High-Fidelity Simulation Improves Long-Term Knowledge of Clinical Swallow Evaluation

Read the Feed: High-Emotion Simulation of Preterm Feeding to Enhance Graduate-Level Training

PURPOSE

Therapeutic bottle feeding is a critical skill for speech-language pathologists (SLPs) managing the increasing and medically complex neonatal intensive care unit (NICU) and early intervention caseloads. Thus, we explored the role of a high-emotion preterm simulator, known as "Paul," to increase knowledge, skills, and confidence related to infant feeding management for speech-language pathology graduate students.

METHOD

A randomized controlled study compared learning outcomes of 27 participants following either a 1-hr lecture or 1-hr training with a preterm simulator. Outcomes included knowledge demonstrated on written examination, accuracy in identifying stress cues during simulated feeding, and self-reported anxiety levels related to clinically assessing infant feeding.

RESULTS

No baseline group differences were found on written examination or during a simulated bottle feeding. Both groups improved in written examination scores and identification of stress cues (p < .001). Gains in written examination scores did not significantly differ between groups; however, after training, the simulator group correctly identified more stress cues during a simulated bottle feeding (p < .001), and the lecture group reported reduced anxiety related to clinically evaluating infant feeding compared to simulator-trained students (p < .05).

CONCLUSIONS

All students demonstrated gains in written knowledge and identification of stress cues; however, simulation-based training was superior in developing the feeders' ability to identify stress cues during a hands-on simulated bottle-feeding scenario. Lecture-based training may have inflated students' perceptions in their clinical skills as they were less accurate in identifying stress cues during a simulated feeding but reported significantly reduced anxiety for administering a clinical evaluation of infant feeding compared to simulation-trained students. Hands-on training using high-fidelity simulation may capitalize on experiential learning to better build clinical feeding skills for future SLPs who may serve in NICU and early intervention settings, while eliminating the risk of potential errors during learning that could affect fragile neonates.

Promoting critical thinking through simulation-based healthcare training (SBHT): A scoping review

Background. Critical thinking (CT) is an essential graduate attribute for health professions (HP) students. Yet, achieving a higher level of CT in HP students through education is often difficult for educators. SBHT has proven to be an effective strategy to promote CT, but it is not clear how this educational pedagogy should be implemented to achieve higher levels of CT.Objective. To identify and describe the use of simulation-based healthcare training (SBHT) strategies to promote CT in HP students. Methods. Based on the revised methodology of Levac et al., a scoping review was conducted on studies reporting an improvement in CT through simulation-based healthcare education published between January 2010 and August 2021.Results. Twenty articles were included. Through thematic analysis, three main themes were identified: contact simulations, computer-based simulations, and debriefing. The focus was on how these approaches were used to promote CT. Various subthemes were also identified. Conclusion. Correctly planning and implementing a simulation-based experience that relates to the relevant learning activities, combined with repeat practice and guided reflection during the debriefing stage, improves the CT skills of HP students.

Increasing Student Confidence With Medically Complex Infants Through Simulation: A Mixed Methods Investigation

PURPOSE

The purpose of this study was to compare student knowledge and confidence, related to the assessment and management of oral feeding readiness in medically complex infants, following a written case study versus a high-fidelity human patient simulation (HPS).

METHOD

A sequential, two-phase, embedded mixed methods design was conducted. Participants were two sequential cohorts of second-year speech-language pathology graduate students enrolled in a didactic Pediatric Dysphagia course. At the end of the course, students completed the same case scenario presented as a written case study (control group; N = 28) or as an HPS (experimental group; N = 24). Pre- and post-knowledge assessment results and self-assessments of confidence conducted at three time points were compared.

RESULTS

All students made gains in knowledge, regardless of intervention (written case study or HPS). Despite different baselines, the percent change in knowledge was significant with the control group improving 33% and the experimental group improving 76% from baseline. Students in the experimental group demonstrated significantly greater gains in confidence with skills enhanced by the hands-on, immersive experience of HPS. Qualitative analysis further identified factors contributing to increased confidence with all students reporting that experience significantly contributes to their confidence in their ability to treat patients.

CONCLUSIONS

While knowledge outcomes were similar between the groups, the confidence that the experimental group gained through the hands-on experiences of HPS fosters student development as confident professionals in assessing feeding readiness and managing medically complex infants. Results support integration of simulation into the graduate curriculum to support student learning.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19233504.