Article Data

  • Views 426
  • Dowloads 165

Original Research

Open Access Special Issue

Improving interprofessional team simulation learning. One more step towards the humanization of health care in emergency situations

  • José Luis Díaz-Agea1
  • Carla Ayensa-Arano1
  • María José Pujalte-Jesús1
  • César Cinesi-Gómez2
  • Juan Manuel Cánovas-Pallarés1
  • Manuel J. Párraga-Ramírez2
  • César Leal-Costa3

1Official Masters in Emergency and Special Care Nursing, Faculty of Nursing, Catholic University of Murcia, 30107 Murcia, Spain

2Official Masters in Emergency Medicine, Faculty of Medicine, Catholic University of Murcia, 30107 Murcia, Spain

3Faculty of Nursing, University of Murcia, 30107 Murcia, Spain

DOI: 10.22514/sv.2021.223

Submitted: 25 July 2021 Accepted: 23 August 2021

Online publish date: 28 October 2021

*Corresponding Author(s): María José Pujalte-Jesús E-mail:


Interprofessional education refers to the collaboration of students from different disciplines towards the resolution of a series of clinical situations. The general objective of this study was to analyze the perspective of the participants in interprofessional simulations (doctors and nurses) in emergency situations. Qualitative study with an inductive approach for the identification of categories derived from the opinions provided by the participants in interprofessional simulations was conducted (n = 58). Individual open-ended questions were provided through a self-completed qualitative questionnaire. The answers were subjected to a descriptive content analysis. Three emergent themes, 13 categories and 21 sub-categories were obtained. Emotions-related aspects, strengths, and areas to be improved were identified with respect to the interprofessional simulations. The participants highlighted the great closeness to reality, they felt comfortable and confident, and their positive emotions had a greater weight than the negative ones (uncomfortableness, frustration, and insecurity). The most prominent positive aspects were teamwork, the realism of the training, and the empowerment of the nurses. The areas that could be improved were those related to aspects associated with carrying out the simulations, the demand for joint planning, and the improvements in the development of the sessions by the facilitators (co-debriefers). This work demonstrates the good reception of the learning experience by the participants. Interprofessional simulations are great learning tools, although weaknesses were found that could be improved with adequate planning by the educators.


Interprofessional simulation; Interprofessional collaboration; Interprofessional team-work; Simulation training; Qualitative research

Cite and Share

José Luis Díaz-Agea,Carla Ayensa-Arano,María José Pujalte-Jesús,César Cinesi-Gómez,Juan Manuel Cánovas-Pallarés,Manuel J. Párraga-Ramírez,César Leal-Costa. Improving interprofessional team simulation learning. One more step towards the humanization of health care in emergency situations. Signa Vitae. 2021.doi:10.22514/sv.2021.223.


[1] Bertakis KD, Azari R. Patient-centered care is associated with decreased health care utilization. Journal of the American Board of Family Medicine. 2011; 24: 229–239.

[2] Alerte AM, Behme J, Kosowicz L, Nowicki T, Pfeiffer C. Inter-professional Teaching via Simulation in Medical Education. Medical Science Educator. 2013; 23: 414–416.

[3] Schmitt M, Blue A, Aschenbrener CA, Viggiano TR. Core Competencies for Interprofessional Collaborative Practice: Reforming Health Care by Transforming Health Professionalsʼ Education. Academic Medicine. 2011; 86: 1351.

[4] la Rosa-Salas V, Arbea Moreno L, Vidaurreta Fernández M, Sola Juango L, Marcos Álvarez B, Rodríguez Díez C, et al. Educación interprofesional: una propuesta de la Universidad de Navarra. EducacióN MéDica. 2020; 21: 386–396.

[5] Kyrkjebø JM, Brattebø G, Smith-Strøm H. Improving patient safety by using interprofessional simulation training in health professional education. Journal of Interprofessional Care. 2006; 20: 507–516.

[6] Omer T. Nursing Students’ Perceptions of Satisfaction and Self-Confidence with Clinical Simulation Experience. Journal of Education and Practice. 2016; 7: 131–138.

[7] World Health Organization (WHO). Transforming and scaling uphealth professionals’ education and training. 2013. Available at: 93635/9789241506502_eng.pdf (Accessed: 12 June 2020).

[8] Costello M, Huddleston J, Atinaja-Faller J, Prelack K, Wood A, Barden J, et al. Simulation as an Effective Strategy for Interprofessional Education. Clinical Simulation in Nursing. 2017; 13: 624–627.

[9] Freire JR, Costa MV da, Magnago C, Forster AC. Actitudes para la colaboración interprofesional de equipos de Atención Primaria participantes del Programa Más Médicos. Rev Latino-Am Enfer-magem. 2018. Available at: (Accessed: 28 June 2021).

[10] Palaganas JC, Brunette V, Winslow B. Prelicensure Simulation-Enhanced Interprofessional Education: a Critical Review of the Research Literature. Simulation in Healthcare. 2016; 11: 404–418.

[11] INACSL Standards of Best Practice: SimulationSM Simulation Design. Clinical Simulation in Nursing. 2016; 12: S5–S12.

[12] Bagnasco A, Tubino B, Piccotti E, Rosa F, Aleo G, Di Pietro P, et al. Identifying and correcting communication failures among health professionals working in the Emergency Department. International Emergency Nursing. 2013; 21: 168–172.

[13] Komasawa N, Berg B. Interprofessional Simulation Training for Periop-erative Management Team Development and Patient Safety. Journal of Perioperative Practice. 2016; 26: 250–253.

[14] Reime MH, Johnsgaard T, Kvam FI, Aarflot M, Engeberg JM, Breivik M, et al. Learning by viewing versus learning by doing: a comparative study of observer and participant experiences during an interprofessional simulation training. Journal of Interprofessional Care. 2017; 31: 51–58.

[15] Bristowe K, Siassakos D, Hambly H, Angouri J, Yelland A, Draycott TJ, et al. Teamwork for clinical emergencies: interprofessional focus group analysis and triangulation with simulation. Qualitative Health Research. 2012; 22: 1383–1394.

[16] Hernández E, Camacho M, Leal-Costa C, Ruzafa-Martínez M, Ramos-Morcillo AJ, Cazorla E, et al. Does Multidisciplinary Team Simulation-Based Training Improve Obstetric Emergencies Skills? Healthcare. 2021; 9.

[17] Glaser BG, Strauss AL. Discovery of Grounded Theory: Strategies for Qualitative Research. Routledge. 2017; 282.

[18] Rutherford-Hemming T, Lioce L, Breymier T. Guidelines and Essential Elements for Prebriefing. Simulation in Healthcare. 2019; 14: 409–414.

[19] Tyerman J, Luctkar-Flude M, Graham L, Coffey S, Olsen-Lynch E. Pre-simulation preparation and briefing practices for healthcare professionals and students. JBI Database of Systematic Reviews and Implementation Reports. 2016; 14: 80–89.

[20] Cheng A, Palaganas J, Eppich W, Rudolph J, Robinson T, Grant V. Co-debriefing for simulation-based education: a primer for facilitators. Simulation in Healthcare. 2015; 10: 69–75.

[21] Hsieh H, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005; 15: 1277–1288.

[22] Elo S, Kyngäs H. The qualitative content analysis process. Journal of Advanced Nursing. 2008; 62: 107–115.

[23] Darawsheh W. Reflexivity in research: Promoting rigour, reliability and validity in qualitative research. International Journal of Therapy and Rehabilitation. 2014; 21: 560–568.

[24] Weil A, Weldon SM, Kronfli M, Watkins B, Kneebone R, Bello F, et al. A new approach to multi-professional end of life care training using a sequential simulation (SqS SimulationTM ) design: A mixed methods study. Nurse Education Today. 2018; 71: 26–33.

[25] Fransen A, van de Ven J, Schuit E, van Tetering A, Mol B, Oei S. Simulation-based team training for multi-professional obstetric care teams to improve patient outcome: a multicentre, cluster randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2017; 124: 641–650.

[26] Liaw SY, Ooi SW, Rusli KDB, Lau TC, Tam WWS, Chua WL. Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Trial on Team Communication and Teamwork Attitudes. Journal of Medical Internet Research. 2020; 22: e17279.

[27] Roh YS, Ahn J, Kim E, Kim J. Effects of Prebriefing on Psychological Safety and Learning Outcomes. Clinical Simulation in Nursing. 2018; 25: 12–19.

[28] Page-Cutrara K. Prebriefing in Nursing Simulation: a Concept Analysis. Clinical Simulation in Nursing. 2015; 11: 335–340.

[29] Díaz-Agea JL, Pujalte-Jesús MJ, Leal-Costa C, García-Méndez JA, Adánez-Martínez MG, Jiménez-Rodríguez D. Motivation: bringing up the rear in nursing education. Motivational elements in simulation. the participants’ perspective. Nurse Education Today. 2021; 103: 104925.

[30] INACSL Standards of Best Practice: SimulationSM Debriefing. Clinical Simulation in Nursing. 2016; 12: S21–S25.

[31] Alinier G. Developing High-Fidelity Health Care Simulation Scenarios: a Guide for Educators and Professionals. Simulation & Gaming. 2011; 42: 9–26.

[32] Poore JA, Dawson JC, Dunbar D, Parrish K. Debriefing Interprofession-ally: a Tool for Recognition and Reflection. Nurse Educator. 2019; 44: 25–28.

[33] Committee IS. INACSL standards of best practice: SimulationSM facilitation. Clinical Simulation in Nursing. 2016; 12: S16–S20.

[34] Kelly M, Guinea S. Facilitating healthcare simulations (pp. 143–151). En: Healthcare Simulation Education. John Wiley & Sons, Ltd. 2017. Available at: 1002/9781119061656.ch19 (Accessed: 9 October 2020).

[35] Brown DK, Wong AH, Ahmed RA. Evaluation of simulation debriefing methods with interprofessional learning. Journal of Interprofessional Care. 2018; 32: 779–781.

[36] Rudolph JW, Raemer DB, Simon R. Establishing a safe container for learning in simulation: the role of the presimulation briefing. Simulation in Healthcare. 2014; 9: 339–349.

[37] Sharoff L. Simulation: Pre-briefing Preparation, Clinical Judgment and Reflection. What is the Connection? Çağdaş Tıp Dergisi. 2015; 5: 88–101.

[38] Omura M, Maguire J, Levett-Jones T, Stone TE. The effectiveness of assertiveness communication training programs for healthcare pro-fessionals and students: a systematic review. International Journal of Nursing Studies. 2017; 76: 120–128.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time