To assess physiotherapy students’ knowledge and self-efficacy after 12 sessions (two 2-hour sessions per week for six weeks) of high-fidelity acute care physiotherapy simulations with role-play.
Students were invited to participate in an anonymous, online survey before their clinical simulation unit and after their first acute care clinical placement. The survey consisted of 28 questions using a 6-point Likert scale with response options ranging from Strongly Disagree (1) to Strongly Agree (7). Questions were about their comfort in performing tasks (such as, reviewing vital signs, assessing critical laboratory values and X-rays, identifying medications and implications for therapy, communicating with multidisciplinary team members, and assessing the method of supplementary oxygen delivery). After placement, students answered five additional questions reflecting on the role of simulation in achieving certain competencies. These were ‘I feel that my participation in simulation improved my…’ a) confidence in managing lines and tubes when mobilising patients, b) ability to transfer an acute patient from bed to chair, c) ability to safely walk a patient with or without an aid and d) clinical decision making on placement. Students were also asked, ‘I felt that the simulation experiences in the acute care subject prepared me for my acute care placement’. A complete case analysis was performed. The percent agreement of student comfort was compared before simulation and after placement. A 70% agreement threshold indicated comfort with tasks.
Eighteen students completed the survey before simulation and after clinical placement. Before simulation, students were comfortable with 1/28 items, whereas responses after placement show students were comfortable with 21/28 items. Students were less comfortable with interpreting a patient's laboratory values (67% agreement), identifying a patient's current medications and their implications for therapy (67% agreement), performing auscultation (67% agreement), explaining precautions/contraindications for medications (47% agreement), demonstrating proper management of chest tubes (50% agreement), demonstrating proper use of various positioning devices in the ICU (44% agreement), using objective measures to determine etiology, and signs/symptoms of managing a patient with cognitive impairment (44% agreement). All students agreed that simulation experiences in the acute care subject prepared them for their acute care placement and 100% also said it gave them confidence to manage lines, transfer patients from a bed to a chair, walk a patient (with or without an aid), and clinical decision making.
High-fidelity acute clinical simulation prepares students for acute care placements. The combination of the simulation experience and placement provides students with the confidence to perform most clinical tasks.
Clinical simulations are a good addition to physiotherapy course to prepare students for acute care placements. Although students perceived simulations as valuable, they still felt uncomfortable performing some skills after simulation and placement. These skills could be emphasized more during simulation.
Acute care
education
