IntroductionThe use of simulation in health professional education has increased rapidly over the past 2 decades. While simulation has predominantly been used to train health professionals and students for a variety of clinically related situations, there is an increasing trend to use simulation as an assessment tool, especially for the development of technical-based skills required during clinical practice. However, there is a lack of evidence about the effectiveness of using simulation for the assessment of competency. Therefore, the aim of this systematic review was to examine simulation as an assessment tool of technical skills across health professional education.MethodsA systematic review of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medical Literature Analysis and Retrieval System Online (Medline), and Web of Science databases was used to identify research studies published in English between 2000 and 2015 reporting on measures of validity, reliability, or feasibility of simulation as an assessment tool. The McMasters Critical Review for quantitative studies was used to determine methodological value on all full-text reviewed articles. Simulation techniques using human patient simulators, standardized patients, task trainers, and virtual reality were included.ResultsA total of 1,064 articles were identified using search criteria, and 67 full-text articles were screened for eligibility. Twenty-one articles were included in the final review. The findings indicated that simulation was more robust when used as an assessment in combination with other assessment tools and when more than one simulation scenario was used. Limitations of the research papers included small participant numbers, poor methodological quality, and predominance of studies from medicine, which preclude any definite conclusions.ConclusionSimulation has now been embedded across a range of health professional education and it appears that simulation-based assessments can be used effectively. However, the effectiveness as a stand-alone assessment tool requires further research.

Purpose: MASK-ED™ (KRS Simulation) involves an educator donning a silicone mask to portray a patient character that has been specifically developed in line with learning outcomes. The effectiveness of MASK-ED™ (KRS Simulation to prepare physiotherapy students prior to commencing work integrated learning has not been investigated.Methodology: This randomised cluster trial will investigate MASK-ED™ (KRS Simulation) in addition to usual teaching in neurological physiotherapy. Physiotherapy students in an intervention group will receive simulated learning via a MASK-ED™ (KRS Simulation) character as well as usual teaching. Students in a control group will receive usual teaching only, including role-play with peers. Consent will be concealed from the investigating team and blinded assessors will assess the primary outcome. Secondary outcomes will be practical and written examination results and a satisfaction survey.Research implications: This will be the first randomised trial investigating MASK-ED™ (KRS Simulation)’s effect on students’ readiness for work integrated learning.Practical implications: The results from this study will inform physiotherapy education and curriculum development by increasing the evidence base for the use of simulation in training physiotherapy students prior to work integrated learning.Originality: MASK-ED™ (KRS Simulation) was developed in nursing education at Central Queensland University, Australia. Although it has been investigated in medical imaging, this is its first practical application within physiotherapy curricula.Limitations: It will be impractical and unfeasible to blind the participants and the investigators to tutorial group allocation and impractical for blind assessing of practical examinations.

Background In physiotherapy there is a growing body of literature exploring the benefits simulation could have in the university-setting, prior to the commencement of work-integrated learning. MASK-ED™ simulation is one form of simulation that could be beneficial for student learning and improve performance in the clinical setting. MASK-ED™ simulation involves an educator donning a silicone mask and portraying a patient role that has been specifically developed to meet learning objectives. Objective To evaluate the effectiveness of MASK-ED™ simulation compared to role-play with peers for training pre-clinical physiotherapy students. Methods A single-centre, single-blind, cluster randomized trial with concealed allocation, between group post-measures, and intention-to-treat analysis was conducted at an Australian university between February 2018 – January 2021. Participants were 144 physiotherapy students, cluster randomized by tutorial groups (exp n = 70, con n = 74), undertaking their neurological curricula. The experimental group was exposed to MASK-ED™ simulation in five out of a potential thirty-two tutorials (16%) whilst the control continued with role-play with peers. The primary outcome measure was Assessment of Physiotherapy Practice scores from the students’ rehabilitation work-integrated learning clinical placement. These were compared between the experimental and control groups using Mann–Whitney U tests. Secondary outcome measures include practical and written examination scores. These were compared between groups via independent t-tests. Participant satisfaction surveys were also administered to the experimental group. Results One hundred thirty-two participants’ (exp n = 62, con n = 72) results were analyzed. There were no significant differences between the experimental and control groups for Assessment of Physiotherapy Practice scores (p = 0.699–0.995). There were no significant differences found between the groups, across the secondary outcome measures. Participants found MASK-ED™ simulation was somewhat helpful for preparing them for clinical practice, however felt that a group setting was not as effective as a one-on-one encounter would have been. Conclusions MASK-ED™ simulation was no more effective than role-play with peers in preparing physiotherapy students for work-integrated learning. The influence of the design of simulation on effective learning and the number of classroom-based simulation encounters required to impact clinical performance requires further investigation.

Purpose: The aim of this exploratory research was to investigate the use of simulation in physiotherapy curricula across Australia and New Zealand. The key areas of focus were whether simulation was being used, the forms of simulation used for training and assessment, evidence for educational simulation practices, and the enablers and barriers to implementing simulation into the curricula. Method: All Australian and New Zealand Universities offering a physiotherapy degree were invited to participate in an electronic survey. As no pre-existing tool was available to answer the aims of the study, a custom designed survey was developed. The survey was pilot tested on three physiotherapy academics to limit ambiguity and ensure the questions directly related to the purpose of the study. An introductory invitation was circulated via the Council of Physiotherapy Deans Australia and New Zealand. Open and closed ended questions were analyzed following a sequential explanatory strategy. Results: Fourteen (14) of the possible 22 universities (64%) responded, with all indicating that they use simulation for training or assessment and many using it for both. All core areas of clinical practice were represented, as were low to high-fidelity forms of simulation. Role play (77%), low/medium fidelity manikins (77%), and standardized patients (62%) were the most frequently used for training. Role play (73%), standardized patients (45%), objective structured clinical examinations (45%), and low/medium fidelity manikins (37%) were the most frequently used modalities for assessment. The key enablers appear to be availability of equipment, academic support, growing evidence for its use, safety, and positive student experiences. The key barriers appear to be time, cost, and access to trained staff and equipment. Conclusions: Academics across Australia and New Zealand described simulation practices for both training and assessing physiotherapy students. Academics were able to identify a limited but expanding evidence-base for simulation, more strongly focused on training than simulation-based assessments. Recommendations: Further research may justify increased investment of time, money, resources, and training in different simulation modalities.