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The Participant-Reported Implementation Update and Score (PRIUS): A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Implementation and assessment of a novel interprofessional educational initiative in the medical intensive care unit:
Cecile M Foshee1, Aanchal Kapoor2, Ronna Romano1
1Education, Office of Interprofessional Learning, Cleveland Clinic, Cleveland, OH, United States.
Background:
Effective interprofessional collaboration is essential to high-quality care, yet siloed training, unclear roles, and hierarchical structures frequently undermine teamwork in clinical care environments. Efforts to achieve sustained behavioral change have yielded inconsistent results despite decades of advocacy for interprofessional education. Time constraints, staff turnover, and limited opportunities for shared learning exacerbate these challenges, particularly in high-acuity settings.
Objectives:
We developed the Strengthening Minds by Leveraging Education (SMiLESM) program to address these barriers and enhance teamwork within a medical intensive care unit.
Methods:
Co-designed by educators and frontline clinicians, the curriculum is grounded in transformative learning theory and structured using the RAPR model (Recognize, Analyze, Practice, Reflect). Sessions rotate through 4 core domains: role clarity, psychological safety, teaming, and empathy. SMiLE was designed to be a weekly, low-burden educational activity that brings together professionals from at least 4 professional groups, to reflect on challenges and learn with, from, and about each other.
Results:
Between 2019 and 2023, 127 SMiLE sessions were facilitated for caregivers from 15 professions, totaling 1416 learning encounters. Qualitative narratives and focus group data reflected increased clarity around roles, enhanced use of structured communication, and improved team dynamics. Organizational surveys showed gains in psychological safety and teamwork among a high-acuity workforce. Accreditation Council for Graduate Medical Education milestone ratings suggested growth in communication and professionalism competencies among graduate medical education trainees.
Conclusions:
SMiLE is an adaptable and practical approach for improving team behaviors and cultivating collaborative culture in high-acuity environments like intensive care units. We find it to be a promising educational method to enhance interprofessional practice.
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