International Journal of Healthcare Simulation

Background:

‘Preparing for on-call’ is a level 6 physiotherapy module delivered face-to-face to enable synthesis of respiratory knowledge and application to real ‘on-call scenarios’, preparing students for the transition into clinical practice. Due to lockdown, we could not deliver this module face-to-face and changed it to a ‘virtual delivery’ for teaching and assessment.

Aims:

The aim of the study was to deliver a face-to-face SBE module and assessment virtually.

Methods/design:

We used the principles of SBE design ^[1] pre-brief, virtual simulation and debrief. We involved simulated patients (SPs) (in their own homes, with blurred background, thereby simulating a hospital environment). They were delivered appropriate props: hospital gown, range of oxygen masks, BP cuff and saturation probe. The SPs were trained online in how to portray respiratory deterioration, a nurse facilitator was trained to give appropriate information about the patient and a physiotherapy clinical educator supported the students with their A-E assessment and management of the patient. Although normal ‘hands-on’ could not be achieved, we ensured that the students demonstrated their clinical reasoning using the ‘think aloud’ technique ^[2].

Implementation:

We achieved a ‘virtual on-call experience’ by involving SPs, confederate nurse facilitators and physiotherapy clinical educators working synchronously with students via Microsoft Teams. With teaching groups of eight, we kept to the principles of SBE by pre-briefing, running a realistic scenario with clear learning outcomes, followed by a debrief facilitated by the nurse and physiotherapy educator. Students were able to rehearse their clinical reasoning by ‘thinking out-loud’; these preparatory ‘virtual on-call scenarios’ enabled them to become familiar with ‘performing’ on Teams. This ‘process-familiarity’ led to a preparedness, professionally and psychologically for their subsequent ‘virtual on-call assessments’. Four on-call scenarios were delivered in this module, enabling the learning outcomes to be achieved via this method of delivery. The virtual on-call assessment was run in three virtual rooms on Teams, with an SP, a clinical educator as an examiner, a confederate nurse, and one student in each room. The assessment scenario ran for 30 minutes replicating the normal examination time, giving students the opportunity to rehearse the skills they had learnt in the module. Additional supportive information was given to the students by sharing a ‘patient monitor’ (screenshots from the ALS Laerdal manikin monitors). In total, 28 assessments were achieved in 1 day, with two taken separately for extenuating circumstances. Student feedback has been positive with all students passing, enabling graduation this summer.