Simulated Learning in the Clinical Education of Novice Physiotherapy Students

Abstract

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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“…This was achieved by the provision of an appropriate, well-structured, supportive and realistic simulated learning environment (Gaba, 2004;Issenberg, Mcgaghie, Petrusa, Gordon, & Scalese, 2005). The positive student attitudes following the SLE component are consistent with other research findings of improvements in physiotherapy students' self-rated communication, patient assessment and management following one week of SLEs (Blackford et al, 2015;Blackstock et al, 2013;Watson et al, 2012). While not formally evaluated as part of this research project, the educators who supervised students who had undertaken the SLE placements also had very positive attitudes regarding the impact of the SLE component on the students' skills and preparedness.…”

“…In healthcare, there have been various forms of SLEs developed and used with varying levels of fidelity, including cardiopulmonary resuscitation dummies, modelled body segments, technologically advanced full body mannequins and actors portraying patient roles (Blackstock & Jull, 2007;Bradley, 2006;Gaba, 2004;May et al, 2009;Weller et al, 2012). High fidelity SLEs that involve patient actors known as simulated patients (SPs), are emerging as an effective teaching tool in physiotherapy education (Blackford, McAllister, & Alison, 2015;Blackstock et al, 2013;Cahalin & Markowski, 2011;Ladyshewsky & Gotjamanos, 1997;Lewis, Bell, & Ashgar, 2008;Pritchard, Blackstock, Nestell, & Keating, 2016;Watson et al, 2012). The purpose of SLEs is to allow students to acquire, consolidate and implement knowledge and practical skills in a safe and supportive environment (Gaba, 2004;Kant & Cooper, 2010;Lasater, 2007;Steadman et al, 2006;Weller et al, 2012).…”

“…Simulated learning experiences in physiotherapy have been used to improve student preparedness for clinical education and facilitate the acquisition of communication, team work and specific technical skills (Blackford et al, 2015;Blackstock et al, 2013;Ladyshewsky & Gotjamanos, 1997;Lewis et al, 2008;Watson et al, 2012). Studies have shown that SLEs may replace traditional placement time without detriment to student attainment of clinical competencies, and enhance confidence levels (Blackstock et al, 2013;Watson et al, 2012).…”

Simulation as a component of introductory physiotherapy clinical placements

“…In healthcare, there have been various forms of SLEs developed and used with varying levels of fidelity, including cardiopulmonary resuscitation dummies, modelled body segments, technologically advanced full body mannequins and actors portraying patient roles (Blackstock & Jull, 2007;Bradley, 2006;Gaba, 2004;May et al, 2009;Weller et al, 2012). High fidelity SLEs that involve patient actors known as simulated patients (SPs), are emerging as an effective teaching tool in physiotherapy education (Blackford, McAllister, & Alison, 2015;Blackstock et al, 2013;Cahalin & Markowski, 2011;Ladyshewsky & Gotjamanos, 1997;Lewis, Bell, & Ashgar, 2008;Pritchard, Blackstock, Nestell, & Keating, 2016;Watson et al, 2012). The purpose of SLEs is to allow students to acquire, consolidate and implement knowledge and practical skills in a safe and supportive environment (Gaba, 2004;Kant & Cooper, 2010;Lasater, 2007;Steadman et al, 2006;Weller et al, 2012).…”

Patient education best practice; enhancing physiotherapy students’ self-efficacy and skills

“…Simulation offers these advantages, and has demonstrated efficacy in improving student performance and self-efficacy in communication and clinical skills (May, Park & Lee, 2009;Bosse et al, 2012;Blackford, McAllister & Alison, 2015). These approaches may allow opportunities for direct experience, observation and feedback to enhance patient education selfefficacy and skills.…”