Implementing a Interprofessional Clinical Simulation Experience for Medical and Psychiatric Nurse Practitioner Students: Addressing the Turf War

Introduction and Purpose: Patients with mental illness require multidisciplinary teams to address co-morbidities such as diabetes mellitus, hypertension, substance use and poor social functioning. A barrier to teamwork and communication use in clinical practice is the hierarchical beliefs of both professions in preserving and developing their power status. Nurse practitioners (NPs) and physicians have considerable strife nationally in regards to NPs’ scopes of practice impeding teamwork among these professions. By working together, psychiatric NPs and psychiatrists can improve patients’ experiences with mental health care and decrease service duplications that increase costs. Both groups would benefit from learning with, from and about each other. Psychiatric NPs and psychiatrists bring their own expertise to clinical care; so addressing these hierarchical issues in a safe learning environment can improve teamwork skills. The purpose of this study is to test the feasibility of teaching and evaluating teamwork and communication skills through an interprofessional clinical simulation experience.

Approach: A clinical simulation experience was developed for and tested with medical and psychiatric NP students. Each team included one student from each program (n= 5 teams). The experience occurred over a 4 week time period for each team. Teams learned about teamwork and communication concepts and discussed preconceptions about each other’s roles in a synchronized moderated online session.  A standardized patient (SP) presented as an individual with bipolar disorder and multiple medical conditions. Teams interviewed the SP, participated in an online planning session to implement health education together at the second SP visit. Following each SP visit, teams attended debriefing sessions to discuss their experience. Two faculty members measured teamwork and communication skills with the Performance Assessment for Communication and Teamwork Tool Set.

Results and Implications: Interrator reliability was established between the two scorers. Preliminary results on feasibility and scores will be presented. Lessons learned from the experience and plans for incorporating this experience into Doctor of Nursing Practice and medical students’ curriculum will be addressed. By providing a safe venture for students in the psychiatric NP program and medical school to learn teamwork skills, it prepares students for clinical experiences with patients who have mental illness.