ISBARR Huddle: First-Year Medical Students Managing Critical Hypoglycemia as an Interprofessional Team

Abstract

Introduction Recognizing a patient requiring urgent or emergent care and initiating evaluation and management must include elements that support teams working and thinking together. Although team communication strategies exist, a standardized approach for communicating about patients with urgent or emergent conditions is lacking. This simulation was designed to provide first-semester medical students with the opportunity to deliberately practice the foundational teamwork skills required to think as a team while caring for a patient with critical hypoglycemia. Methods Students were introduced to a team huddle that was structured using ISBARR (identify, situation, background, assessment, recommend, recap) to assist in synthesizing gathered information and arriving at a diagnosis and associated care plan. Students practiced in small groups with faculty coaches and then applied the skills learned to two cases of a patient with critical hypoglycemia followed by debriefing. Results Two hundred eight first-semester medical students participated in the simulation course across three campuses. We surveyed a single campus subset of 172 students. One hundred thirty-three students completed a postevent survey. The majority felt that the difficulty of the simulation was appropriate for their educational level (94%) and that the training would be applicable to real-life clinical events (76%) and would improve the quality and safety of care (100%). Survey comments highlighted teamwork and the use of the ISBARR huddle communication tool. Discussion The course provided first-semester medical students with standardized practice of a team-based approach using huddle communication to advance patient care.

“Asking for help is a strength”—how to promote undergraduate medical students’ teamwork through simulation training and interprofessional faculty

“…Its particular use for improving interprofessional teamwork skills is growing ( Chakraborti et al, 2008 ; Fox et al, 2018 ; Hamilton et al, 2019 ; Sivarajah et al, 2019 ; Challa et al, 2021 ; Pollard and Tombs, 2022 ) and even undergraduate students with limited clinical exposure seem to be able to manage the considerable cognitive load involved in simulation-based learning ( Tremblay et al, 2023 ). However, despite teamwork being part of the learning objectives, it is frequently taught in the context of managing medical emergencies in teams ( Weller, 2004 ; Jowsey et al, 2020 ; Rouse et al, 2022 ; Soellner et al, 2022 ) or in an individual setting (e.g., a single learner performing a tasks with multiple simulated team members and being debriefed individually, Schober et al, 2019 ). The importance of teamwork skills in healthcare expands beyond emergencies and comes into play in a variety of tasks and team settings such as medical board meetings, handovers or preparing a child for general anesthesia ( Foster and Manser, 2012 ; Schmutz and Manser, 2013 ; DiazGranados et al, 2014 ; Taplin et al, 2015 ; Kolbe and Boos, 2019 ; Schmutz et al, 2019 ; Mendoza et al, 2021 ; Walsh et al, 2021 ; Zajac et al, 2021 ; Greilich et al, 2023 ).…”