Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation

Abstract In this methodological intersection article, we describe how we developed a new variation of the established tabletop simulation modality, inspired by institutional ethnography (IE)-informed principles. We aimed to design and conduct pilot implementations of this innovative tabletop simulat...

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Main Authors: Ryan Brydges, Lori Nemoy, Stella Ng, Nazanin Khodadoust, Christine Léger, Kristen Sampson, Douglas M. Campbell
Format: Article
Language:English
Published: BMC 2021-11-01
Series:Advances in Simulation
Subjects:
Online Access:https://doi.org/10.1186/s41077-021-00191-z
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author Ryan Brydges
Lori Nemoy
Stella Ng
Nazanin Khodadoust
Christine Léger
Kristen Sampson
Douglas M. Campbell
author_facet Ryan Brydges
Lori Nemoy
Stella Ng
Nazanin Khodadoust
Christine Léger
Kristen Sampson
Douglas M. Campbell
author_sort Ryan Brydges
collection DOAJ
description Abstract In this methodological intersection article, we describe how we developed a new variation of the established tabletop simulation modality, inspired by institutional ethnography (IE)-informed principles. We aimed to design and conduct pilot implementations of this innovative tabletop simulation modality, which focused uniquely on everyday and everynight work, along with the factors that govern that work. In so doing, we aimed to develop a modality and preliminary findings that researchers and educators can use to simulate healthcare practices across longer episodes of care (i.e., time scales of hours or an entire day) and to detect the ‘latent social threats’ that can emerge during interprofessional clinical care. An interprofessional team designed tabletop simulation scenarios of interprofessional challenges during transfers of care on a labour and delivery (L&D) unit. Within each scenario, participants provided real-time explanations for their work and associated drivers, both independently and as a team. Thus, we combined ‘think-aloud’ and simulation principles to design tabletop simulation scenarios to elicit healthcare professionals’ descriptions of how they collaborate in their work on the L&D unit. We completed a total of five tabletop simulations with eight participants (obstetricians, N = 2; midwives, N = 2; nurses, N = 5). The conversations stimulated by the tabletop simulation scenarios and debriefs allowed us to generate a preliminary understanding of the texts that govern and organize clinicians’ everyday work processes. We generated data about longitudinal, multi-hour work processes in a condensed timeline, with opportunities to pause and probe, and with reduced focus on individual practitioner’s competence. We believe our innovative tabletop simulation approach allowed us to examine clinical work in ways no other simulation permits. Participants described how the scenarios opened a productive dialogue between professional groups and suggested this simulation-based approach might contribute to enhanced interprofessional understanding and cultural change. We suggest that others can adapt our low-resource approach to understand clinicians’ everyday work and to map how this work is governed by documents, like policies, with the end goal of facilitating system change and managing latent social threats.
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spelling doaj.art-e78aa97823404af09b8e52193504aa752022-12-21T19:09:02ZengBMCAdvances in Simulation2059-06282021-11-01611810.1186/s41077-021-00191-zGetting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulationRyan Brydges0Lori Nemoy1Stella Ng2Nazanin Khodadoust3Christine Léger4Kristen Sampson5Douglas M. Campbell6Allan Waters Family Simulation Centre, St. Michael’s Hospital, Unity Health TorontoAllan Waters Family Simulation Centre, St. Michael’s Hospital, Unity Health TorontoUniversity of Toronto’s Centre for Interprofessional Education, University Health NetworkAllan Waters Family Simulation Centre, St. Michael’s Hospital, Unity Health TorontoAllan Waters Family Simulation Centre, St. Michael’s Hospital, Unity Health TorontoAllan Waters Family Simulation Centre, St. Michael’s Hospital, Unity Health TorontoAllan Waters Family Simulation Centre, St. Michael’s Hospital, Unity Health TorontoAbstract In this methodological intersection article, we describe how we developed a new variation of the established tabletop simulation modality, inspired by institutional ethnography (IE)-informed principles. We aimed to design and conduct pilot implementations of this innovative tabletop simulation modality, which focused uniquely on everyday and everynight work, along with the factors that govern that work. In so doing, we aimed to develop a modality and preliminary findings that researchers and educators can use to simulate healthcare practices across longer episodes of care (i.e., time scales of hours or an entire day) and to detect the ‘latent social threats’ that can emerge during interprofessional clinical care. An interprofessional team designed tabletop simulation scenarios of interprofessional challenges during transfers of care on a labour and delivery (L&D) unit. Within each scenario, participants provided real-time explanations for their work and associated drivers, both independently and as a team. Thus, we combined ‘think-aloud’ and simulation principles to design tabletop simulation scenarios to elicit healthcare professionals’ descriptions of how they collaborate in their work on the L&D unit. We completed a total of five tabletop simulations with eight participants (obstetricians, N = 2; midwives, N = 2; nurses, N = 5). The conversations stimulated by the tabletop simulation scenarios and debriefs allowed us to generate a preliminary understanding of the texts that govern and organize clinicians’ everyday work processes. We generated data about longitudinal, multi-hour work processes in a condensed timeline, with opportunities to pause and probe, and with reduced focus on individual practitioner’s competence. We believe our innovative tabletop simulation approach allowed us to examine clinical work in ways no other simulation permits. Participants described how the scenarios opened a productive dialogue between professional groups and suggested this simulation-based approach might contribute to enhanced interprofessional understanding and cultural change. We suggest that others can adapt our low-resource approach to understand clinicians’ everyday work and to map how this work is governed by documents, like policies, with the end goal of facilitating system change and managing latent social threats.https://doi.org/10.1186/s41077-021-00191-zQuality improvementHealthcare systemsInterprofessional educationInstitutional ethnographyEthnography
spellingShingle Ryan Brydges
Lori Nemoy
Stella Ng
Nazanin Khodadoust
Christine Léger
Kristen Sampson
Douglas M. Campbell
Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
Advances in Simulation
Quality improvement
Healthcare systems
Interprofessional education
Institutional ethnography
Ethnography
title Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
title_full Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
title_fullStr Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
title_full_unstemmed Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
title_short Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
title_sort getting everyone to the table exploring everyday and everynight work to consider latent social threats through interprofessional tabletop simulation
topic Quality improvement
Healthcare systems
Interprofessional education
Institutional ethnography
Ethnography
url https://doi.org/10.1186/s41077-021-00191-z
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