J Grad Med Educ. 2015 Jun; 7(2): 285–286.
PMCID: PMC4512813
Stephanie Nothelle, MDInstructor of Medicine, Chief Resident, Internal Medicine Residency Program, Johns Hopkins Bayview Medical Center
Jennifer Hayashi, MDAssistant
Professor of Medicine, Associate Program Director, Internal Medicine
Residency Program, Johns Hopkins Bayview Medical Center
Daniel Kim, MDInstructor of Medicine, Chief Resident, Internal Medicine Residency Program, Johns Hopkins Bayview Medical Center
Stacey Schott, MDInstructor of Medicine, Chief Resident, Internal Medicine Residency Program, Johns Hopkins Bayview Medical Center
Sammy Zakaria, MD, MPHAssistant
Professor of Medicine, Associate Program Director, Internal Medicine
Residency Program, Johns Hopkins Bayview Medical Center
Colleen Christmas, MDAssociate Professor of Medicine, Program Director, Internal Medicine Residency Program, Johns Hopkins Bayview Medical Center
Setting and Problem
Physicians
must work effectively in teams, and the Accreditation Council for
Graduate Medical Education requires that residency programs teach
trainees team skills. To successfully participate in well-functioning
teams, physicians first need to understand the roles of other team
members. We developed a highly engaging “Guess My Role” game to teach
our internal medicine residents about the roles of nonphysician health
care professionals with whom they work, and we conducted a preliminary
study of the game's impact on residents' knowledge about these
professional roles.
Intervention
Study
team members used a modified Delphi method to identify the 15
nonphysician professionals who most commonly interact with residents and
whose roles are poorly understood by the residents. The professions
identified included pharmacists, respiratory, occupational, and physical
therapists, chaplains, risk managers, nurses (charge and floor), social
workers, case managers, sitters (nonmedical personnel who supervise
patients for safety), patient care technicians, dietitians, unit
secretaries, patient relations professionals, and care coordinators.
Leaders from each profession were invited to list the top 5 things they
wished physicians knew about their given profession's role. We used the
lists to create a true/false knowledge test about each of the 15
professional roles. The knowledge test was generated by adding 1 false
statement to each submitted list and inverting 1 submitted item to make
it false, thereby yielding 6 possible correct answers for the 12
professions that submitted 5 items, and 5 possible correct answers for 1
profession that submitted 4 items. This resulted in a knowledge test
with 76 possible correct answers/points. The knowledge test and scoring
is available from the authors.
The Guess My Role game
occurred during a regularly scheduled 1-hour conference and included
residents, teaching service faculty, medical students, and nonphysician
professionals. Upon arrival, residents, faculty, and student
participants completed the knowledge pretest. Afterward, a name tag
designating the role of 1 nonphysician team member (eg, “social worker”)
was placed on each participant's back in a position that did not allow
him or her to read the assigned profession. Each participant was
instructed to ask other participants up to 10 yes/no questions in order
to guess their assigned profession. Once they were confident in
identifying their assigned profession, participants sat at a table with
the nonphysician professional that best matched their “guessed” role,
joining other participants who also believed they were assigned the same
role.
At each table, participants
discussed questions they used to identify their “guessed” profession.
Each nonphysician professional leader then addressed the larger group
with a 1-minute summary detailing their actual role and clarified common
misperceptions identified in the small group discussions. At the
conclusion of the session, participants completed a repeat knowledge
test identical to the preintervention test. The intervention was
conducted under Institutional Review Board approval.
Outcomes to Date
The
game intervention engendered enthusiastic participation and positive
comments from all participants. Thirty-three participants (medical
students, residents, and faculty) completed the pretest, and 25
participants completed the posttest. There was statistically significant
improvement in both the residents' and the participants' knowledge of
nonphysician roles after the Guess My Role intervention (mean score of
56 points versus mean score of 52 points; P = .014; TABLE). For both tests, there were nonsignificant trends favoring higher scores with higher levels of training.
Preintervention and Postintervention Scores on Roles Knowledge Test
Our
highly engaging Guess My Role game improved participants' knowledge of
nonphysician team member roles. Given the ease of implementing this
game, it may serve as a readily available tool for other residency
programs to teach trainees about interprofessional roles. We have not
determined whether correctly identifying nonphysician professional roles
leads to more effective collaboration or patient care, and we do not
know if the knowledge gain is sustained over time. Despite these
limitations, we successfully engaged participants in an interactive
activity aimed to improve the awareness, understanding of, and
participation in team-based care, an increasingly important component of
physician training. Future interventions may solidify knowledge of
nonphysician roles by including case-based conferences that further
highlight the specific roles various professionals have in patient care.
Articles from Journal of Graduate Medical Education are provided here courtesy of Accreditation Council for Graduate Medical Education
