JMIR Publications

ABSTRACT

Background:

Effective interprofessional collaboration (IPC) is essential for patient safety, yet poor teamwork and communication remain key challenges in high-pressure settings like the emergency department (ED), contributing to medication errors. Although TeamSTEPPS-based interprofessional education addresses these issues, adaptation in clinical settings remains difficult. To bridge this gap, we developed ER-VIPE (Emergency Room Virtual Simulation-Based Interprofessional Education), a multimodal, TeamSTEPPS-integrated platform designed to enhance IPC and reduce medication errors.

Objective:

To evaluate the effectiveness of ER-VIPE in enhancing IPC performance among emergency physicians, nurses, and pharmacists, and in reducing medication errors. The primary objective is to assess changes in IPC performance in both real-world ED settings and virtual simulation-based IPE (SIMBIE) with co-debriefing sessions. The secondary objective is to examine the intervention's impact on medication error rates in the ED.

Methods:

This single-blinded (statistician) quasi-experimental study involved 15 interprofessional teams, each comprising a physician, a pharmacist, and two nurses. The intervention included two medical films, a massive open online courses (MOOCs) on TeamSTEPPS and IPC, and a computer-based virtual SIMBIE session with co-debriefings on acute chest pain and cardiac arrest scenarios. TeamSTEPPS performance was measured using the modified Team Performance Observation Tool (mTPOT) in both simulation and real-world ED settings. Generalized Estimating Equations (GEE) with a Gaussian family, identity link, and exchangeable correlation structure were used to evaluate IPC score changes. Chi-square and Fisher’s Exact tests were applied to compare near-miss and actual medication errors pre- and post-intervention. A two-tailed P-value <.05 was considered statistically significant.

Results:

The study was conducted from November 2023 to January 2024 at a university hospital with 60 participants. Following the co-debriefing session in the simulation, overall mTPOT scores increased by 2.00 points (P<.001), with the greatest improvement among physicians (+2.70), followed by nurses (+1.75) and pharmacists (+1.56). In the ED, most mTPOT domains improved significantly across all professions two months post-intervention (P<.001). Although no significant reduction in harmful medication errors was observed, reporting of near-miss prescription errors increased significantly (P = .011).

Conclusions:

ER-VIPE enhanced IPC among ED physicians, nurses, and pharmacists, with sustained effects observed up to two months in real-world settings. The combination of medical films and a MOOCs provided accessible foundational knowledge, while computer-based virtual SIMBIE with co-debriefing reinforced practical communication and teamwork. Increased near-miss reporting suggests improved situational awareness and a more transparent safety culture. This multimodal training model shows promise for advancing collaboration and patient safety in emergency care. Clinical Trial: -