Students' Views on Simulation-Based Interprofessional Training in Gynecologic Oncology Palliative Care: A Qualitative Study

Abstract

Aim: In this study, it was aimed to determine the opinions, ideas and suggestions of the students about simulation-based interprofessional training in gynecologic oncology palliative care.

Material and Methods: The research is a qualitative study using an interpretative phenomenological approach. The study was conducted between April 2017-May 2017. The sample consisted of 28 students (eight nursing, eight nutrition-dietician, eight social worker and four medical students). The data were collected through four focus group interviews with socio-demographic information form and semi-structured focus group interview question directive. The data obtained from the interviews were evaluated by using the inductive approach and content analysis method.

Results: Themes resulting from interviews with students (1)“the team approach in the provision of palliative care services”; (2)“Interprofessional Training in Gynecologic Oncology Palliative Care”; (3)“Simulation-Based Interprofessional Training in Gynecologic Oncology Palliative Care”. In the research, the students stated that understood the importance of teamwork and interdisciplinary training in palliative care; in order to learn the roles and responsibilities of other professions, to work as a team, and to provide patient safety and patient-centered care, it is necessary to have a simulation-based interprofessional training. The students emphasized the necessity of simulation-based interprofessional training in undergraduate education curricula. It was determined that students had the opportunity to improve their mistakes, correct their mistakes/errors and realized their professional professionalism with simulation applications.

Conclusion: It is recommended that trainers and students be encouraged and integration into undergraduate education curricula to use interprofessional simulation practices in the training of health professionals.

Keywords

• Nursing research,gynecology,cancer,qualitative research,palliative care,healthcare team,simulation training

Jinekolojik Onkoloji Palyatif Bakımda Simülasyona Dayalı Mesleklerarası Eğitime Yönelik Öğrencilerin Görüşleri: Nitel Çalışma

Abstract

Amaç: Bu araştırmada, jinekolojik onkoloji palyatif bakımda simülasyona dayalı mesleklerarası eğitime yönelik öğrencilerin görüş, düşünce ve önerilerinin belirlenmesi amaçlanmıştır.

Gereç ve Yöntemler: Araştırmada nitel araştırma yöntemlerinden yorumlayıcı fenomenolojik yaklaşım kullanılmıştır. Araştırmanın uygulaması Nisan 2017 - Mayıs 2017 tarihleri arasında gerçekleştirilmiştir. Araştırmanın örneklemini 28 öğrenci (sekiz hemşirelik, sekiz beslenme ve diyetetik, sekiz sosyal hizmet ve dört tıp öğrencisi) oluşturmuştur. Araştırmanın verileri sosyo-demografik bilgi formu ve yarı yapılandırılmış odak grup görüşmesi soru yönergesi ile dört odak grup görüşmesi yapılarak toplanmıştır. Görüşmelerden elde edilen veriler tümevarım yaklaşımı ve içerik analizi yöntemi kullanılarak değerlendirilmiştir.

Bulgular: Öğrenciler ile yapılan görüşmeler sonucunda ortaya çıkan temalar (1) “palyatif bakım hizmeti sunumunda ekip yaklaşımı” (2) “Mesleklerarası Jinekolojik Onkoloji Palyatif Bakım Eğitimi”; (3) “Simülasyona Dayalı Mesleklerarası Jinekolojik Onkoloji Palyatif Bakım Eğitimi” olarak sıralanmıştır. Araştırmada öğrenciler, palyatif bakımda ekip çalışması ve mesleklerarası eğitimin önemini daha iyi anladıklarını; diğer mesleklerin rol ve sorumluluklarını öğrenebilmek, ekip olarak çalışabilmek, hasta güvenliğini ve hasta merkezli bakımın sağlayabilmek için simülasyona dayalı mesleklerarası eğitimin gerekli olduğunu belirtmişlerdir. Öğrenciler lisans eğitim müfredatlarında simülasyona dayalı mesleklerarası eğitimin gerekliliğini vurgulamışlardır. Öğrencilerin simülasyon uygulamaları ile teorik eğitimde öğrendiklerini daha iyi pekiştirdikleri, yanlışlarını/hatalarını düzeltme fırsatı buldukları, mesleki profesyonelliklerinin farkına vardıkları belirlenmiştir.

Sonuç: Sağlık profesyonellerinin eğitiminde mesleklerarası simülasyon uygulamalarının kullanımı için eğiticilerin ve öğrencilerin teşvik edilmesi ve lisans eğitim müfredatlarına entegre edilmesi önerilmektedir.

Keywords

• Hemşirelik araştırması,jinekoloji,kanser,niteleyici araştırma,palyatif bakım,sağlık ekibi,simülasyon eğitimi

References

1. 1. Uslu Sahan F, Terzioglu F. Nurses’ knowledge and practice toward gynecologic oncology palliative care. J Palliat Care Med. 2017; 7(4): 1-5.
2. 2. Terzioglu F, Uslu Sahan F. Palliative care in gynecologic cancers. J Palliat Care Med. 2016; 6(5): 25–7.
3. 3. Terzioğlu F, Uslu F. Palliative care to the cancer patient : Turkish nurses’ perspectives. J Palliat Care Med. 2015; 5(4): 1–5.
4. 4. nationalconsensusproject.org [Internet]. Pittsburgh: National Consensus Project Quality Palliative; 2013 [Updated: 2018 May 24; Cited: 2019 July 8]. Available from: https://www.nationalcoalitionhpc.org /wp-content/uploads/2017/04/NCP_Clinical_ Practice_Guidelines_3rd_Edition.pdf.
5. 5. sgo.org [Internet]. 2013 [Updated: 2013 January 4; Cited: 2019 July 8]. Available from: https://www.sgo.org/choosing-wisely/.
6. 6. kanser.org [Internet]. Ankara; 2010 [Son güncelleme tarihi: 10 Aralık 2010; Erişim tarihi: 8 Temmuz 2019]. Erişim adresi: https://www.kanser.org/saglik/userfiles/file/11Mayis2011/turkiye_onkoloji_hizmetleri_kitapcik.pdf.
7. 7. Silbermann M, Fink RM, Min S-J, Mancuso MP, Brant J, Hajjar R, et al. Evaluating palliative care needs in Middle Eastern Countries. J Palliat Med. 2015; 18(1): 18–25.
8. 8. Turgay G, Kav S. Turkish healthcare professionals’ views on palliative care. J Palliat Care. 2012; 28: 267–73.

9. 9. Bahçecioğlu Turan G, Türben Polat H, Mankan T. İntörn hemşi̇reli̇k öğrenci̇leri̇ni̇n palyati̇f bakima i̇li̇şki̇n görüşleri̇. Cumhur Hemşirelik Derg. 2017; 6(2): 54–60.
10. 10. Çitil R, Okan İ, Önder Y, Çeltek NY, Süren M, Bulut YE, et al. Tıp Fakültesi öğrencilerinin palyatif bakım konusundaki farkındalıklarının değerlendirilmesi. Bezmialem Science. 2018; 6(2): 100–7.
11. 11. Efstathiou N, Walker WM. Interprofessional, simulation-based training in end of life care communication: A pilot study. J Interprof Care. 2014; 28(1): 68–70.
12. 12. Fineberg IC, Wenger NS, Forrow L. Interdisciplinary education: Evaluation of a palliative care training intervention for pre-professionals. Acad Med. 2004; 79(8): 769–76.
13. 13. Starks H, Coats H, Paganelli T, Mauksch L, Van Schaik E, Lindhorst T, et al. Pilot study of an interprofessional palliative care curriculum: Course content and participant-reported learning gains. Am J Hosp Palliat Med. 2018; 35(3): 390–7.
14. 14. Prelock PA, Melvin C, Lemieux N, Melekis K, Velleman S, Favro MA. One Team – patient, family, and health care providers: An interprofessional education activity providing collaborative and palliative care. Semin Speech Lang. 2017; 38(5): 350–9.
15. 15. caipe.org [Internet]. Fareham: Centre for the Advancement of Interprofessional Education; 2017 [Updated: 2017 August 4; Cited: 2019 July 8]. Available from: https://www.caipe.org/resources/ publications/caipe-publications/caipe-2017-interprofessional-education-guidelines-barr-h-ford-j-gray-r-helme-m-hutchings-m-low-h-machin-reeves-s.
16. 16. Lefebvre K, Wellmon R, Ferry D. Changes in attitudes toward interprofessional learning and collaboration among physical therapy students following a patient code simulation scenario. Cardiopulm Phys Ther J (Lippincott Williams Wilkins). 2015; 26(1): 8–14.
17. 17. Birk TJ. Principles for developing an interprofessional education curriculum in a healthcare program. J Healthc Commun. 2017; 2(1): 1–4.
18. 18. Wilhaus J, Palaganas J, Manos J, Anderson J, Cooper A, Jeffries P, et al. ssih.org [Internet]. 2013 [Updated: 2013 March 8; Cited: 2019 July 8]. Available from: http://www.ssih.org/LinkClick.aspx?fileticket=FQKvyEp0k3k=&portalid=48.
19. 19. Costello M, Huddleston J, Atinaja-Faller J, Prelack K, Wood A, Barden J, et al. Simulation as an effective strategy for interprofessional education. Clin Simul Nurs. 2017; 13(12): 624–7.
20. 20. Baker C, Pulling C, McGraw R, Dagnone JD, Hopkins-Rosseel D, Medves J. Simulation in interprofessional education for patient-centred collaborative care. J Adv Nurs. 2008; 64(4): 372–9.
21. 21. Pınar G. Simulation-enhanced interprofessional education in health care. Creat Educ. 2015; 6(17): 1852–9.
22. 22. Jimenez YA, Thwaites DI, Juneja P, Lewis SJ. Interprofessional education: Evaluation of a radiation therapy and medical physics student simulation workshop. J Med Radiat Sci. 2018; 65(2): 1–8.
23. 23. Wang JN, Petrini M. Chinese health students’ perceptions of simulation-based interprofessional learning. Clin Simul Nurs. 2017; 13(4): 168–75.
24. 24. Randall D, Garbutt D, Barnard M. Using simulation as a learning experience in clinical teams to learn about palliative and end-of-life care: A literature review. Death Stud. 2018; 42(3): 172–83.
25. 25. Kotsakis A, Mercer K, Mohseni-Bod H, Gaiteiro R, Agbeko R. The development and implementation of an inter-professional simulation based pediatric acute care curriculum for ward health care providers. J Interprof Care. 2015; 29(4): 392–4.
26. 26. Wagner J, Liston B, Miller J. Developing interprofessional communication skills. Teach Learn Nurs. 2011; 6(3): 97–101.
27. 27. Joekes K, Brown J, Boardman K, Tincknell L, Evans D, Amy Spatz. Hybrid simulation for integrated skills teaching. Int J Clin Ski. 2016; 10(1): 1–5.
28. 28. Cunningham S, Foote L, Sowder M, Cunningham C. Interprofessional education and collaboration: A simulation-based learning experience focused on common and complementary skills in an acute care environment. J Interprof Care. 2018; 32(3): 395–8.
29. 29. Brezis M, Lahat Y, Frankel M, Rubinov A, Bohm D, Cohen MJ, et al. What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel. Isr J Health Policy Res. 2017; 6(1): 1–9.
30. 30. Pastor DK, Cunningham RP, White PH, Kolomer S. We have to talk: Results of an interprofessional clinical simulation for delivering bad health news in palliative care. Clin Simul Nurs. 2016; 12(8): 320–7.
31. 31. Saylor J, Vernoony S, Selekman J, Cowperthwait A. Interprofessional education using a palliative care simulation. Nurse Educ. 2016; 41(3): 125–9.
32. 32. Yıldırım A, Şimşek H. Sosyal bilimlerde nitel araştırma yöntemleri. Ankara: Seçkin Yayınevi; 2018.
33. 33. Jeong H, Othman J. Using interpretative phenomenological analysis from a ralist perspective. The Qualitative Report. 2016; 21(3): 558-70.
34. 34. Collins KM, Onwuegbuzie AJ, Jiao QG. Prevalence of mixed-methods sampling designs in social science research. Evaluation and Research in Education. 2006; 19(2): 83-101.
35. 35. Creswell JW, Miller DL. Determining validity in qualitative inquiry. Theory Into Practice. 2000; 39(3): 124–30.
36. 36. Caylor S, Aebersold M, Lapham J, Carlson E. The use of virtual simulation and a modified TeamSTEPPSTM training for multiprofessional education. Clin Simul Nurs. 2015; 11(3): 163–71.
37. 37. Rutherford-Hemming T, Lioce L. State of interprofessional education in nursing: A systematic review. Nurse Educ. 2018; 43(1): 9–13.
38. 38. Sicat BL, Huynh C, Willett R, Polich S, Mayer S. Interprofessional education in a primary care teaching clinic: Findings from a study involving pharmacy and medical students. J Interprof Care. 2014; 28(1): 71–3.