Fostering Interprofessional Communication through a Telehealth Care Conference
Purpose: Interprofessional (IP) healthcare education and telehealth are contemporary focus areas in higher education. IP education is advocated by accrediting bodies of multiple healthcare disciplines. The need for IP education arose out of high rates of medical errors, which resulted from a lack of interprofessional collaboration. State and federal policies are encouraging the use of telehealth to address vulnerable rural and low-income communities that lack access to comprehensive health care. Telehealth sessions have increased substantially in recent years, including a seven-fold increase for physicians in Minnesota. Increasing use of telehealth in physical therapy has the potential to improve access to services and provide consultations from experts to underserved areas. The purpose of this simulation was to enhance IP team collaboration while using telehealth across three separate IP simulations based upon one standardized patient case in different stages of illness. Simulated settings included an acute MI in the emergency room, CHF in the home health setting, and hospice in long term care. Students from physical therapy participated in the home health simulation with students from occupational therapy, nursing, social work, and medicine. Methods/Description: Prior to the simulation, all students were provided with objectives, discipline specific case scenarios, a video on effective telehealth communication, and an orientation to the facility. An interprofessional patient care conference was completed using WebEx® video conferencing software and standard computer hardware. The patient care conference was completed using standardized actors for the patient and a family member. Students from PT, OT, SW, and nursing were located in one room with the patient while medical students consulted via teleconference from a separate, nearby room. Evidence-based teaching methods of bed-side debriefing, repeat simulation and large group debriefing were incorporated into the simulation. Students completed a post-simulation survey to evaluate the facilitation, interprofessional communication, team skills, and the perceived value of incorporating telehealth. The survey included questions with an ordinal Likert scale (1 strongly disagree, 5 strongly agree) and space for qualitative comments. Results/Outcomes: There were 156 students that participated in the simulation including 52 PT’s, 5 OT’s, 25 nursing, and 74 from medicine. There were four one hour sessions completed. Each session included six groups made up of 2 PT’s, 1 OT, 1 nursing and 5 medical students facilitated by 1-2 interprofessional faculty per group. The students completed the care conference, received immediate feedback and then repeated the care conference. Following the care conference, all students in a session participated in a general debrief session. Survey response rates were 31% for all students while the PT response rate was 27%. Responses of “agree” and “strongly agree” are combined for reporting purposes. Overall respondents felt the simulation was realistic (80% agree & strongly agree), appropriate for their educational level (87%), and improved their interprofessional communication skills (84%) and teamwork (89%). The students valued the interprofessional interaction (91%) more than the telehealth component (80%). Individual physical therapy student responses were also very positive with slightly higher ratings for improved interprofessional communication (86%) and team interaction (100%) along with valuing telehealth at a higher level (93%). Medical students portraying the specialist at a distance felt less involved in the simulation, as reflected in a lower rating on a question about sufficient opportunity to participate ( 32% vs 62% for the overall group). Conclusions/Relevance to the conference theme: A simulated care conference using telehealth provided a unique educational opportunity for interprofessional collaboration and exposure to telehealth consultation. The participants felt the experience increased their interprofessional communication and teamwork although the specialist consultant at a distance felt less involved in the activity. Interprofessional communication and telehealth technology are important skills for future clinicians to practice using this unique simulation experience. This project was funded by a grant from the American Medical Association’s Accelerating Change in Medical Education Consortium program.