BackgroundNovice students may have limited learning opportunities during their early exposure to complex clinical environments, due to the priorities of patient care. Immersive, high-fidelity simulation provides an opportunity for physiotherapy students to be exposed to relatively complex scenarios in a safe learning environment before transitioning to the clinical setting. The present study evaluated the influence of immersive simulation on student confidence and competence.MethodsSixty penultimate year physiotherapy students completed an 18-day full-time immersive simulation placement. The placement involved students spending 6 days working in each of three core practice areas (cardiopulmonary, musculoskeletal, neurological) in which they interacted with simulated patients portrayed by professional role-play actors. The patient scenarios were developed by groups of expert practitioners and incorporated full documentary and imaging information. Students completed a questionnaire to evaluate their confidence in the clinical environment at the start and completion of each 6-day rotation. Their clinical competence was evaluated at the end of each 6-day rotation using the Assessment of Physiotherapy Practice (APP) tool. In a secondary analysis, the clinical competence of this cohort was evaluated in comparison to a matched cohort of students from the same year group that had not completed an immersive simulation placement.ResultsStudent confidence improved significantly in each 6-day rotation (p < 0.001); however, it reduced again at the commencement of the next rotation, and there was no cumulative improvement in confidence over the 18-day placement (p = 0.22). Students who had completed the immersive simulation placement achieved higher APP (p < 0.001) scores in an evaluation of their competence to practice during their subsequent clinical placement.ConclusionImmersive simulation provides a beneficial learning environment to enable physiotherapy students to transition from university-based education to working in the clinical environment.Electronic supplementary materialThe online version of this article (10.1186/s41077-018-0062-9) contains supplementary material, which is available to authorized users.

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Background: Whilst relatively new in physiotherapy, simulation has been used in various medical and nursing programs to develop manual and communication skills and clinical reasoning. The primary aim of this study was to develop and introduce simulation activities into the physiotherapy curricula at an Australian University and evaluate students' motivation to learn. The secondary aim was to evaluate differences in perceived value between first and second year students. Methods: During 2014, first and second year physiotherapy students at Curtin University, Western Australia enrolled in three units had the opportunity to participate in newly developed simulated scenarios as part of their program. On completion of these novel learning activities, students were invited to undertake the Instructional Materials Motivation Scale (IMMS) questionnaire. Results: Total IMMS scores for the three units (147, 137 and 156) indicated that overall, students found the simulation based learning activities motivating. First year students found that simulation gained their attention and was more enjoyable than second year students. Conclusions: As motivation entices people to learn and to complete activities, there may be great potential for improved learning outcomes using this modality in physiotherapy curricula, especially in the first year of the program.

Of the physiotherapy students enrolled in the unit, 83 per cent took part in the SBL and 100 per cent of the participants completed the follow-up survey. Mean scores for each subscale ranged from 3.8 to 4.0, reflecting that students agreed more than moderately with the statements made in the scale. The median total IMMS score for all students was 149, well above the published median total score of the scale (108). Simulation-based learning activities provide students with opportunities to interact with realistic patients and environments DISCUSSION: The SBL activity model was successfully implemented and received positively by the students in terms of their motivation to learn. It gained the attention of participants by providing an opportunity to practise the non-technical skill of 'communicating with patients', previously learned in the classroom, in a simulated realistic environment and by using a design that seemed to consider the needs of the millennial generation.

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