Interprofessional Disaster Simulation
Purpose: The Institute of Medicine (IOM, 2002, 2010) calls for more interprofessional collaboration between nurses and physicians. At the same time, organizations who accredit health professional education call for more interprofessional education. The need for interprofessional collaboration becomes very apparent during disaster when time is critical, health professionals must work together, and all are under high stress. The purpose of this presentation is to describe the process whereby nurse educators constructed a curriculum and prepared senior nursing students to participate in an interprofessional simulated disaster event (SDE).
Background: The XXXX University School of Medicine (SM) has conducted a one-day (SDE) for senior medical students for several years. After a trial run which included students from nursing, pharmacy, and allied health, representatives from the four schools met to debrief and consider the possibility of members from all four schools, (about 400 senior students) participating in a similar event.
Description: The school of nursing’s planning committee reviewed literature to identify core competencies. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication model were applied to all activities requiring time-critical decision-making skills. On-line modules were to be completed prior to the SDE which used power-point presentations with voice-over, hyperlinks, videos, and pre- and post-testing of student knowledge. Evaluations were completed following SDE.
Four competencies identified as suitable to teach and evaluate during an SDE, focused on communication skills, chain of command, disaster safety principles, and ethical issues. The didactic portion was presented in three on-line modules. Module one was a general introduction to disaster care. Module two included Team STEPPS, disaster triage, public health response, decontamination, bomb blast injuries, and mental health. Module three was school specific and nursing’s module contained: emergency management systems, crush injuries, cholinergic crisis, and cardiac crisis. The live, in-person experience was four hours and covered decontamination, three emergency patients using high-fidelity patient simulators, and a simulated home invasion with gunshot and blunt trauma victims. Four days were necessary to accommodate 402 students.
Outcomes: An on-line course and SDE can prepare student nurses to be effective communicators during a real event. Having faced an ethical dilemma in simulation can increase students’ awareness of the potential moral issues faced during a disaster. This introduction to disaster safety principles inspired some to join an emergency response team.
Conclusions: Students from all four schools demonstrated improvement in both content knowledge and attitudes regarding a critical event response. An SDE should be part of nursing students’ educational experience. At any time any nurse may need to respond to a disaster and being prepared with the appropriate knowledge and skills will help to ensure good patient care and patient safety. To determine sustained improvement in knowledge, attitudes, and skills further research is required.