Abstract
Background: Internationally, research has found that patients in rural areas are at a higher risk of trauma and death in emergency situations when compared to urban areas and this can be attributed to several factors which include, geographical locality, infrequent presentations, limited access to specialty services, and limited resources (Fleet et al., 2015).The Rural Interprofessional Simulation Course (RISC), first ran in 2017, and was developed to increase the understanding and confidence in management of rural trauma and to improve communication, teamwork and leadership skills through simulation-based learning (Gutenstein, Kiuru & Withington, 2019). RISC is a three-day immersive course that brings rural interprofessional teams (doctors and nurses) from around New Zealand together to practice emergency and trauma skills through communication and skills workshops and high-fidelity simulations. Little research has been completed on simulation enhanced interprofessional experiences (SEIPE) with rural health professionals in New Zealand, with the exception of one study completed by Gutenstein et al. (2019) on the development and evaluation of RISC.
Aim: The aim of this study was to explore the experiences of the rural nurses who have participated in RISC.
Methods: An exploratory, descriptive qualitative design was used. Data was obtained through in-depth interviews. Semi-structured interviews were undertaken with six New Zealand registered nurses who participated in RISC. The transcribed interviews were analysed using a general inductive approach.
Findings: Five main themes and 12 subthemes were identified from the analysis. They included; the benefits and caveat of simulation (learning styles, building confidence with practice, learning from other rural teams and anxiety and nervousness due to being watched); the impact of realism on simulation (environmental set-up and team make-up); interprofessional dynamics (interprofessional hierarchy and reinforcing positive relationships); communication (the impact of interprofessional relationships on communication and transferring communication skills to practice); and transferring skills to nursing practice (skills utilised in trauma situations and skills utilised in non-trauma situations).
Conclusion: From the nurses' experiences it is evident that interprofessional simulation is an effective learning platform for improving the management of rural trauma. The findings of this study indicate that there are many benefits to utilising interprofessional simulation, however caution must be used to ensure the psychological safety of the participants. From the nurses' experiences it is also evident that matters such as fidelity, interprofessional dynamics, and communication need to be considered when preparing interprofessional simulation.