International Journal of Healthcare Simulation

Introduction:

Physiotherapy students must complete 1000 hours of practice placement experience during a pre-registration programme. It is essential that academic practice aids in preparing students for practice placements. A reduced level of confidence regarding the ‘unknown’ of working within a clinical environment can be challenging, especially for international students. Simulation-based learning could be a tool to aid the transition from the classroom environment to practice placement, through improving student confidence [1]. The purpose, within the curriculum provision, was to design, implement and formally evaluate a developmental simulation-based learning experience.

The aim of the research was to explore the effectiveness of simulation-based learning for physiotherapy placement preparation, from the students’ perspective.

The objectives of this study included:

● To understand whether the simulation experience was authentic, in relation to the possible practice placement environment.

● To understand factors impacting on confidence and feelings of preparedness for placement and whether simulation has an impact.

● To understand, from the student’s perspective, the strengths and areas for improvement within simulation design in the physiotherapy curriculum.

Methods:

The scenario’s used were developmental in nature and the physiotherapy students were required to assess and treat the ‘simulated patient’ on day 1 of a hospital admission, on day 2 and then the home setting follow-up after discharge. Two scenarios used the ‘observer-participant’ format and the other was active participation from all students. The learning outcomes, content and debrief were aligned to the objectives of the practice placement module and the Chartered Society of Physiotherapy (CSP) Common Placement Assessment Form (which is the assessment criteria for a practice placement).

Semi-structured interviews were conducted with physiotherapy students after completion of their first practice placement to gain an understanding as to whether, on reflection, the simulation-based learning experience aided their preparation for practice placement.

Results:

A total of 6 Physiotherapy students who met the inclusion criteria were interviewed. An inductive thematic analysis was completed, which identified three themes and respective sub-themes. Firstly, the feeling of preparedness, which was accounted to the application of clinical reasoning strategies during SBL and the replication to ‘real-life’ scenarios which students encountered on practice placement. The second theme was the consensus of SBL being a positive experience. The concept of reflection, filtered through the debrief process, was the main sub-theme and an identified factor that contributed to the request of further opportunities for SBL to be embedded within the physiotherapy curriculum. The last theme related to the structure, which included the sub-themes of managing the complexity, service-user involvement and the operational format.

Discussion:

Simulation-based learning was found to be beneficial for students and aids the preparation for practice placement experience. This was achieved through realism of scenario design, involvement of service users as the simulated patients and the practice of key skills such as clinical reasoning and communication, which are transferable to placement. The ‘observer-participant’ format was well received and a suggested area for improvement was to increase the environmental complexity.

Ethics statement:

Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

References

1. Wright A, Moss P, Dennis DM, Harrold M, Levy S, Furness AL, Reubenson A. The influence of a full-time, immersive simulation-based clinical placement on physiotherapy student confidence during the transition to clinical placement. Advances in simulation (London). 2018;3:3.