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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Autores principales:	Ryan Brydges, Lori Nemoy, Stella Ng, Nazanin Khodadoust, Christine Léger, Kristen Sampson, Douglas M. Campbell
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Quality improvement Healthcare systems Interprofessional education Institutional ethnography Ethnography Computer applications to medicine. Medical informatics R858-859.7
Acceso en línea:	https://doaj.org/article/e78aa97823404af09b8e52193504aa75
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spelling	oai:doaj.org-article:e78aa97823404af09b8e52193504aa752021-11-08T11:14:54ZGetting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation10.1186/s41077-021-00191-z2059-0628https://doaj.org/article/e78aa97823404af09b8e52193504aa752021-11-01T00:00:00Zhttps://doi.org/10.1186/s41077-021-00191-zhttps://doaj.org/toc/2059-0628Abstract 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.Ryan BrydgesLori NemoyStella NgNazanin KhodadoustChristine LégerKristen SampsonDouglas M. CampbellBMCarticleQuality improvementHealthcare systemsInterprofessional educationInstitutional ethnographyEthnographyComputer applications to medicine. Medical informaticsR858-859.7ENAdvances in Simulation, Vol 6, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Quality improvement Healthcare systems Interprofessional education Institutional ethnography Ethnography Computer applications to medicine. Medical informatics R858-859.7
spellingShingle	Quality improvement Healthcare systems Interprofessional education Institutional ethnography Ethnography Computer applications to medicine. Medical informatics R858-859.7 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
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.
format	article
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
title	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_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_sort	getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation
publisher	BMC
publishDate	2021
url	https://doaj.org/article/e78aa97823404af09b8e52193504aa75
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Getting everyone to the table: exploring everyday and everynight work to consider ‘latent social threats’ through interprofessional tabletop simulation

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