklists was conducted on each of the remaining 10 studies selected for inclusion. Results A total of 10 studies met the inclusion criteria for this review (eight prospective, pre/post-test studies and two prospective observational studies). Randomization and participant/researcher blinding were not present in the majority of the studies and reporting bias was also found to be a concern throughout the literature. However, all of the studies noted increased teamwork scores post-intervention, though they differed in the tools used to evaluate this outcome. Discussion Collectively, the studies included in this review demonstrate that interprofessional simulation experiences including respiratory therapists enhance teamwork. The various tools used to assess change in teamwork had evidence of validity; however, studies varied in their outcomes measured, making quantitative analysis inappropriate. There are challenges involved in creating and assessing these simulations, particularly when performed within a clinical environment, which make it difficult to fully remove bias from the study design. It is unclear if the teamwork improvement can strictly be attributed to the simulation intervention or in part due to the general development of team members’ competencies throughout the research period. Additionally, the permanency of the effects cannot be evaluated based on the studies included and could be an area for future research. Conclusion Despite the limited number and met...

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“…Concerns have been raised about how hierarchy and professional position may negatively impact psychological safety, learning, and perceptions of other professions in interprofessional simulations [ 38 ]. In the present simulation the other professional, an anesthesiologist, was played by an actor and the purpose of the simulation was for students to directly confront and address professional hierarchies through PD/SU.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal study on the impact of simulation on positive deviance through speaking up

Violato¹

2022

Can J Respir Ther

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Background Students reported positive learning outcomes during a simulation study addressing compliance and speaking up. Purpose Investigate if the impacts of the simulation had a lasting effect on participants after moving into practice. Method Semi-structured interviews focusing on memory of the study, psychological impacts, educational impacts, professional impacts, and experiences in practice were conducted with Advanced Care Paramedics (3) and Respiratory Therapists (7) between 19 and 24 months after the original study. Discussion Participants indicated the simulation helped them develop the skill and confidence to speak up, preparing them to speak up in practice. Primary findings included: ( i ) the importance of experience for speaking up, ( ii ) the benefit of high-impact simulation, and ( iii ) the importance of simulation training. Conclusions Simulation for speaking up should occur early. Conducting high-impact simulations for speaking up is a practical and actionable intervention that appears to enhance confidence, ability, and likelihood of speaking up in practice.

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Creating psychological safety in interprofessional simulation for health professional learners: a scoping review of the barriers and enablers

Cited by 20 publications

References 56 publications

Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study

Development and Pilot Testing of Telesimulation for Pediatric Feeding: A Feasibility Study

Effects of simulation-based cardiopulmonary and respiratory case training experiences on interprofessional teamwork: A systematic review

A longitudinal study on the impact of simulation on positive deviance through speaking up

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