This page provides the materials for student to prepare for the simulation Ambulatory Care Team Roles. The purpose of this simulation is for students to develop basic understanding of the Ambulatory Care Team members and how they work together to make a seamless visit from the patient perspective. Students will practice arriving for the day and having a brief huddle with the team to clarify roles, responsibilities, and work flow.
Learning Objectives • Expectations • Topics Covered • Preparation • Application Questions • Observer Form • Simulation Agreement • Evaluation
Learning Objectives
By the end of this simulation-based experience, the learner will be able to…
- Define the roles of key members of the ambulatory care team.
- Participate effectively in a team huddle to address safety, quality, and patient care planning.
- Plan an approach to the RN’s daily work in ambulatory care, taking into account the RN’s role in the team, work that is within the scope of other team members, and work that will be delegated by the RN.
- Communicate effectively with an ambulatory care team to clarify roles and responsibilities.
Expectations
Learners are expected to arrive in professional attire (as per course/Simulation Center policy) at the in-person or online synchronous simulation session having (1) fully reviewed this student guide, (2) completed the assigned readings and videos, and (3) completed the reflection questions. Students are also expected to have the Observer Form ready to complete should they be assigned that role, and to adhere to the Simulation Agreement.
The simulation session will begin with a prebriefing, during which the facilitator will take attendance, assign roles, review expectations, review the learning objectives and reflection questions, and read the learner brief to begin the scenario.
The clinical scenario will be a team huddle. Several students will be given scripts for their role (either a paper copy or e-mailed link) in the ambulatory care clinic. Learner participants may be assigned the role of a nurse, medical assistant, nurse resident, physician, receptionist, or clinical social worker. The facilitator (that is, the instructor) will lead the huddle in the role of the nurse manager. The learners will know when to speak because they will be cued by the facilitator (in character as the nurse manager). When cued, the learner will read their script. Those who are not assigned active an role in the scenario will be expected to observe attentively and take notes on the Observer Form.
The scenario will be followed by a debriefing session, in which the facilitator will guide the learners through reflective examination of the events and decisions that occurred during the scenario.
The prebriefing, scenario, and debriefing will take about 60 minutes.
Topics
- Team huddle using the IHI template
- Respectful communication with colleagues and patients
- Team member roles in ambulatory care
- Quality and safety principles
- Nursing responsibilities within the context of a primary care clinic schedule
- Scope of practice of an RN in primary care
- How nursing practice complements other team members in ambulatory care
Preparation (Readings and Videos)
To be prepared to participate effectively in this simulation-based learning experience, students must have the following knowledge. It is important that every student arrives fully prepared so you can participate to the greatest extent that you are able, and so this is a good learning experience for you and your colleagues.
- D-H Learning. (2016). Initiating team huddles at Dartmouth-Hitchcock [Video]. YouTube. https://youtu.be/ykYUGZJP9Wo. This video provides a scripted example of a team huddle, along with brief explanation of the purpose of huddles.
- Institute for Healthcare Improvement. (2019). Patient safety essentials toolkit: Huddles. Retrieved July 8, 2020 from http://www.ihi.org/resources/Pages/Tools/Huddles.aspx. The IHI’s toolkit provides a standardized approach to huddles. Review this short document to understand the purpose and contact of team huddles.
- MacColl Center for Healthcare Innovation. (2020). Building a primary care team. Retrieved July 9, 2020 from http://improvingprimarycare.org/team. This website is an initiative from Kaiser Permanente of Washington to support improvement of primary care teams. Click on the link “View Learning Modules” (or click into the links directly from this page) for Medical Assistant, PCP, Registered Nurse, Lay Person, Clinical Pharmacist, and Behavioral Health Specialist to learn about each person’s role.
Pre-simulation Application Questions
The Pre-simulation Reflection Questions are intended to help you begin to integrate understanding from your readings and prepare to apply this knowledge in the simulation scenario. Each question addresses the corresponding learning objective. You will discuss these questions during the pre-briefing with your facilitator.
- Who are the members of the ambulatory care team? Who might be extended team members who are not healthcare workers but have important encounters with patients?
- What is the purpose of a huddle? Why are these important? How do you think a clinic day would be different if it started without a huddle versus with a huddle?
- What are some specific strategies that enhance effective team communication?
- How would understanding other workers’ roles for the day help the nurse plan their work?
Observer Form
Learners who are not active participants in the scenario are expected to complete an Observer Form. Observers’ insights offer key learning opportunities during debriefing. Have this form ready to fill out during the scenario.
Simulation Agreement
I understand and agree to the following responsibilities for making simulation a valuable learning experience for all students. I agree to honor the following principles:
Fiction Contract
- I will treat the simulation as if it were a real clinical situation to the greatest extent that I can.
Professionalism
- I will complete preparatory assignments so I am ready to fully participate in the simulation experience and to support effective learning for the whole group,
Confidentiality
- Maintain confidentiality of debriefing discussions and students’ performance in the simulation scenarios to support a safe and collegial learning environment; and
- Keep the content of this simulation activity confidential to avoid spoiling the experience for those who have not yet participated.
Respect
- I will offer comments to colleagues in a respectful and sensitive manner and will be respectful to persons with varied viewpoints, including those with whom I do not agree; and
- Appreciate the contributions of diversity to varied student and patient perspectives, seeking understanding, equity, and inclusion.
Evaluation
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