Who Am I as a Healthcare Provider?: Identity and Transformative Learning in Virtual Environments

Who Am I as a Healthcare Provider?: Identity and Transformative Learning in Virtual Environments

Rachel Umoren (University of Washington, USA) and Natalia Rybas (Indiana University East, USA)
DOI: 10.4018/978-1-5225-9679-0.ch009
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The U.S. healthcare delivery system relies on the formation of ad hoc teams of experienced, highly trained providers of various specialties. The providers work in interprofessional teams that converge to address situations around acute patient care. Various models of virtual training provide structured opportunities for interprofessional education, whereby learners engage with roles and responsibilities essential for their professions and active collaboration with other team members. This learning is transformative as it influences the development of professional identity and teamwork skills needed for successful collaborative practice in interprofessional teams. This chapter explores the role of training healthcare professional students using virtual simulations and the emerging potential of virtual and augmented reality for health professional education.
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Virtual Healthcare Team Interactions

Teamwork in healthcare settings is similar to teamwork in other disciplines with a few distinctions. Patient care demands 24/7 coverage by a team capable of efficient, high-quality care. Although team composition is fluid due to the constraints of shiftwork, team roles are often stable describing a job position, e.g. the role of surgeon or anesthesiologist; or a job function, e.g. the role of providing chest compressions or rescue breathing. In some cases, there is a need to rotate the leadership structure, for example, the anesthesiologist is the leader in the operating room when anesthesia is being administered, and the surgeon takes over the leadership role once the patient is under anesthesia (Hughes et al., 2016). Learners who are just beginning to understand their roles on the healthcare team are often part of the team. There is an established hierarchy, which is particularly evident when learners are working with senior physicians but may not be as obvious when there are multiple senior team members providing care.

All healthcare teams are at risk of making medical errors if team members lack strong communication and conflict management skills. For this reason, there is increasing attention to the role of teamwork at all levels, from training to practice. Teamwork training programs such as the Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), developed by the Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense have been used to train an estimated 1.5 million healthcare providers (Hughes et al., 2016). Even though these learning opportunities are available, they are still not sufficient to address the gap in the teamwork skills at all levels of healthcare systems. Virtual environments provide increased opportunity for instructors and learners to engage with each other from remote locations and across geographically separated campuses or other types of locations (Figure 1).

Figure 1.

Virtual team members interact in a multi-player team training environment.

Image credit: Rachel Umoren.

Key Terms in this Chapter

Virtual Simulation: The use of 3D objects and environments to create immersive and engaging learning experiences.

TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety): An evidence-based framework to optimize team performance across the healthcare delivery system.

Augmented Reality (AR): A technology that superimposes a computer-generated image on a user’s view of the real world, thus providing a composite view.

Gamification: The process of using game mechanics and game thinking in non-gaming contexts to engage users and to solve problems.

Interprofessional Education (IPE): When students from two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes.

Standardized Patients (SP): Someone who has been trained to portray, in a consistent, standardized manner, a patient in a medical situation; also known as a simulated patient.

Disorienting Dilemma: The catalyst for perspective transformation, dilemmas usually occur when people have experiences that do not fit their expectations or make sense to them and they cannot resolve the situations without some change in their views of the world.

Laparoscopy: A surgical procedure in which a fiber-optic instrument is inserted through the abdominal wall to view the organs in the abdomen or to permit a surgical procedure.

Virtual Environment: A computer-generated, three-dimensional representation of a setting in which users perceive themselves to be, and within which interaction occurs, also called virtual landscape, virtual world, or virtual space.

Single Player: An application in which an individual user interacts with objects in the virtual environment.

Non-Player Character (NPC): Any character that is controlled by the computer through artificial intelligence, also known as a non-person character or non-playable character.

Simulated Multiplayer: Application, the user interacts with non-player characters or avatars controlled by individuals who may or may not be colleagues, but who are role-playing as patients or other health team members.

True Multiplayer: An application in which the user interactions are with team members in educational, or work-related activities.

Interprofessional Practice (IPP): Is a collaborative practice which occurs when healthcare providers work with people from within their profession, with people outside their profession and with patients and their families.

High-Fidelity Patient Simulation (HPS): The use of computerized manikins that simulate real-life scenarios.

Agency for Healthcare Research and Quality (AHRQ): A U.S. government agency that functions as a part of the Department of Health and Human Services (HHS) to support research to help improve the quality of healthcare.

Debriefing: The process of sharing and discussing information after a mission, meeting, project, or another event that allows key players to obtain important information and leads to process improvement.

Virtual Reality (VR): The computer-generated simulation of a three-dimensional image or environment that can be interacted with in a seemingly real or physical way by a person using specialized electronic equipment, such as a head mounted display or gloves fitted with sensors.

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