Transcript Document

A LEND Program’s Case-Based Simulation Approach to Measuring
Interdisciplinary Communication in the Context of Family-Centered Care
Rachel Esch, Emily Graybill, PhD, Stephen Truscott, PsyD, Anna Torres, Kirnel Daniel, Mark Crenshaw, MTS, Erin Vinoski, MPH, & Daniel Crimmins, PhD
Overview
Case-Based Simulation Procedures
Key Findings
Our GaLEND Program is committed to better understanding
the development and use of MCH interdisciplinary
competencies as a result of training experiences. The current
study examined family member involvement in simulated
interdisciplinary team discussions at two times during the
training year.
• The group facilitator gave each trainee a case summary,
written instructions for the activity, and a facilitation form to
guide the activity. One case file was provided to the group.
• The groups were given 30 minutes to complete the simulation
and to answer the questions outlined on the facilitation form.
• The groups debriefed with the group facilitator and
afterward, the groups joined together to participate in a
discussion about the experience led by a GaLEND research
team member.
• F-RCCCS
• From T1 to T2, trainees increased in dominance.
From T1 to T2, family decreased in dominance.
• In other words, trainees became more and families became
less effective at controlling the conversation.
• LSM
• LSM was high in all groups at T1 and T2, across family
members and trainees, suggesting that language mimicry
was high throughout the activity.
• MCH-LACCS
• Trainee Individual and Family-Centered Care increased from
T1 to T2 due to increased questioning.
• Family Balance of Power (average # of responses made
to their initiating statements) decreased from T1 to T2
Guiding Questions
(1) How does family member and LEND trainee involvement
change from Time 1 to Time 2?
(2) What information can be provided by each of the three
communication coding schemes on family member and
trainee communication patterns?
Coding Scheme Author
Participants
• Two case-based simulation (CBS) activities were scheduled
for the 2013-2014 GaLEND year: one in the Fall semester
(Time 1 [T1]) and one in the Spring semester (Time 2 [T2]).
• At Time 1, GaLEND trainees were divided into two groups.
Group 1T1
Group 2T1
• At Time 2, GaLEND trainees were divided into three groups.
Group 1T2
Table 1. Coding Process
Group 2T2
Group 3T2
Family Relational
Communication
Control Coding
System
(F-RCCCS)
Language Style
Matching
(LSM)
Utility
Heatherington Analyzes the power dynamics of
& Friedlander, teams:
 Domineeringness: an individual’s
1987
attempts to control a team
conversation;
 Dominance: an individual’s
successful attempts to control the
conversation.
Summary
Trainees increased in dominance, not necessarily a bad thing as
it involves being more focused on furthering the conversation;
they may, however, have dominated by asking lots of questions.
Niederhoffer & Measures verbal mimicry of dyads
Pennebaker, through the relative use of function
2002
word categories (e.g., personal
pronouns, articles, conjunctions,
prepositions, auxiliary verbs,
quantifiers, etc.).
Figure 1. GaLEND trainees discuss the
CBS materials.
Case-Based Simulation Activity Development
• The CBS activities consisted of two cases in which the
family of a child with a disability was seeking services and
supports.
• At each time point, trainees received a case file intended to
mirror a file that an interdisciplinary team might work from
during service planning and provision.
• The case files were developed in collaboration with a local
community-based organization and were derived from an
existing case.
• The “family member” was played by a former GaLEND
trainee.
Maternal Child
Health Leadership
Applied
Competencies
Coding Scheme
(MCH-LACCS)
Internally
developed by
the GaLEND
research team,
2013
Identifies a team’s use of problemsolving steps (i.e., identifying a
problem, devising a plan, carrying
out a plan, and evaluating) while
demonstrating MCH leadership
competencies (e.g., Interdisciplinary
Team Building, Family Balance of
Power, and Individual and FamilyCentered Care).
Figure 2. A GaLEND trainee engages with
the “family member.”
Future Directions
• Develop more specific instructional activity occurring between
Time 1 and Time 2 to develop skills related to interdisciplinary
team communication and family-centered care.
• Drop LSM as scheme and continue with the other two.
• Assess the quality of communication through participant
interviews; the present study did not measure quality, only
nature, of communication.
• Standardize activity:
• Improve training for “family members.”
• Use equivalent groups at Time 1 and Time 2.