A SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF SIMULATION IN PHYSIOTHERAPY EDUCATION

¹Queen Margaret University, Edinburgh, United Kingdom

Background: The goal of physiotherapy education is to facilitate continuing intellectual, professional, and personal development of students through formal teaching, self-directed learning, practice-based learning, technology-based and learning from and through experience ("World Physiotherapy" 2020). Accordance with this goal, simulation-based education (SBE) is a useful pedagogical approach in healthcare that replicates real-world experiences in a safe and supportive learning environment. Existing literature of SBE have shown positive effects on student’s knowledge, skills, and attitudes, in physiotherapy education but lack clarity on how interactions between simulation fidelity and simulation modalities influences SBE learning experiences. This systematic review aimed to synthesize the evidence on effectiveness of simulation in physiotherapy education by summarizing how simulation fidelity and different simulation modalities influences physiotherapy students’ learning experience.

Purpose: To identify the effectiveness of simulation fidelity and simulation modalities on learning domains on physiotherapy students’ academic experiences and to establish the level of evidence of literature on the efficacy of learning in simulation-based physiotherapy education.

Methods: The systematic literature review was structured according to the PRISMA guidelines. Selected studies were assessed for risk of bias and quality of study method by using the Medical Education Research Study Quality Instrument (MERSQI). An initial data synthesis was performed on extracted articles and grouped according to Kirkpatrick’s framework level 1, level 2, and level 3 for categorising outcome criteria of simulation-based education (SBE) training. Data that concerned with the three learning domains: cognitive, affective, and psychomotor were synthesized. Further, the data was analysed according to study characteristics (author name, publication year, study design), simulation intervention (simulation fidelity/simulation modalities), outcomes (level of skills trained; cognitive, affective, psychomotor) and MERSQI scores.

Results: From a pool of 457 abstracts, 15 articles, were included in this systematic review. Study designs included a variety of study designs, including single-group (n=2), two-group post-test only (n=1), single-group pre-/post-test (n=3), nonrandomized two-group (n=1), and randomized clinical trial (n=8) designs. The median quality of MERSQI score for all studies was 10.2 (SD: 12.17), with a range of between 6-16, out of maximum 18 points.

Conclusions: Simulation based educational interventions were shown to be effective in physiotherapy education. Simulation-based education led to a significant increase in students’ overall learning experience which encompassed all three learning domains: affective, cognitive, and psychomotor domain. This systematic review identified evidence that simulation in physiotherapy education significantly benefited all three learning domains regardless of the different simulation fidelity or simulation modalities utilized, which complements each other, contributing to student learning experience. Hence, an accurate and elective form of simulation level will advance all levels of learning outcomes.

Implications: This systematic review identified evidence that simulation in physiotherapy education significantly benefited all three learning domains: affective, cognitive, and psychomotor domain, regardless of the different simulation fidelity or simulation modalities utilized. The accurate use of all three domains in simulation based education, complements each other by contributing to positive student learning experience. Therefore, physiotherapy educators should consider perceptions of physiotherapy students, from various learning levels and learning styles, when applying simulation based education as an intervention to meet learning goals.

Funding acknowledgements: This research did not receive any form of grant from any funding agencies in the public, commercial, educational, or not-for-profit sectors.

Keywords:
Simulation based education
Fidelity
Physiotherapy

Topics:
Education: methods of teaching & learning
Innovative technology: information management, big data and artificial intelligence
Education: continuing professional development

Did this work require ethics approval? No

Reason: It is a systematic review