In our previous columns this year, we referenced the Association for Talent Development Capability Model to explore new avenues for nursing professional development (NPD) practitioners to build their personal capabilities, including communication and emotional intelligence. Strategies offered for self-reflection and for improved verbal interactions with colleagues within the interprofessional learning environments were well received by our readers. In this column, we will focus on another aspect, cultural awareness and inclusion. The Association for Talent Development defines this broad capability as "adapting and adjusting attitude, perspective, and behavior to function effectively in diverse environments or situations; and integrating diversity and inclusion principles in talent development strategies and initiatives" (Galagan et al., 2020, p. 21).
Thriving NPD practitioners need to continuously assess the state of their growth and be willing to refine and retool their personal capabilities as it pertains to the interprofessional learning environment and interprofessional learners. The skills necessary to facilitate interprofessional learners is often different from the traditional learner groups that reflect a single discipline. Poor facilitation skills in interprofessional learning environments can actually add to the problematic situations that often accompany learning in isolation or in silos. In the recently updated NPD Scope and Standards of Practice, Fourth Edition, Standard 9 outlines how NPD practitioners must "role model culturally humble and sensitive behaviors" and "engage in[horizontal ellipsis]self-awareness and critical reflection on potential biases and assumptions[horizontal ellipsis]" (Harper & Maloney, 2022, p. 91). Indeed, focusing on personal growth helps us show up at our best, which ultimately helps others perform better too.
In order to illustrate these points, we talked with NPD practitioners who were finalists in the annual Association for Nursing Professional Development (ANPD) SimWars session held at the Aspire to Trailblaze Convention in March 2022 in San Antonio, Texas. The participants in this friendly annual competition embraced the opportunity to demonstrate their personal simulation debriefing skills before an interprofessional body of judges (composed of simulation leaders from ANPD, the Durham, North Carolina Veterans Affairs Health Care System Simulation Program, and vendor sponsor iSimulate) with the goal of improving their debriefing skills. We asked some of the top performers in this competition to share their personal stories of how NPD practitioners have handled situations involving "inclusion" and "cultural awareness" and the ensuing impact.
ANPD SimWars participant Brianna Qualizza, MSN, RN, NPD-BC, shared that she has seen problems with inclusivity among the different professions. As she explained,
Often, our hospital works with the local school of medicine in our simulation scenarios. With this, there is great opportunity to collaborate with other professionals as we bring in current nurses, physicians, medical students, student nurses, and respiratory therapists to complete simulations. Early on, these efforts would fail. Each profession spoke with their "equals" and would ignore other disciplines. This led to chaotic simulation experiences and frustrations felt by all parties involved.
This example illustrates what commonly occurs in the interprofessional learning environments involving simulation education. This tendency for learners to gravitate and interact in silos can pose debriefing challenges to even the most experienced NPD practitioner. Consequently, it is imperative for modern NPD practitioners to take stock of their debriefing skills for interprofessional learners and, if necessary, to improve their debriefing strategies and skills in order to honor all participant voices. NPD practitioners can use their influential skills to promote diversity in team-building activities, such as simulations. As Mann (2021) emphasizes, "Diverse teams leverage skill sets that have a direct influence on positive patient outcomes and the highest employee engagement and patient satisfaction scores" (p. 160). One potential debriefing question that could be used in such a situation to promote diversity of thought is, "How could the perspectives of each individual involved be heard more clearly?" Or, perhaps the prebriefing session could focus on possible biases that might exist in the team dynamics and emphasizing that all team members bring important knowledge, skills, and abilities to the scenario.
Another ANPD SimWars participant Linda Taylor, DNP, RN, NPD-BC, relayed an example regarding cultural sensitivity and inclusion and reflected on how she learned to change her approach after a challenging situation unfolded.
When I saw the phrase "adapting and adjusting attitude, perspective, and behavior to function effectively in diverse environments or situations; and integrating diversity and inclusion principles in talent development strategies and initiatives," I immediately thought of a simulation I conducted for emergency training in our Community Living Center (long-term care facility). I conducted this training in small groups for about 200 staff colleagues. We had already provided a detailed prebrief and role assignment. When the simulation involving an unresponsive patient began, the four staff in attendance all looked dazed and somewhat confused. After about a minute, one of them finally started an assessment and compressions, the bag valve mask got applied at some point, and the defibrillator never got hooked up. When we finished the actual simulation, I realized that I had not considered that they were all nursing assistants (NAs), and English was not their first language. I gave them a chance to tell me about the events that unfolded and when I reflected back, I worked to make sure I was affirming the role and the ability of the NA. As they reflected and identified practice gaps, they became more comfortable. Once they were at ease, I asked if they would like to reenact the simulation. They agreed, and the differences were dramatic! Immediate assessment, compressions, ventilations, and defibrillator were all done perfectly. When we got done, I told them I was impressed with their skills. All four were beaming as they left the training. For me, I learned to pay more attention to my audience. I assumed that my prebrief was thorough enough. While it was fine for the vast majority of the simulations, it was obviously not adequate in this situation. After that experience, there were a few more groups with similar characteristics. I modified the prebrief to meet my learner needs and had a better outcome.
Often, it takes a situation that did not play out as well as we had planned or envisioned to remind us of our constant need to learn and to strengthen our skills for the evolving complex interprofessional learning environment. Complacency and overreliance on our existing capabilities can severely limit our impact and reach. We thank Ms. Qualizza and Dr. Taylor for sharing their insights with us and experiences with diversity, inclusion, and cultural sensitivity, as they remind us that regular attention to building our personal capabilities keeps us laser-focused and better able to serve our learners.
What do you do to ensure that you are building your personal capabilities and striving for inclusivity in all respects? What situations have you encountered and what have you learned from them that has helped you grow as an NPD practitioner? Please share your comments with us at mailto:[email protected] and mailto:[email protected] to continue our exploration together.
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