Fostering self-determination of bedside providers to promote active participation in rapid response events

• Published in: Medical education online Vol. 24; no. 1; p. 1551028
• Main Authors: Bavare, Aarti C., Thomas, Jenilea K., Gurganious, Lindsey M, Afonso, Natasha, Thomas, Tessy A., Thammasitboon, Satid
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.01.2019; Taylor & Francis Ltd; Taylor & Francis Group
• Subjects: Autonomy; bedside providers; Competence; Educational programs; Hospitalized; Loss of control; Needs assessment; Participation; Patients; Pediatrics; Perceptions; Rapid Response teams; Relatedness; RR training; SDT: Self-Determination Theory; Self determination; Teams; Trend; bedside providers; SDT: Self-Determination Theory; Rapid Response teams; RR training
• ISSN: 1087-2981; 1087-2981
• DOI: 10.1080/10872981.2018.1551028

Background: Widespread implementation of rapid response (RR) systems positively impacts outcomes of clinically unstable hospitalized patients. Collaboration between bedside providers and specialized responding teams is crucial for effective functioning of RR system. Bedside, providers often harbor negative feelings about having to 'call for help' that could impact their active participation in RR. Objective: The objective of the study is to enhance active participation of bedside providers in RR by fostering self-determination through targeted education. Design: Needs assessment affirmed that bedside providers in our tertiary academic pediatric hospital felt loss of control over patient care, lack of competence, and disconnect from the RR team. We used the principles of autonomy, competence, and relatedness posited by the self-determination theory to guide the development, implementation, and evaluation of our educational program for bedside providers. Results: Forty-two bedside providers participated in our program. Participants reported significant improvement in RR-related clinical knowledge. More importantly, there was significant enhancement in individual perceptions of autonomy (pre-mean: 2.12, post-mean: 4.4) competence (pre-mean: 2.15, post-mean: 4.4), and relatedness (pre-mean: 2.65, post-mean: 4.5) with RR (p < 0.01). The evaluation results for overall educational effectiveness showed a mean score of 4.69 ± 0.79. All scores were based on a 5-point Likert scale of 1: poor to 5: excellent. Educators noted good participant engagement. The program's structure, evaluations, and data management were modified based on the feedback. Conclusions: We successfully developed and implemented targeted educational program for bedside providers based on self-determination theory. The evaluations showed improvement in bedside providers' clinical RR knowledge and perceptions of autonomy, competence, and relatedness following the training.