| Literature DB >> 33889044 |
Marina E Zambrotta1,2, Patricia Aylward3, Christopher L Roy1,2, Emily Piper-Vallillo1,4, Stephen R Pelletier2, James P Honan4, Noah Heller4, Subha Ramani1,2, Helen M Shields1,2.
Abstract
INTRODUCTION: High levels of interprofessional collaboration are beneficial for patients and healthcare providers. Co-teaching may be one method for creating a collaborative environment. This pilot study designed, developed, and implemented Nurse-Doctor Co-Teaching on an inpatient medicine service.Entities:
Keywords: coaching team; faculty development; interactive teaching strategies; interprofessional co-teaching; nursing education; resident education
Year: 2021 PMID: 33889044 PMCID: PMC8057953 DOI: 10.2147/AMEP.S300231
Source DB: PubMed Journal: Adv Med Educ Pract ISSN: 1179-7258
Figure 1Blueprint for assessment of Nurse-Doctor Co-Teaching sessions. Timeline highlighting the two-week interval between the Kickoff Dinner and first co-teaching session and the three-month interval between the pre- and post- Collaboration Surveys given to nurses and residents. Each of the ten Nurse-Doctor Co-Teaching sessions was evaluated by an overall rating survey.
Responses from Anonymous Nurse and Resident Learner Surveys after Each Nurse-Doctor Co-Teaching Session
| Overall Ratinga | Rated “Enjoyable”b | Rated “Effective”c | Wants Additional Sessionsd | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Co-Teaching Session | n | Mean | s | n | Mean | s | n | Mean | s | n | Mean | s |
| A | 14 | 1.21 | 0.426 | 14 | 1.21 | 0.426 | 14 | 1.29 | 0.469 | 14 | 1.00 | 0.000 |
| B | 10 | 1.10 | 0.316 | 10 | 1.10 | 0.316 | 10 | 1.20 | 0.632 | 10 | 1.10 | 0.316 |
| C | 16 | 1.19 | 0.403 | 17 | 1.24 | 0.437 | 17 | 1.24 | 0.437 | 17 | 1.00 | 0.000 |
| D | 11 | 1.00 | 0.000 | 11 | 1.18 | 0.405 | 11 | 1.18 | 0.405 | 11 | 1.00 | 0.000 |
| E | 13 | 1.15 | 0.376 | 13 | 1.15 | 0.376 | 13 | 1.23 | 0.439 | 13 | 1.00 | 0.000 |
| F | 12 | 1.33 | 0.492 | 12 | 1.42 | 0.515 | 12 | 1.33 | 0.495 | 12 | 1.00 | 0.000 |
| G | 10 | 1.10 | 0.316 | 10 | 1.10 | 0.316 | 10 | 1.30 | 0.483 | 10 | 1.10 | 0.316 |
| H | 14 | 1.43 | 0.514 | 14 | 1.86* | 0.663 | 14 | 1.71 | 0.607 | 14 | 1.07 | 0.267 |
| I | 12 | 1.17 | 0.577 | 12 | 1.42 | 0.669 | 12 | 1.17 | 0.389 | 12 | 1.08 | 0.289 |
| J | 8 | 1.13 | 0.354 | 8 | 1.88 | 0.641 | 8 | 1.63 | 0.518 | 8 | 1.00 | 0.000 |
Notes: a“Overall, how would you rate today’s session?” (1 = Excellent/4 = Poor). b“How enjoyable was today’s session?” (1 = Very enjoyable/5 = Not enjoyable at all). c“How effective were the methods of teaching in today’s session?” (1 = Very effective, 5 = Not effective at all). d“Would you like to have additional co-teaching sessions?” (Yes/No). *Statistically higher than all sessions except Session F, Session I and Session J at p-value < 0.05 level.
Figure 2Top anonymous nurse and resident responses to the question “What did you like best about today’s session?” Responses are from nurse and resident learner surveys collected after each Nurse-Doctor Co-Teaching session, where n = 8 to 17 surveys depending on the session. Categories of anonymous responses are listed on the Y axis. Frequency of responses (X axis) represents the number of survey responses in each category totaled over the ten co-teaching sessions.
Topics of the Ten Co-Teaching Sessions and the Number and Types of Interactive Teaching Strategies Used in Each Session
| Topic of Co-Teaching Session | Number of Interactive Teaching Strategies | Types of Interactive Teaching Strategies Used in Co-Teaching Session |
|---|---|---|
| Arterial Blood Gases | 1 | Matching Columns |
| Alcohol Withdrawal | 2 | Video with Scoring, Turn and Talk |
| Hyponatremia | 1 | Image Analysis |
| Interruptions on Medical Units | 3 | Stand Up-Sit Down, Back-to-Back and Face-to-Face, Turn and Talk |
| 2 | Polling, Hands-On Activity | |
| Opioid Withdrawal | 3 | Polling, Turn and Talk, Case Discussion |
| Telemetry | 3 | Stand Up-Sit Down, Turn and Talk, Hands-On Activity |
| Catheter Associated Urinary Tract Infections | 4 | Turn and Talk, Case Discussion, Polling, Design |
| 3 | Turn and Talk, Polling, Hands-On Activity | |
| Venous Thromboembolism | 3 | Turn and Talk, Polling, Design |
Description of the Interactive Teaching Strategies Used in Nurse-Doctor Co-Teaching Sessions
| Interactive Teaching Strategy | Description |
|---|---|
| Back-to-Back and Face-to-Face | In pairs, participants stand back-to-back, listening to a prompt or question. They have 30 seconds to think about their response. Then, once the facilitator indicates the time is up, participants turn and face each other to discuss.* |
| Case-Based Discussion | Participants are introduced to a patient case and are asked to discuss the case at key moments, in pairs and/or as a whole group. |
| Design | In teams, participants are challenged to design a solution to a clinical problem. For example, in one session they designed an improved female urinary catheter.** In another, they were asked to design a discharge education sheet for patients who had been diagnosed with a venous thromboembolism.*** |
| Hands-On Activity | Participants actively engage in “Hands-On” activities. For example, learners placed jellybeans on a diagram of the torso in the correct locations of telemetry leads. |
| Image Analysis | Participants look at an image, often a mystery image. They write or discuss what they notice and wonder about the image. |
| Matching Columns | Participants are asked to match the item in Column A with an associated item in Column B. |
| Polling | Participants are polled for their responses to multiple choice questions using tools such as the Immediate Feedback Assessment (IFAT) Cards.**** |
| Scoring | Participants score a scenario or case using an established rubric. For example, participants used the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) to practice scoring a patient with alcohol withdrawal. |
| Stand Up-Sit Down | Participants share their thinking about a statement by standing up if they think the statement is true and staying seated if they think it is false, or vice versa. |
| Turn and Talk | Participants share their thinking about a question, problem, or scenario with their neighbor (s). |
Notes: *Data from ElEducation.org. Expeditionary Learning: Classroom Protocols. Expeditionary Learning. Available from: Back-To-Back and Face-To-Face, Page 8.32 **. ***. ****Immediate Feedback Assessment Technique, Epstein Educational Enterprises, Inc., Cincinnati, Ohio.
Verbatim Comments from Anonymous Nurse and Resident Learner Surveys on What the Learners Liked Best about the Co-Teaching Session, Organized by Top Seven Categories of Response
| “What Did You Like Best about Today’s Session?” | Anonymous Nurse Responses | Anonymous Resident Responses |
|---|---|---|
| 1. Interactive | “Paired discussions” | “Interactive with clear takeaways” |
| 2. Hearing Both Nurse and Doctor Perspectives | “Excellent co-presentation of both MD and RN perspective” | “The fact that we got to hear from nurses too!” |
| 3. Cases/Scenarios | “Activities/case studies” | “Case-based questions” |
| 4. Collaboration | “Collaboration between RN and MDs = better patient care!” “Very good teamwork” “Collaboration with MD/nursing, very informative” | “Always great to collaborate out of the high stress environment on the floors” |
| 5. Relevant, Important and/or Practical | “Real life examples” | “Good mix of learning points for RNs and MDs” |
| 6. Interdisciplinary/Interprofessional | “I love the collaboration between disciplines” | “Interactive, interdisciplinary, relevant” |
| 7. Brief/Short | “Key points, not too long” | “Brief, but very informative” |