The Effect of a Sepsis Interprofessional Education Using Virtual Patient Telesimulation on Sepsis Team Care in Clinical Practice: Mixed Methods Study

Abstract

Background Improving interprofessional communication and collaboration is necessary to facilitate the early identification and treatment of patients with sepsis. Preparing undergraduate medical and nursing students for the knowledge and skills required to assess, escalate, and manage patients with sepsis is crucial for their entry into clinical practice. However, the COVID-19 pandemic and social distancing measures have created the need for interactive distance learning to support collaborative learning. Objective This study aimed to evaluate the effect of sepsis interprofessional education on medical and nursing students’ sepsis knowledge, team communication skills, and skill use in clinical practice. Methods A mixed methods design using a 1-group pretest-posttest design and focus group discussions was used. This study involved 415 undergraduate medical and nursing students from a university in Singapore. After a baseline evaluation of the participants’ sepsis knowledge and team communication skills, they underwent didactic e-learning followed by virtual telesimulation on early recognition and management of sepsis and team communication strategies. The participants’ sepsis knowledge and team communication skills were evaluated immediately and 2 months after the telesimulation. In total, 4 focus group discussions were conducted using a purposive sample of 18 medical and nursing students to explore their transfer of learning to clinical practice. Results Compared with the baseline scores, both the medical and nursing students demonstrated a significant improvement in sepsis knowledge (P<.001) and team communication skills (P<.001) in immediate posttest scores. At the 2-month follow-up, the nursing students continued to have statistically significantly higher sepsis knowledge (P<.001) and communication scores (P<.001) than the pretest scores, whereas the medical students had no significant changes in test scores between the 2-month follow-up and pretest time points (P=.99). A total of three themes emerged from the qualitative findings: greater understanding of each other’s roles, application of mental models in clinical practice, and theory-practice gaps. The sepsis interprofessional education—particularly the use of virtual telesimulation—fostered participants’ understanding and appreciation of each other’s interprofessional roles when caring for patients with sepsis. Despite noting some incongruities with the real-world clinical practice and not encountering many sepsis scenarios in clinical settings, participants shared the application of mental models using interprofessional communication strategies and the patient assessment framework in their daily clinical practice. Conclusions Although the study did not show long-term knowledge retention, the use of virtual telesimulation played a critical role in facilitating the application of mental models for learning transfer and therefore could serve as a promising education modality for sepsis training. For a greater clinical effect, future studies could complement virtual telesimulation with a mannequin-based simulation and provide more evidence on the long-term retention of sepsis knowledge and clinical skills performance.

An Explorative Review of the Constructs, Metrics, Models, and Methods for Evaluating e-Learning Performance in Medical Education

“…The next popular term used to operationalize performance is effectiveness. Twenty-seven authors operationalized performance by evaluating the effectiveness of e-learning in improving students' knowledge and application of key concepts or skills (Afonso, Kelekar and Alangaden, 2020, Alfieri et al, 2023, Burnette et al, 2009, Chang Chan et al, 2019, Chua et al, 2022, Corrigan et al, 2012, Darici et al, 2021, Falusi et al, 2022, Felder, Fauler and Geiler, 2013, Fuji and Galt, 2015, Helms et al, 2009, Kukolja-Taradi et al, 2008, Nomura et al, 2021, Onyeka et al, 2020, Puljak and Sapunar, 2011, Saiboon et al, 2021, Schilling et al, 2006, Schneider, Albers and Muller-Mattheis, 2015, Sichani, Mobarakeh and Omid, 2018, Sikkens et al, 2018, Smolle, Prause and Smolle-Jüttner, 2007, Viteri Jusué et al, 2020, Waugh et al, 2022, Webb and Choi, 2014, Yilmaz et al, 2021. Terms such as module effectiveness, learning effect, and simply effectiveness were clustered together regardless of their terminology.…”

Multiuser immersive virtual reality simulation for interprofessional sepsis recognition and management

“…Multiple clinicians taking part collaboratively in the same immersive VR scenario, which we term multiuser virtual reality (MUVR), utilized it on a very limited basis for interprofessional training. 18,19 Interprofessional…”

“…VR can provide the necessary realism to impact individual and team clinical competency and SA, defined as the timely recognition of, interpretation as, and response to patient decompensation. Multiple clinicians taking part collaboratively in the same immersive VR scenario, which we term multiuser virtual reality (MUVR), utilized it on a very limited basis for interprofessional training 18,19 . Interprofessional VR has yet to focus on pediatric sepsis.…”

Virtual Adaptation of Empathetic Communication Training for Pediatric Interns

“…7,8 Telesimulation and virtual education were identified as a useful innovations during this time in multiple venues and educational fields. [8][9][10][11][12][13][14] The communication skills curriculum for pediatric interns described above was converted from an in-person to telesimulation curriculum to ensure continuation of the curriculum despite the pandemic. The change to virtual learning provided an opportunity to study learner perceptions of telesimulation communication training and thus evaluate an alterative for training programs seeking to implement communication training.…”