Transcript NonverbalMemory and Strategy Use in Children with Marsha J

An Inter-Professional Education Delirium Simulation Pilot Project
Heather S. Anderson, MD1, Daniel L. Swagerty, MD, MPH1, Mary Meyer, RN, MSN, ARNP-BC2
University of Kansas School of Medicine1, University of Kansas School of Nursing2
Abstract
Inter-professional education (IPE) is increasingly being
recognized as a potential means to improve medical
education and patient outcomes. A weakness in neurology
education at KU School of Medicine is in the evaluation of
delirium patients, and a weakness in KU School of Nursing
education is in the treatment of agitated patients. To
address these weaknesses, an IPE delirium simulation pilot
project was developed to improve delirium evaluation and
treatment for third-year medical students and nursing
students.
Objectives
Assess the impact of an inter-professional delirium
simulation experience on
o Attitudes of medical and nursing students towards teams
in training
o Medical students’ knowledge of delirium and its causes
and treatment
o Medical students’ performance on Clinical Skills
Assessment clinical encounter at the end of third-year
Methods
o Recruited for this study
• 30 students enrolled in third-year Neurology Clerkship
• 15 volunteer third-semester nursing students
o Medical students were randomized to either
• Web module only delirium education1
• Web module delirium education1 + IPE simulation
o Developed IPE delirium simulation script, based upon
second-year dementia assessment simulation
o Medical/nursing student pair evaluate and treat an agitated
delirium patient for 20 minutes, then 20 minute debriefing
o Pre- and post-testing
• KidSIM2 administered to IPE students
• Delirium Survey administered to all students on
Neurology Clerkship
o End of third year Clinical Skills Assessment
Background of Case
Ida Mae Homer is an 80 year-old woman with a 10-year
history of Alzheimer’s disease. Her granddaughter has been
caring for her for the last 5 days while her daughter (the
primary caregiver) is out of town. She is brought into the ED
for increasing confusion, agitation, and insomnia.
Acknowledgements
This study was funded by the University of Kansas Medical Alumni
Innovative Teaching Fund.
References
1classes.kumc.edu/coa/Education/AMED900/Neurology.htm
2Sigalet
E, et al. 2011. Simulation Summit; Montreal, 2011:31
Comparison of Students
# of students
Matriculation age
Basic Science GPA
Step 1 – Initial Score
IPE +
web module
Web module
only
p-value
15
24.00
3.16
210.80
16
25.50
3.23
219.75
p=0.215
p=0.728
p=0.312
Results
IPE +
Web
p-value
p-value
web module
module
KidSIM pre-test
138
p<0.001
KidSIM post-test
146
Delirium Survey pre-test
84.6%
82.0%
p=0.37
p=0.35
Delirium Survey post-test
88.5%
85.3%
Summary and Conclusions
CSA History
70%
77%
p=0.5
CSA Physical Exam
CSA Interpersonal Comm
11%
61%
12%
64%
p=0.9
p=0.9
• Delirium knowledge improved through use of both IPE delirium simulation
and web module of the topic
• Post-test scores between the two curricula were not significantly different
• The IPE delirium simulation was not effective in improving end-of-third year
Clinical Skills Assessment, however, attitudes of students towards teams in
training improved through the use of the IPE delirium simulation
• Therefore, the IPE delirium simulation appears to be an effective means of
improving delirium knowledge and attitudes towards teams in training
* This pilot project served as preliminary data for a successful Reynold’s
Foundation Next Steps grant application.