Can simulation replace part of clinical time? Two parallel randomised controlled trials

Watson, Kathryn; Wright, Anthony; Morris, Norman; McMeeken, Joan; Rivett, Darren A.; Blackstock, Felicity; Jones, Anne; Haines, Terrence Peter; O’Connor, Vivienne; Watson, Geoffrey; Peterson, Raymond; Jull, Gwendolen

doi:10.1111/j.1365-2923.2012.04295.x

Cited by 170 publications

(179 citation statements)

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“…This finding has been previously demonstrated by (Watson et al 2012). In their study, the APP was used to assess physiotherapy students' performance after one week in a simulated learning environment and three-week traditional clinical placement.…”

Section: Discussionmentioning

confidence: 80%

Simulated Learning in the Clinical Education of Novice Physiotherapy Students

2015

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Clinical simulation is well established in nursing and medical education. It provides an effective learning opportunity for students to develop confidence to apply their skills in the clinical setting. Using simulation in physiotherapy education is less well established. The aim of the pilot study reported on in this article was to determine if a simulated clinical experience for physiotherapy students could: 1) increase student confidence before commencing a traditional clinical placement; and 2) replace part of the traditional clinical placement without compromising the student's ability to attain competency. The study consisted of replacing the first week of a five-week physiotherapy clinical placement with a simulated learning experience using standardised patients. Other structured learning activities such as peer learning, feedback sessions and opportunities for self-reflection were incorporated into the simulation week. Confidence to undertake clinical placement was measured at the beginning and end of the week and compared with a control group who undertook a five week traditional clinical placement. Assessment of student competence using the Assessment of Physiotherapy Practice, a standardised valid competency assessment tool, was compared between the two groups. Results indicated that the simulated learning experience significantly increased students' confidence to apply their professional and clinical skills. One week of clinical simulation did not compromise students' ability to achieve competency at the completion of their five-week placement. The power of the associated learning activities during the simulation week was evident from the students' feedback. This study highlights the benefits of incorporating simulated learning experiences and well-structured learning activities as part of all clinical experiences.

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Section: Discussionmentioning

confidence: 80%

Simulated Learning in the Clinical Education of Novice Physiotherapy Students

2015

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“…A similarly designed study 31 using the same simulation intervention in the context of cardiorespiratory physiotherapy internships found no improvement in clinical ability for the intervention group relative to the control group. The shorter duration of this simulation experience (8 hours, vs. 1 week in previously discussed studies 29,30 ) may partially explain why the intervention group did not show any additional benefits. In addition, complete data were available for only 20 of the 29 participants in the control group and 10 of 21 participants in the intervention group, which may have affected the results.…”

Section: Group D: Using Simulation To Represent Clinical Education (7mentioning

confidence: 86%

“…The second study used a similar design, but the cases focused on musculoskeletal diagnoses using SPs. 30 Neither study 29,30 found any differences in the main outcome, the Assessment of Physiotherapy Performance (APP), between traditional clinical immersion and either SLE model, which suggests that structured SLE is a viable substitute for hard-to-find clinical experiences. Secondary outcomes for both studies included students' self-rated confidence in communicating with, assessing, and managing patients.…”

Section: Group D: Using Simulation To Represent Clinical Education (7mentioning

confidence: 98%

“…29,30 These were multicentre randomized controlled trials with large sample sizes that used at least one valid outcome measure and assessed behaviours as well as satisfaction, knowledge, and skill. Each of these studies described two trials comparing models that replaced 25% of clinical immersion time with SLEs in a 4-week internship to a traditional model.…”

Section: Group D: Using Simulation To Represent Clinical Education (7mentioning

confidence: 99%

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Use of Simulation Learning Experiences in Physical Therapy Entry-to-Practice Curricula: A Systematic Review

Mori

Carnahan

Herold

2015

Physiotherapy Canada

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Purpose: To review the literature on simulation-based learning experiences and to examine their potential to have a positive impact on physiotherapy (PT) learners' knowledge, skills, and attitudes in entry-to-practice curricula. Method: A systematic literature search was conducted in the MEDLINE, CINAHL, Embase Classic+Embase, Scopus, and Web of Science databases, using keywords such as physical therapy, simulation, education, and students. Results: A total of 820 abstracts were screened, and 23 articles were included in the systematic review. While there were few randomized controlled trials with validated outcome measures, some discoveries about simulation can positively affect the design of the PT entry-to-practice curricula. Using simulators to provide specific output feedback can help students learn specific skills. Computer simulations can also augment students' learning experience. Human simulation experiences in managing the acute patient in the ICU are well received by students, positively influence their confidence, and decrease their anxiety. There is evidence that simulated learning environments can replace a portion of a full-time 4-week clinical rotation without impairing learning. Conclusions: Simulation-based learning activities are being effectively incorporated into PT curricula. More rigorously designed experimental studies that include a cost-benefit analysis are necessary to help curriculum developers make informed choices in curriculum design.Key Words: education; patient simulation; physical therapy specialty; students; systematic review. RÉ SUMÉObjectif : Examiner les publications sur les expé riences d'apprentissage par la simulation afin de dé terminer si ces expé riences peuvent avoir un effet positif sur les connaissances, l'attitude et les compé tences des é tudiants en physiothé rapie dans un programme de formation au niveau dé butant. Mé thode : Une recherche systé matique a é té effectué e dans les publications des bases de donné es MEDLINE, CINAHL, Embase Classic+Embase, Scopus et Web of Science, à l'aide des mots-clé s tels physiothé rapie, simulation, é ducation et é tudiants. Ré sultats : Un total de 820 ré sumé s ont é té examiné s et 23 articles ont é té inclus dans l'examen systé matique. Bien qu'il y ait eu peu d'essais contrô lé s randomisé s avec des mesures de ré sultats validé es, certaines dé couvertes au sujet de la simulation peuvent avoir un effet positif sur la conception des programmes de formation au niveau dé butant en physiothé rapie. L'utilisation de simulateurs pour fournir des donné es de ré troaction pré cises peut aider les é tudiants à acqué rir des compé tences spé cifiques. Les logiciels de simulation peuvent é galement optimiser l'expé rience d'apprentissage des é tudiants. Les expé riences de simulation humaine pour la gestion des patients en soins de courte duré e dans une unité de soins intensifs sont reç ues favorablement par les é tudiants, leur donnent plus d'assurance et diminuent leur anxié té . Des preuves portent à conclure que les e...

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“…A parallel randomised controlled trial by Watson et al (2012) found that simulated learning environments could replace clinical time of physiotherapy students in part (25%) "without compromising students' attainment of the professional competencies required to practise" (p. 657). Clearly, further quantitative research is required into the transfer of training, the effects of simulation on learning outcomes, and the impact of replacement of clinical placement time with simulation.…”

Section: Transfer Of Trainingmentioning

confidence: 99%

An investigation of the use of simulated patients in audiology student education

Hughes¹

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Audiologists are health care professionals responsible for the non-medical management of hearing and hearing disorders. A review of population and health statistics in Australia indicates that increasingly more audiologists are needed to service its growing and ageing population.The task of training audiologists falls to the universities that offer audiology programs. One of the biggest limiters on this training is the diminishing numbers of clinical placement opportunities available to the audiology students as a result of clinics external to the universities withdrawing their support of student training (due mostly to commercial pressures). As a result, many university audiology programs have begun to investigate simulation as a method of preparing students for clinical placements, and in particular, simulated patients (SPs).While SPs have been used widely in medicine and allied health professional education, only two studies have been conducted on their use in audiology. While both studies showed audiology students enjoyed working with SPs, neither showed if this work results in measurable gains in student skills.To investigate the potential of using SPs to train basic audiology skills in audiology students, the present research aimed to: (1) develop a tool for assessing the clinical skills of students working with SPs; and (2) compare the effectiveness of SP training versus seminar training for improving the clinical skills of first year audiology students.To develop a tool for assessing audiology students taking a case history from and giving feedback to a simulated patient (SP), a tool from the cognate discipline of speech pathology was modified for use on audiology students. The modified tool, the Audiology Simulated Patient Interview Rating Scale (ASPIRS), was then used by three evaluators to assess 24 first-year masters of audiology students taking case histories from and providing feedback to SPs. Analysis of the 3To compare seminar training versus SP training as methods for training audiology students to take case histories from and give feedback to adult patients, a randomised controlled trial with cross-over design was used to put 24 first-year audiology students through SP then seminar training (n=12) or seminar then SP training (n=12). The SP training involved one student per SP in a clinic setting with individualized feedback. The seminar training involved one academic staff member for the student group in a seminar setting with group feedback. The students were assessed taking a case history and giving feedback to an SP before the first training block, between the two training blocks, and after the final training block. A mixed model analyses of derived factors for case history and feedback showed significant (p<0.05) effects for assessment occasion (i.e., student skills improved with more training) but not for training sequence (i.e., order of training did not affect skill improvements) or training type (i.e., type of training did not affect skill improvements). Results indicated that ...

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Can simulation replace part of clinical time? Two parallel randomised controlled trials

Abstract: These RCTs provide evidence that clinical education in an SLE can in part (25%) replace clinical time with real patients without compromising students' attainment of the professional competencies required to practise.

Cited by 170 publications

References 56 publications

Simulated Learning in the Clinical Education of Novice Physiotherapy Students

Simulated Learning in the Clinical Education of Novice Physiotherapy Students

Use of Simulation Learning Experiences in Physical Therapy Entry-to-Practice Curricula: A Systematic Review

An investigation of the use of simulated patients in audiology student education

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