Bayliss A1, Johnson R1, Clark K1, Strunk V1, Altenburger P1
1Indiana University, Physical Therapy, Indianapolis, United States
Background: Limitations in didactic training and opportunity for clinical exposure provide challenges when preparing students for acute care clinical practice in an intensive care unit (ICU).
Purpose: The purpose of this project was to compare the impact of two high fidelity human simulation (HFHS) sessions vs one on Doctor of Physical Therapy (DPT) student's acute care confidence and therefore clinical readiness to function in a critical care environment.
Methods: 83 DPT students participated, with 41 students in Cohort A and 42 students in Cohort B. Cohort A participated in one HFHS session and Cohort B in two HFHS sessions. Teams of 3-4 students were given objectives and a case history one week prior to each HFHS experience. The HFHS used the Laerdal's SimMan 3G mannequin. The mannequin was connected to an oxygen delivery system, equipped with lines and tubes typically seen in an ICU setting, and with vitals displayed on a telemetry unit. The format for each simulation lab included a 15 minute pre-brief session which included reviewing the objectives and case history, then assigning a task to each student, thereby rotating the PT role throughout the experience. The student-SimMan encounter lasted 20 minutes and required the team to assess readiness to mobilize, perform range of motion, and then mobilize the SimMan to sitting. Following the HFHS, the student teams participated in a debrief session for 15 minutes. Three course instructors were present each day, one assigned to perform all the pre-briefs and the other two observed the student-SimMan encounter and then debriefed student teams. The cost for Cohort A was US$625 vs US$1250 for Cohort B.
Results: Both cohorts completed the Acute Care Confidence survey (ACCS) prior to and following the completion of the HFHS learning experience. A Wilcoxon Signed Ranks test was used to compare confidence score change. There were significant positive findings in the overall survey score for both groups (P 0.0001) with students feeling more confident after the HFHS sessions. Additionally 3 of the 4 subscales within Cohort A and all 4 subscales in Cohort B were significantly higher after the learning experience. A Mann-Whitney U test was used to assess between cohort differences in confidence following HFHS exposure. There was a significant difference for overall survey score and for all 4 subscale scores (P .03) with students in Cohort B experiencing greater increases in confidence. Students in Cohort B experienced on average a 10% greater increase in confidence across all 4 subscales when compared to Cohort A.
Conclusion(s): Students were impacted positively and significantly improved their self-confidence in an critical care environment regardless of whether they attended one vs two sessions in the simulation lab; however, students in Cohort B experienced a significantly greater improvement in self-confidence justifying the cost of two HFHS sessions.
Implications: The HFHS learning experience enhanced student self-confidence which has been linked to clinical readiness and performance, where confident students are more likely to be effective physical therapists.
Keywords: Cardiorespiratory, clinical readiness, self confidence
Funding acknowledgements: This work is unfunded.
Purpose: The purpose of this project was to compare the impact of two high fidelity human simulation (HFHS) sessions vs one on Doctor of Physical Therapy (DPT) student's acute care confidence and therefore clinical readiness to function in a critical care environment.
Methods: 83 DPT students participated, with 41 students in Cohort A and 42 students in Cohort B. Cohort A participated in one HFHS session and Cohort B in two HFHS sessions. Teams of 3-4 students were given objectives and a case history one week prior to each HFHS experience. The HFHS used the Laerdal's SimMan 3G mannequin. The mannequin was connected to an oxygen delivery system, equipped with lines and tubes typically seen in an ICU setting, and with vitals displayed on a telemetry unit. The format for each simulation lab included a 15 minute pre-brief session which included reviewing the objectives and case history, then assigning a task to each student, thereby rotating the PT role throughout the experience. The student-SimMan encounter lasted 20 minutes and required the team to assess readiness to mobilize, perform range of motion, and then mobilize the SimMan to sitting. Following the HFHS, the student teams participated in a debrief session for 15 minutes. Three course instructors were present each day, one assigned to perform all the pre-briefs and the other two observed the student-SimMan encounter and then debriefed student teams. The cost for Cohort A was US$625 vs US$1250 for Cohort B.
Results: Both cohorts completed the Acute Care Confidence survey (ACCS) prior to and following the completion of the HFHS learning experience. A Wilcoxon Signed Ranks test was used to compare confidence score change. There were significant positive findings in the overall survey score for both groups (P 0.0001) with students feeling more confident after the HFHS sessions. Additionally 3 of the 4 subscales within Cohort A and all 4 subscales in Cohort B were significantly higher after the learning experience. A Mann-Whitney U test was used to assess between cohort differences in confidence following HFHS exposure. There was a significant difference for overall survey score and for all 4 subscale scores (P .03) with students in Cohort B experiencing greater increases in confidence. Students in Cohort B experienced on average a 10% greater increase in confidence across all 4 subscales when compared to Cohort A.
Conclusion(s): Students were impacted positively and significantly improved their self-confidence in an critical care environment regardless of whether they attended one vs two sessions in the simulation lab; however, students in Cohort B experienced a significantly greater improvement in self-confidence justifying the cost of two HFHS sessions.
Implications: The HFHS learning experience enhanced student self-confidence which has been linked to clinical readiness and performance, where confident students are more likely to be effective physical therapists.
Keywords: Cardiorespiratory, clinical readiness, self confidence
Funding acknowledgements: This work is unfunded.
Topic: Education: methods of teaching & learning; Critical care
Ethics approval required: Yes
Institution: Indiana University
Ethics committee: Office of Research Compliance
Ethics number: 1106006079 R004
All authors, affiliations and abstracts have been published as submitted.
