PROMOTING EFFECTIVE COMMUNICATION AND COLLABORATION USING VIRTUAL SIMULATION

Rationale/Background:According to the Joint Commission, the leading cause of sentinel events in the United States is miscommunication. The Institute of Medicine (IOM), the Agency for Health Care Research and Quality (AHRQ) and the Joint Commission recommend using simulation as a tool to promote effective communication and collaboration skills using the adopted  Introduction, Situation, Background, Assessment and Request/Read Back (I-SBAR) and  Concerned, Uncomfortable, Unsafe, Scared (CUUS) tools. 

Approach:In an on-line Leadership course, a simulation focusing on communication and collaboration skills was developed by faculty. The simulation scenarios consist of a potential sentinel event requiring immediate provider response, thus necessitating a phone call and a courageous conversation from a primary nurse (student) to a health care provider (faculty).

Students are assigned readings and AHRQ TeamStepps videos, incorporating the use of I-SBAR and CUUS; and are sent one of three scenarios and reflection questions prior to the simulation. Initially the simulations were conducted via phone with one student; later sessions were conducted in a web conferencing room with three students and one faculty member. Prior to the simulation students assign themselves roles – primary nurse, secondary nurse or recorder. The faculty pay close attention to the students’ use of I-SBAR and CUS. If the students fail to provide the necessary information, faculty coach the students.

 Following the simulation there is an immediate structured debriefing led by the faculty. Students submit a written reflection of the activity, which focuses on the experiential learning during the courageous conversations simulation.

Outcomes Achieved:  The use of the web conferencing system promotes social presence as students work collaboratively to communicate effectively and courageously with a provider about an eminent patient care situation. Faculty involvement, debriefing and reflection support teaching and cognitive presence.

Conclusion:   This online experiential learning activity, Courageous Conversations,  demonstrates the use of simulation using web-based technology to promote effective communication skills in high stake events. The structured activity promotes social, teaching and cognitive presence.