Classroom-Based Simulation: Participants and Observers Perceive High Psychological Fidelity and Improved Clinical Preparedness

Abstract

Introduction. High-fidelity simulationbased learning experiences (SBLEs) can improve student confidence for clinical practice, but there are several barriers to incorporating these activities into physical therapy program curricula. Review of Literature. Studies have explored high-fidelity acute care SBLEs in simulation laboratories, but little is known about the effectiveness of low-cost classroom-based SBLES in physical therapy education. Additionally, there is a gap in the literature related to the role of the active observer during SBLEs in physical therapy education. e purpose of this study was to uncover student perspectives about participating as both participant and observer in classroom-based SBLEs and the impact of this experience on preparedness for acute care clinical practice. Subjects. Subjects included a convenience sample of first-year doctor of physical therapy (DPT) students. Methods. Students participated in a series of classroom-based SBLEs as part of a firstyear DPT course. is mixed methods study included focus groups to qualitatively analyze student perspectives of classroom-based SBLEs and a pre-post quasi-experimental design to evaluate changes in perceived self-efficacy for acute care clinical practice before and after a series of classroom-based SBLEs using the Acute Care Confidence Survey (ACCS).Results. Quantitative data analysis (n = 60) revealed a statistically significant increase in perceived self-efficacy for the total ACCS (Z = 26.250, P < .000) and all 4 subscales from presimulation to postsimulation. Qualitative data analysis (n = 22) revealed 4 primary themes related to participating in classroom-based SBLEs: (1) psychological fidelity-it felt real; (2) promotes clinical reasoning for participants and observers;(3) stimulates self-reflection and observational learning; and (4) fosters self-efficacy for future clinical practice. Conclusion. Classroom-based SBLEs can provide a high-fidelity and cost-effective means of exposing students to a range of clinical situations that engage all participants in experiential learning through both direct participation and active observation.

Examining Clinical Readiness and Performance of Students on Clinical Education Experiences: Is There an Influence From Virtual Learning?

“…Peer simulation is an interactive educational technique in which students portray patientclinician scenarios to enhance clinical skills and interpersonal skills and to mimic clinical training. 17,18 is educational technique has been considered safe, supportive, engaging, and valuable for clinical readiness as perceived by students. Students who receive these education methods have been shown to report more confidence in their clinical skills, improved clinical reasoning, and increased ratings in CPI criteria.…”

“…Students who receive these education methods have been shown to report more confidence in their clinical skills, improved clinical reasoning, and increased ratings in CPI criteria. 17,18 In alignment with these concepts, the University of Central Florida (UCF) DPT program delivers a peer simulation course in the fourth semester of the program before the first full-time CEE to foster clinical reasoning skills in a safe, controlled environment. is course, titled "Clinical Integrations," serves as a mock clinical course designed to assimilate the content covered throughout the curriculum and to present students with common clinical scenarios through a peer-simulation approach.…”

“…Students who receive these education methods have been shown to report more confidence in their clinical skills, improved clinical reasoning, and increased ratings in CPI criteria. 17,18…”

The lived experience of clinical instructors as simulated patients: a qualitative study

“…[3][4][5][6] Physical therapist (PT) educators often create high fidelity environments using simulated patients (SPs), rather than manikins, who actively participate in SLE to mimic physical therapy practice. [7][8][9][10] An SP is 'a person who has been carefully coached to simulate an actual patient so accurately that the simulation cannot be detected by a skilled clinician… the SP presents the gestalt of the patient being simulated; not just the history, but the body language, the physical findings, and the emotional and personality characteristics as well'. 1,11 SPs may be actors, educators, students, patients, or clinicians.…”

Partial Substitution of Simulation-Based Learning Allows Equal Student Self-confidence in the Acute Care Setting

“…Over the past decade, clinical site placement in physical therapist (PT) education has become increasingly difficult in the acute care and intensive care unit (ICU) environments 1–13. The growing acuity of patients with complex diagnoses and comorbidities in these environments may be a hindrance to student placement 9–11,14–16.…”