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Roos R1, Van Aswegen H1, Thurling CH2, Casteleijn D3
1University of the Witwatersrand, Department of Physiotherapy, Johannesburg, South Africa, 2University of the Witwatersrand, Centre for Health Sciences Education, Johannesburg, South Africa, 3University of the Witwatersrand, Department of Occupational Therapy, Johannesburg, South Africa
Background: Skills such as suction and manual hyperinflation (MHI) are often needed to manage patients with cardiopulmonary impairments in an intensive care unit (ICU). High-fidelity simulation is used in Health Sciences Education as a means of optimising clinical education by allowing students to focus on perfecting a skill by improving their confidence, competency and clinical decision making in a safe learning environment. Less is known whether high-fidelity simulation of suction and MHI skills before students' clinical ICU rotation would translate to inclusion of skills in their clinical practice.
Purpose: The purpose of the study was to determine undergraduate students' opinions of high-fidelity simulation of suction and MHI before their ICU clinical rotation. Clinical educators' opinions were sought regarding implementation of these skills by students during patient care in their ICU rotation.
Methods: The project consisted of two parts: part 1 was a retrospective record review of students' feedback using the Simulation Effectiveness Tool-Modified (SET-M); part 2 was a nominal group technique using a focus group discussion with the clinical educators who supervised students during their ICU rotation in 2017. Final ranking of opinions generated with the group discussion was facilitated with a REDCap survey. Descriptive data analysis with IBM SPSS 25 and transcription of focus group discussion for explanatory quotations of opinions were done.
Results: Six high-fidelity simulation sessions, lasting 3 hours each, with a total of 49 students (n=8-9 students per session) were done during the 2017 academic year. Forty five SET-M questionnaires (91.9%) were completed but six excluded due to incomplete data. Feedback from students were positive due to scoring mostly in the 'strongly agree' category: n=39 (100%) indicated pre-briefing increased their confidence and was beneficial to their learning; n=39 (100%) found debriefing allowed for self-reflection on their performance, helped with increasing their clinical judgement, was a constructive evaluation of the simulation and contributed to their learning. Fifteen clinical educators were invited to participate in part 2. Five participated, had a median age of 31 (28.5-45.5) years, were qualified for 8 (7.3-23.5) years and had been supervising students for 4 (2.5-15.0) years. The clinical educators' top five opinions regarding students' implementation of the ICU skills were: handling skills improved; students had greater confidence performing skills; students were more observant of a patient's response to the skill being performed; students had better theoretical knowledge; had more accurate recall for precautions. Barriers highlighted included: fear of real patients and real scenarios; skills learned during simulation was not always carried over into clinical practice due to lack of equipment or the culture at a unit; experience and confidence of a supervisor affected learning outcomes of students.
Conclusion(s): Students had positive opinions regarding the high-fidelity simulation and clinical educators reported change in students' clinical practice during their ICU rotation following simulation.
Implications: High-fidelity simulation of suction and MHI in a simulation laboratory is a beneficial adjunct teaching method in the physiotherapy ICU curriculum for final year undergraduate students. Implementation of skills into clinical practice may be hampered by context specific barriers.
Keywords: High-fidelity simulation, ICU, opinions
Funding acknowledgements: Not applicable.
Purpose: The purpose of the study was to determine undergraduate students' opinions of high-fidelity simulation of suction and MHI before their ICU clinical rotation. Clinical educators' opinions were sought regarding implementation of these skills by students during patient care in their ICU rotation.
Methods: The project consisted of two parts: part 1 was a retrospective record review of students' feedback using the Simulation Effectiveness Tool-Modified (SET-M); part 2 was a nominal group technique using a focus group discussion with the clinical educators who supervised students during their ICU rotation in 2017. Final ranking of opinions generated with the group discussion was facilitated with a REDCap survey. Descriptive data analysis with IBM SPSS 25 and transcription of focus group discussion for explanatory quotations of opinions were done.
Results: Six high-fidelity simulation sessions, lasting 3 hours each, with a total of 49 students (n=8-9 students per session) were done during the 2017 academic year. Forty five SET-M questionnaires (91.9%) were completed but six excluded due to incomplete data. Feedback from students were positive due to scoring mostly in the 'strongly agree' category: n=39 (100%) indicated pre-briefing increased their confidence and was beneficial to their learning; n=39 (100%) found debriefing allowed for self-reflection on their performance, helped with increasing their clinical judgement, was a constructive evaluation of the simulation and contributed to their learning. Fifteen clinical educators were invited to participate in part 2. Five participated, had a median age of 31 (28.5-45.5) years, were qualified for 8 (7.3-23.5) years and had been supervising students for 4 (2.5-15.0) years. The clinical educators' top five opinions regarding students' implementation of the ICU skills were: handling skills improved; students had greater confidence performing skills; students were more observant of a patient's response to the skill being performed; students had better theoretical knowledge; had more accurate recall for precautions. Barriers highlighted included: fear of real patients and real scenarios; skills learned during simulation was not always carried over into clinical practice due to lack of equipment or the culture at a unit; experience and confidence of a supervisor affected learning outcomes of students.
Conclusion(s): Students had positive opinions regarding the high-fidelity simulation and clinical educators reported change in students' clinical practice during their ICU rotation following simulation.
Implications: High-fidelity simulation of suction and MHI in a simulation laboratory is a beneficial adjunct teaching method in the physiotherapy ICU curriculum for final year undergraduate students. Implementation of skills into clinical practice may be hampered by context specific barriers.
Keywords: High-fidelity simulation, ICU, opinions
Funding acknowledgements: Not applicable.
Topic: Education; Education: methods of teaching & learning; Education: clinical
Ethics approval required: Yes
Institution: University of the Witwatersrand, Johannesburg, South Africa
Ethics committee: University of the Witwatersrand Human Research Ethics Committee (Medical)
Ethics number: M180151
All authors, affiliations and abstracts have been published as submitted.
