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A Flipped Classroom Approach to Improving the Quality of Delirium Care Using an Interprofessional Train-the-Trainer
Sanjeev Sockalingam1, Sandra-Li James, Rebecca Sinyi
1Dr. Sockalingam: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Ms. James: University Health Network, Toronto, ON, Canada. Ms. Sinyi: University Health Network, Toronto, ON, Canada. Ms. Carroll: University Health Network, Toronto, ON, Canada. Dr. Laidlaw: Surrey Memorial Hospital, Surrey, BC, Canada. Dr. Yanofsky: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Dr. Sheehan: Centre for Mental Health, University Health Network, Toronto, ON, Canada and Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
Introduction:
Given the prevalence and morbidity associated with delirium, there is a need for effective and efficient institutional approaches to delirium training in health care settings. Novel education methods, specifically the "flipped classroom" (FC) and "train-the-trainer" (TTT), have the potential to address these delirium training gaps. This study evaluates the effect of a TTT FC interprofessional delirium training program on participants' perceived ability to manage delirium, delirium knowledge, and clinicians' delirium assessment behaviors.
Methods:
FC Delirium TTT sessions were implemented in a large four-hospital network and consisted of presession online work and a 3-hour in-session component. The 156 TTT interprofessional participants who attended the sessions (ie, trainers) were expected to then deliver delirium training to their patient care units. Delirium care self-efficacy and knowledge test scores were measured before, after, and 6 months after the training session. Clinician delirium assessment rates were measured by chart audits before and 3 months after trainer's implementation of delirium training sessions.
Results:
Delirium knowledge test scores (7.8 ± 1.6 versus 9.7 ± 1.2, P < .001) and delirium care self-efficacy were significantly higher immediately after the TTT session compared with those of presession and these differences remained significant at 6-month after the TTT session. Trainer sessions significantly improved clinician delirium assessment rates from 53% for pretraining to 66% for posttraining.
Discussion:
Our data suggest that a TTT FC delirium training approach can improve participants' perceived delirium care skills and confidence, and delirium knowledge up to 6 months after the session. This approach provides a model for implementing hospitalwide delirium education that can change delirium assessment behavior while minimizing time and personnel requirements.
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