USING SIMULATED LEARNING TO PROMOTE DOCTOR OF PHYSICAL THERAPY STUDENTS’ CONFIDENCE IN COMPLEX PATIENT MANAGEMENT

N. Early¹, L. Hidalgo², C. Scrivani², C. Salmon², R. Marinas²

¹University of St Augustine for Health Sciences, Physical Therapy, St. Augustine, United States, ²University of St Augustine for Health Sciences, Physical Therapy, Miami, United States

Background: Health care students are expected to be knowledgeable in providing care to patients across the spectrum of complexity. No established standard exists regarding how health care educational programs should prepare students to perform care for patients with complex health conditions. Many programs utilize simulation-based learning (SBL) to ensure students are competent with patient management skills however, limited information exists regarding the ideal placement of SBL within the curriculum. While emerging data is available pertaining to physical therapy students’ perceived self-efficacy in managing acute patients, inadequate data exists for complex patients in the outpatient setting.

Purpose: This mixed method longitudinal study investigated if Doctor of Physical Therapy (DPT) students’ confidence levels toward complex patients in outpatient settings changed following exposure to case-based simulation learning opportunities. The pretest-posttest design performed during the second year of the DPT curriculum also explored students’ preferred educational methodology.

Methods: Following IRB approval, an online Physiotherapist Self-Efficacy (PSE) Questionnaire, consisting of 13 Likert scale questions and an open-ended question, was completed by 80 consenting second-year students, across three consecutive cohorts. The PSE was administered at the start and end of an 8-week simulation-based course focused on managing complex outpatients. A coding system tracked and matched multicampus university participants’ pre- and post-survey responses. Students also answered an open-ended question related to factors that could further improve their confidence, the qualitative data was reviewed for themes. PSE self-efficacy scores were analyzed using Paired Sample t-Tests for descriptive statistics and the Levene test for variance.

Results: Based on curricular timeline changes, cohort 1 students (N =19) completed the course after their first full-time clinical experience while cohort 2 and 3 students (N=61) took the course before. For most students, confidence levels for pre-test surveys were ranked low by selecting “little confidence or neutral” for all 13 items. Post-test survey responses indicated increased confidence with most students selecting “confident” as their confidence level. Paired Samples t-Test,t statistics were highly significant (<.001) indicating a significant difference between pre- and post-PSE scores across all 80 records. For conceptual content analysis, students (unspecific to cohort) identified practicing mock evaluations and access to real patients as factors impacting their confidence prior to the first simulation activity. Post-survey students indicated exposure to more real and complex patients as influential factors in their confidence.

Conclusions: Students experienced significant improvements in confidence related to the management of complex outpatients following an 8-week simulation-based course. Prior exposure to the University’s first clinical experience resulted in fewer gains in confidence compared to students who had not completed a full-time clinical experience. There was variance in factors that could improve confidence between the cohorts but overall, students indicated a need for more contact with real patients and clinical skills practice.

Implications: Health education programs should consider interweaving SLB within the curriculum and course objectives to improve DPT student confidence in managing complex outpatients. This in-depth simulation education method for complex outpatient management would be beneficial prior to any full-time clinical experience.

Funding acknowledgements: None

Keywords:
Simulated Learning
Patient management
Curriculum

Topics:
Education
Education: clinical
Disability & rehabilitation

Did this work require ethics approval? Yes

Institution: University of St Augustine for Health Sciences

Committee: IRB

Ethics number: UR-0129-407