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A. Bayliss1, K. Elsasser1, R. Johnson2, V. Strunk1, P. Altenburger1
1Indiana University, Physical Therapy, Indianapolis, United States, 2University of Indianapolis, Physical Therapy, Indianapolis, United States
Background: Limitations in clinical exposure provide challenges when preparing physical therapy (PT) students for practice in a critical care environment. This has necessitated PT programs add learning experiences such as high fidelity human simulation (HFHS). These learning opportunities help to bridge didactic and clinical training with hands-on experiential learning in a safe environment that allows for mistakes and provides ample opportunity for debriefing and reflection. However, when the coronavirus pandemic necessitated a change to online learning in the 2020 spring semester PT educators had to quickly adapt content delivery.
Purpose: The purpose of this project was to assess the impact of the combination of in-person and virtual HFHS sessions on PT students’ acute care confidence and therefore clinical readiness.
Methods: 120 PT students participated, with 41 students in Cohort A and B and 38 students in Cohort C. The 3 cohorts participated in two HFHS sessions in 3-member teams with the following similarities; case histories were received one week prior, a 15-minute pre-brief, a 20-minute SimMan™ encounter, a 15-minute debrief and reflection of performance between HFHS sessions delivered 4 weeks apart. Cohorts B and C completed both HFHS sessions in person at a simulation center. However, Cohort A completed one HFHS session in person and then the second HFHS session was virtual. The virtual HFHS consisted of pre-recorded treatment sessions where experienced PTs performed one of the treatment sessions as an “ideal” session and the other performed with multiple errors in manual skills, mobilization, instruction and judgement.
Results: All cohorts completed the Acute Care Confidence survey (ACCS) prior to and following the completion of the HFHS sessions. A Kruskal-Wallis analysis of variance was used to compare changes in total and subscale confidence scores with adjustments for multiple comparisons. There were no statistically significant cohort differences in ACCS scores prior to the simulation. Cohorts A and C scored significantly higher (p < .05) in total confidence and the subscale of judgment when compared to cohort B. Cohort C was significantly more confident in the instruction subscale when compared to cohort B. A Wilcoxon Signed Ranks test was used to assess within cohort differences prior and following HFHS exposure. Each cohort was found to have a significant increase (p < .01) in overall confidence following HFHS participation.
Conclusion(s): Students significantly improved self confidence in an acute care setting after participating in two HFHS sessions. Cohort A experienced one of their simulation sessions virtually due to the COVID-19 pandemic, however despite this change to simulation delivery they meet or exceeded confidence when compared to their counterparts. Cohort A had higher ratings in the total score and judgment subscale when compared to Cohort B. It is possible the virtual simulation where DPT students watched experts’ function in the simulated acute care setting allowed them to reflect on an ideal patient session and model their future judgment and clinical decisions based on expert clinician actions thereby increasing their confidence.
Implications: HFHS was successfully adapted from a face-to-face experiential learning activity to a virtual learning experience without undermining student confidence.
Funding, acknowledgements: No funding was obtained.
Keywords: Virtual simulation, Critical care, Student confidence
Topic: Education: methods of teaching & learning
Did this work require ethics approval? Yes
Institution: Indiana University Purdue University Indianapolis
Committee: Indiana University Human Subjects & Institutional Review Board
Ethics number: 1106006079
All authors, affiliations and abstracts have been published as submitted.
