Due to the fast pace and high complexity of managing patients in intensive and acute care units (ICUs), healthcare students often feel challenged and unprepared to practice in this environment. Simulations and standardised patients provide "hands-on" learning experiences that are realistic and help students to gain competence and confidence. This study examined the impact of an intensive case simulation laboratory using a patient simulator and standardised patients on students' perceptions of their confidence and preparedness to work in acute care settings. Second-year Masters of Occupational Therapy (MOT; n = 127) and Doctor of Physical Therapy (DPT; n = 105) students participated in a three-hour intensive care simulation laboratory comprised of four stations that were designed to simulate common ICU patient care scenarios. Data analysed were student pre- and post-simulation surveys and written comments, and clinical instructors' (CIs; n = 51) ratings on DPT students' preparedness and confidence within the first two weeks of their acute care internships obtained after the laboratory. There was a significant increase for DPT (p < 0.0001) and MOT (p < 0.10) students in median ratings of how prepared they felt to practice in acute care settings following the ICU simulation compared to before the laboratory. CIs rated the DPT students as either prepared or very prepared for and moderately confident or very confident in the acute care setting. The use of simulation training using standardised patients and patient simulators was beneficial in increasing student confidence and preparing OT and PT students to practice in the acute care setting. Health professional educators should consider using an interprofessional simulation experience to improve their students' confidence and preparedness to provide appropriate care in the acute setting.
Background Clinical education is an integral component of physical therapy education. Both benefits and barriers exist in clinical education, but 1 commonly stated barrier includes the perception that students have a negative impact on clinical instructor (CI) productivity. Objective The purposes of this study were to evaluate the productivity of physical therapist CIs in an academic medical center before, during, and after clinical education experiences (CEEs), determine if there are differences in productivity during CEEs across settings, and compare CI productivity to that of therapists who did not have a student during the same time frames. Design A retrospective design examined productivity across 3 years in acute care (AC), inpatient rehabilitation (IPR), outpatient orthopedics (OPO), and outpatient neurology (OPN). Mean daily productivity was computed, normalized to an 8-hour day, and averaged for each week of the year. Data was analyzed using a repeated-measures ANOVA. Post-hoc comparisons were made within each setting to compare therapists with a student to those without. The Bonferonni-correction was used to control for multiple comparisons. Results CI productivity was significantly increased in OPO and IPR, approached significance in OPN, but was not significant in AC. The presence of a student made CIs more productive, but had no effect on the productivity of other therapists in that setting during the same time frame. Limitations We studied only 1 academic medical center and could not account for CI factors such as years of experience or student factors such as year in their program. Conclusions Our results indicate that having a student increases productivity of therapists in various settings. Future studies should examine the impact of CI experience, student characteristics, and should expand to other settings.
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