Transitioning from specialisation to collaboration: interprofessional clinical simulation, metacognition and the phenomenon of convergence.

Abstract

Research into metacognitive processes within interprofessional clinical simulation has been largely overlooked in the literature. This study explores how interprofessional simulation may influence cognitive and metacognitive processes across several professional programmes; medicine, nursing, pharmacy, and occupational therapy. This study focused on changes in performance pre- and post-simulation, with undergraduate students from each profession answering a set of questions related to the simulation case, requiring specialized knowledge from each profession. Question scores, item confidence judgment ratings, and calibration values were collected and analyzed. The data revealed a pattern of convergence in post-simulation assessments, where professions initially with lower performance in the pre-simulation phase improved, and those initially performing well demonstrating a decline in performance. Calibration values indicated that medical students developed metacognitive errors from their interactions in the simulation, which were not present pre-simulation, and that occupational therapy students suffered a loss of confidence and calibration in questions within their own field resulting from their experience (being more accurate pre-simulation). The authors anticipate that the phenomenon of convergence may have longer-term consequences, potentially fostering distrust among professions for those with declining performance. The authors propose that expanding awareness of convergence phenomena and conducting repeated simulations (thus facilitating further team development) could mitigate this issue.