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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.