Innovative Interprofessional Simulation: Adult Nursing and Paramedic Science Students


When did you first introduce the innovation?

More than 24 months ago

Please describe the innovation you have developed

Interprofessional simulation training sessions have been developed at the University of the West of England by a team including the University’s Clinical Skills Technicians and Adult Nursing and Paramedic Science Lecturers. The sessions have involved participants in the final year of the Adult Nursing and Paramedic Science degrees.

This involved developing scripted medical emergency scenarios, initially in the setting of a simulated home environment using a ‘live’ patient; attendance by an ambulance crewed by student paramedics; assessment, treatment and transport to a high-fidelity, simulated emergency department environment, where ongoing care is provided by student nurses.

The student paramedics respond to the simulation house in real-time in an ambulance. Upon arrival at the house they have to manage the ‘live’ patient acting out a scripted medical emergency. For example, 56 year-old male with chest pains or 36 year-old female with difficulty breathing.

They will assess the patient and then provide simulated treatment prior to loading them into the ambulance. The care is monitored by paramedic lecturers and recorded for feedback via CCTV systems. On route to the mock Emergency department, they will radio through a pre-alert and send a 12-lead ECG to the department via telemetry. On arrival at the ED, the student paramedics hand-over the patient to up to four groups of student nurses.

The patient then transforms into four high-fidelity simulation mannequins in the four-bedded ED. Thus allowing larger numbers of students to participate. Ongoing care is monitored by nursing lecturers and recorded and played live to other students in lecture rooms for peer review. University technicians provide scripted verbal responses and adjust vital signs according to treatments.

What prompted you to develop this innovation?

Emergency care is a multidisciplinary, multi-specialty environment where health professionals work but rarely train together. The lack of team training can result in misunderstanding and an under-appreciation of each other’s role, particularly when time-critical emergencies occur.

In your view, what is it about this innovation that makes it different/important?

This is true interprofessional learning; using scenarios in realistic simulated environments. Very different from sitting alongside each other in a classroom environment listening to the same lecture. This is real-world learning blended with technology enhanced learning. We think it is this combination that makes it innovative and important.

To what extent does your innovation make use of existing approaches, resources or technologies?

Both the Adult Nursing programme and Paramedic Science Programme use clinical simulation routinely as part of their programmes. Both programmes utilise technology enhanced learning. By combining the two it significantly increases the learning potential for the participants.

To what degree has this innovation led to changes in education or clinical practice?

The simulations allow participants to respond to medical emergencies without the pressure they will experience in placement. The time-critical nature of emergency care and the limited scope of practice for students mean that it is not always possible for them to be fully involved in care when in placement.

These simulations allow the student to fully immerse themselves into the scenario and make autonomous clinical decisions without the risk of serious consequences should they get it wrong.

What evidence do you have of the impact of the innovation?

To assess the impact of this learning intervention, the participants were asked to provide feedback on how they felt it might make a difference in their clinical practice. A number of themes were explored. It can be seen from the participant evaluation that they felt the interprofessional simulation would have an effect on their clinical practice; it would allow them to be more confident when managing acutely unwell patients and would improve their ability to communicate effectively with other professions.

Overwhelmingly the participants also said they felt they would benefit from further interprofessional simulation.

To what degree has the innovation been disseminated in your organisation or elsewhere?

The innovation has been disseminated through the University’s internal publications and has attracted interest from other Allied Health Professions wanting to get involved. It has the potential to involve, for example, student radiographers and student social workers.

Externally, the design team have presented the innovation at both national and international simulation conferences.

Please provide details of any plans you have to disseminate the innovation in the future.

We are keen to continue to disseminate and share this successful innovation and are continually looking at conferences where we can share this.