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Background Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK. Method Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured. Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures. Results A total of 194 medical and 266 nursing students completed questionnaires. A five-item subset of RIPLS (RIPLS Core ) was used in analysis. In both studies RIPLS Core increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLS Core scores than medical students at one site. Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students. Conclusions Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace. Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect.

Objectives During the SARS-CoV-2 pandemic, clinicians were instructed to move all but emergency consultations to remote means to reduce the spread of the virus. The aim of this study was to evaluate patients’ and clinicians’ experiences of moving to remote means of consultation with their health care professionals during the SARS-CoV-2 pandemic. Methods The study design was a qualitative service evaluation. Twenty-six clinicians and forty-eight patients who met the inclusion criteria consented to be interviewed. Clinician participants were from either medical, nursing, or allied health professional backgrounds. Patients were recruited from diabetes, acute care, and haematology and cancer areas. Data analysis was conducted using a thematic analysis framework. Results Following coding and thematic analysis of the data collected from clinicians, five themes were identified: personal and professional well-being; providing a safe and high-quality experience; adapting to a new way of working; making remote consultations fit for purpose and an awareness of altered dynamics during consultation. Patient data was coded into 3 themes: remote consultation adds value; remote consultation brings challenges and concerns about remote consultation. Conclusions Clinician and patient experiences reported here are reflected in the literature. The study indicates that remote consultation is not suitable for all patients and in all contexts. Whilst maintaining the benefits to patients, remote means of consultation needs organisational support and preparation. A way forward that maintains the benefits whilst addressing concerns seems urgent.

ObjectivesTo investigate nursing and medical students’ readiness for interprofessional learning before and after implementing geriatric interprofessional education (IPE), based on problem-based learning (PBL) case scenarios. To define the optimal number of geriatric IPE sessions, the size and the ratio of participants from each profession in the learner groups, the outcomes related to the Kirkpatrick four-level typology of learning evaluation, students’ concerns about joint learning and impact of geriatric IPE on these concerns. The study looked at the perception of roles and expertise of the ‘other’ profession in interprofessional teams, and students’ choice of topics for future sessions. Students’ expectations, experience, learning points and the influence on the understanding of IP collaboration, as well as their readiness to participate in such education again were investigated.DesignA controlled before–after study (2014/2015, 2015/2016) with data collected immediately before and after the intervention period. Study includes additional comparison of the results from the intervention with a control group of students. Outcomes were determined with a validated ‘Readiness for Interprofessional Learning’ questionnaire, to which we added questions with free comments, combining quantitative and qualitative research methods. The teaching sessions were facilitated by experienced practitioners/educators, so each group had both, a clinician (either geratology consultant or registrar) and a senior nurse.Participants300 medical, 150 nursing students.SettingTertiary care university teaching hospital.ResultsAnalysis of the returned forms in the intervention group had shown that nursing students scored higher on teamwork and collaboration post-IPE (M=40.78, SD=4.05) than pre-IPE (M=34.59, SD=10.36)—statistically significant. On negative professional identity, they scored lower post-IPE (M=7.21, SD=4.2) than pre-IPE (M=8.46, SD=4.1)—statistically significant. The higher score on positive professional identity post-IPE (M=16.43, SD=2.76) than pre-IPE (M=14.32, SD=4.59) was also statistically significant. Likewise, the lower score on roles and responsibilities post-IPE (M=5.41, SD=1.63) than pre-IPE (M=6.84, SD=2.75).Medical students scored higher on teamwork and collaboration post-IPE (M=36.66, SD=5.1) than pre-IPE (M=32.68, SD=7.4)—statistically significant. Higher positive professional identity post-IPE (M=14.3, SD=3.2) than pre-IPE (M=13.1, SD=4.31)—statistically significant. The lower negative professional identity post-IPE (M=7.6, SD=3.17) than pre-IPE (M=8.36, SD=2.91) was not statistically significant. Nor was the post-IPE difference over roles and responsibilities (M=7.4, SD=1.85), pre-IPE (M=7.85, SD=2.1).In the control group, medical students scored higher for teamwork and collaboration post-IPE (M=36.07, SD=3.8) than pre-IPE (M=33.95, SD=3.37)—statistically significant, same for positive professional identity post-IPE (M=13.74, SD=2.64), pre-IPE (M=12.8, SD=2.29), while negative professional identity post-IPE (M=8.48, SD=2.52), pre-IPE (M=9, SD=2.07), and roles and responsibilities post-IPE (M=7.89, SD=1.69), pre-IPE (M=7.91, SD=1.51) shown no statistically significant differences. Student concerns, enhanced understanding of collaboration and readiness for future joint work were addressed, but not understanding of roles.ConclusionsEducators with nursing and medical backgrounds delivered geriatric IPE through case-based PBL. The optimal learner group size was determined. The equal numbers of participants from each profession for successful IPE are not necessary. The IPE delivered by clinicians and senior nurses had an overall positive impact on all participants, but more markedly on nursing students. Surprisingly, it had the same impact on medical students regardless if it was delivered to the mixed groups with nursing students, or to medical students alone. Teaching successfully addressed students’ concerns about joint learning and communication and ethics were most commonly suggested topics for the future.

To develop and pilot a mnemonic to increase the willingness and ability of bedside nurses to contribute to patient reviews in the daily interprofessional ward round. Appreciative inquiry quality improvement study, using ethnographic observations and appreciative inquiry discussions, augmented by quantitative data collection of basic facts. Large (44 beds) critical care unit in the United Kingdom. Interprofessional development and acceptance of mnemonic; successful preparation for pilot; use and usability of mnemonic; improvements in bedside nurses’ contributions to ward round discussions (frequency and focus). Interprofessional development of a usable and useful mnemonic was successful, pilot implementation showed promising levels of take up and acceptance. Compared to before the quality improvement project bedside nurses were more willing and able to participate in ward round discussions, did so more often, and used the mnemonic script with insight and flexibility. The implementation of a mnemonic supported bedside nurses’ contributions to the ward round. This could provide a framework for introducing similar programmes to other intensive care units. Appreciative inquiry methodology could be replicated in other settings to aid the improvement of interprofessional ward rounds, or to address other quality improvement priorities. A mnemonic can provide a structure which supports bedside nurses’ contributions in ways that make good use of bedside nurses’ professional expertise and most up to date knowledge of patients’ clinical state. Furthermore, a well-designed mnemonic can be used flexibly and provides an outline script that supports less experienced and less confident nurses to make well-focused and well received contributions to rapid interprofessional discussions. In turn, this can increase these nurses’ confidence and capability. More experienced and confident nurses, and ward round leaders, can use the same mnemonic flexibly as an aide memoir that guards against missing information and insights that could affect the quality and safety of patient care.

Background and Aims Interprofessional simulation has the potential to enhance the perceived realism of clinical simulation in the education of different healthcare professionals. This study considers how the inclusion of more than one profession in clinical simulation contributes to this psychological fidelity, defined as the subjective perception of the realism of a simulation, and the cues identified by medical and nursing students. Methods Eight focus groups were carried out with 27 medical and 18 nursing students in Newcastle and Oxford, UK. These were carried out immediately after students' participation in simulation sessions consisting of three acute scenarios. Focus group discussions encompassed perceptions of the realism of the simulation and of participants' own and other professional groups. Thematic analysis was carried out on transcripts. Results The analysis identified features of psychological fidelity that were influenced by the interprofessional element of the simulation. These included overall impressions of realism, and the perceived roles and expectations of doctors and nurses within the simulation. In particular, the presence of the other professional group afforded a more authentic response. Other features varied with the viewpoint of the student groups, in particular the realism of the patient manikin, which held lower psychological fidelity for the nursing students, because it did not allow them to fulfill their perceived role of delivering holistic, relational care. Conclusion Recognizing “psychological fidelity” as a subjective response to simulation allows greater consideration of the limitations of fidelity as a designed or engineered property of a simulation. While interprofessional involvement directly enhances psychological fidelity in some ways, potential differences in the views of students from different professional groups should be considered when implementing interprofessional simulation.

Background1 in 4 experience a mental health problem per year, with a 25  year reduced life expectancy in those with the most severe mental illnesses. Despite the drive to put physical and mental health on equal footing, Psychiatry teaching to non-Psychiatric colleagues is still woefully under-developed leading to trainees who are unequipped in assessing and managing such zpatients in acute hospital settings. This has overall implications on patient safety and care. Simulation Aims: * To assess a patient with a psychiatric illness including performing a mental state examination * To utilise communication skills and recognise these are transferrable to psychiatric patients * To discuss management plans appropriate to an FY1/FY2 at the start of their year * To reflect on the challenges that interactions with psychiatric patients may pose, and how this could be replicated in other scenarios dealing with those without mental health issues * To adopt learning strategies to manage these challenges to facilitate improved outcomes next time.Project Description36 FY1s were timetabled to participate over two dates. FY1s divided into 3 simulations with actors and facilitators: 1. Assessing capacity in depressed patient 2. Managing the agitated delirious patient 3. Managing the antisocial patient demanding methadone Each simulation had specific learning outcomes for communication skills and clinical knowledge. Plenary session concluded main clinical and communication learning points, with shared peer learning outcomes and reflections on similar situations on the wards. Facilitators were Psychiatric, Medical and Nursing colleagues, enhancing inter-professional learning.OutcomesPre and post course confidence questionnaire using 1–10 likert scale was administered. Seven questions were posed covering the sessions’ aims. White space text for identifying three learning points and further scenarios they wish to observe.Provisional results from the first session demonstrated a mean increased confidence in all areas measured, with mean score ranges of 1.0–3.6. Largest confidence increase was seen in prescribing methadone and managing the acutely agitated and disturbed patient.Abstract P81 Table 1 Depression/Capacity Delirium Methadone Other Effects of depression on capacity Delirium pathway Opiate withdrawal management Importance of physical signs/history and examination in assessing these patents MSE when capacity assessment Patient may have delirium longer than clinically indicated Call methadone clinic for all those patients Importance of mental health assessment when assessing capacity Not to treat delirium unless emergency Opiate withdrawal pathway Not to label delirious patients with dementia To treat methadone withdrawal symptomatically How to handle acutely confused patients You can test urine for methadone Delirium pathway online How to manage patients demanding methadone Delirium management No one dies from opiate withdrawal Methadone prescribing Not to prescribe methadone on TTA Qualitative data echoed largest learning areas were in managing opiate withdrawal, prescribing methadone and assessing and managing delirium.Conclusions and RecommendationsOverall results following the delivery of the second session will provide a clearer description of whether the specified learning outcomes were obtained. Current faculty simulation members who observed suggested scenarios will be suitable for other trainee grades and professionals. Scenarios have therefore been proposed to simulation lead at Trust for further development of this pilot project.Abstract P81 Figure 1Provisional results session 1: pre and post confidence questionnaires

Background 1 in 4 experience a mental health problem per year, with a 25 year reduced life expectancy in those with the most severe mental illnesses. Despite the drive to put physical and mental health on equal footing, Psychiatry teaching to non-Psychiatric colleagues is still woefully under-developed leading to trainees who are unequipped in assessing and managing such zpatients in acute hospital settings. This has overall implications on patient safety and care. Simulation Aims: * To assess a patient with a psychiatric illness including performing a mental state examination * To utilise communication skills and recognise these are transferrable to psychiatric patients * To discuss management plans appropriate to an FY1/FY2 at the start of their year * To reflect on the challenges that interactions with psychiatric patients may pose, and how this could be replicated in other scenarios dealing with those without mental health issues * To adopt learning strategies to manage these challenges to facilitate improved outcomes next time. Project Description 36 FY1s were timetabled to participate over two dates. FY1s divided into 3 simulations with actors and facilitators: 1. Assessing capacity in depressed patient 2. Managing the agitated delirious patient 3. Managing the antisocial patient demanding methadone Each simulation had specific learning outcomes for communication skills and clinical knowledge. Plenary session concluded main clinical and communication learning points, with shared peer learning outcomes and reflections on similar situations on the wards. Facilitators were Psychiatric, Medical and Nursing colleagues, enhancing inter-professional learning. Outcomes Pre and post course confidence questionnaire using 1-10 likert scale was administered. Seven questions were posed covering the sessions' aims. White space text for identifying three learning points and further scenarios they wish to observe. Provisional results from the first session demonstrated a mean increased confidence in all areas measured, with mean score ranges of 1.0-3.6. Largest confidence increase was seen in prescribing methadone and managing the acutely agitated and disturbed patient. Abstract P85 Table 1 Depression/Capacity Delirium Methadone Other --- Effects of depression on capacity Delirium pathway Opiate withdrawal management Importance of physical signs/history and examination in assessing these patents MSE when capacity assessment Patient may have delirium longer than clinically indicated Call methadone clinic for all those patients - Importance of mental health assessment when assessing capacity Not to treat delirium unless emergency Opiate withdrawal pathway - - Not to label delirious patients with dementia To treat methadone withdrawal symptomatically - - How to handle acutely confused patients You can test urine for methadone - - Delirium pathway online How to manage patients demanding methadone - - Delirium management No one dies from opiate withdrawal - - - Methadone prescribing - - - Not to prescribe methadone on TTA - Qualitative data echoed largest learning areas were in managing opiate withdrawal, prescribing methadone and assessing and managing delirium. Conclusions and Recommendations Overall results following the delivery of the second session will provide a clearer description of whether the specified learning outcomes were obtained. Current faculty simulation members who observed suggested scenarios will be suitable for other trainee grades and professionals. Scenarios have therefore been proposed to simulation lead at Trust for further development of this pilot project.

Debriefing methods adopting a three-phase conversational structure-reaction, analysis and summary with a 'good-judgement' advocacy and enquiry approach-are popular in healthcare simulation. 1 2 This active dissection of the situation and reflection of events is thought to be fundamental in developing learners' understanding and transfer of knowledge. Benefits of in-simulation debriefing A 'teachable moment' has been referred to as being made of perfect timing for knowledge and ability to influence development. 3 It could, therefore, be argued that the traditional method of debriefing in the final stage does not provide the flexibility to allow for learning to occur immediately when the teachable moment has occurred. Origami has been used extensively within education to illustrate complexity and learning theories. 4 The 'fortune teller' is a long-established children's game made from one piece of folded paper.

Background/contextThe population of people who develop Dementia is growing as is the commitment to providing timely and appropriate responses as evidenced by the Government led ‘Dementia Challenge’. Much attention has been drawn to the skills and capabilities of the Health and Social Care workforce and care environments, which are rarely geared to be ‘dementia friendly’. This presentation will describe a simulated dementia training day geared towards nurses and allied health professionals which incorporated experiential learning and simulation with a patient actress towards exploring the issues for hospital based staff. Methods and outcomes are discussed alongside barriers and facilitators for others considering these methods.Methodology (used or planned)Participants were asked to contribute towards this pilot training package by simulating their typical responses in a range of scenarios that are common for people with dementia. These included issues around communication difficulties, behaviour which challenges, and receptive language difficulties.Participants were also asked to perform a range of simple activities using an ageing suit which enabled them to further understand and empathise with the complex difficulties of older adults with dementia.Throughout the scenarios, small ‘teaching’ segments were embedded through discussion of the issues following a particular formatThe environment was discussed, and a range of environmental and assistive technology solutions were demonstrated. Participants then developed an action plan for their own work area based on the day, and a second follow-up day was planned to review and progress these into action.Results/outcomes (anticipated or recorded to date)Teams will be better prepared to look after patients in hospital based settings.In patient environments will be more ‘dementia friendly’.Potential impactDementia patients experiences of being cared for in hospital will be improved and untoward incidents/complaints will be reduced.ReferencesDH (2009). Living Well with Dementia: A National Dementia Strategy. Available at https://www.gov.uk/government/publications/living-well-with-dementia-a-national-dementia-strategy [accessed June 2014]DH (2012). Prime Minister’s Challenge on Dementia. Available at https://www.gov.uk/government/publications/prime-ministers-challenge-on-dementia [accessed June 2014]

Background Participation in simulation-based interprofessional education (sim-IPE) may affect students’ attitudes towards interprofessional learning (through gaining experience with others) and their professional identity (by increasing the ‘fit’ of group membership). We examined this in two questionnaire studies involving students from four universities in two areas of the UK. Method Questionnaire data were collected before and after students took part in a sim-IPE session consisting of three acute scenarios. Questionnaires included the Readiness for Interprofessional Learning Scale (RIPLS) and measures of professional identity derived from the social identity theory literature. In Study 1, only identification with Professional Group (doctor or nurse) was measured, while in Study 2 identification with Student Group (medical or nursing student) and the immediate interprofessional Team worked with in the simulation were also measured. Linear mixed effects regression analysis examined the effect of the simulation session, and differences between medical and nursing students, sites and identity measures. Results A total of 194 medical and 266 nursing students completed questionnaires. A five-item subset of RIPLS (RIPLSCore) was used in analysis. In both studies RIPLSCore increased for all groups following participation in sim-IPE, although this was larger for nursing students in Study 1. Nursing students had consistently higher RIPLSCore scores than medical students at one site. Effects of the session on identity varied between sites, and dimensions of identity. Notably, while positive emotions associated with group membership (Ingroup Affect) increased for Student Group, Professional Group and Team, the sense of belonging (Ingroup Ties) and importance (Centrality) of the group increased only for Team. Nursing students had consistently higher identification scores than medical students. Conclusions Participation in a sim-IPE session can improve attitudes towards interprofessional learning. It can also enhance professional identity, particularly as related to emotional aspects of group membership, with possible benefits for wellbeing. Changes in identification with the immediate Team suggest positive psychological consequences of ad hoc Team formation in the workplace. Differences between medical and nursing students suggest their differing opportunities to work with other professions during training may change baseline attitudes and identity. However, a single sim-IPE session can still have an additive effect