Delivering introductory physiotherapy clinical placements incorporating simulated learning experiences in rural settings

OBJECTIVE

To investigate the delivery, in rural settings, of introductory physiotherapy clinical placements incorporating simulation and describe the impact of these placements on the uptake of longer-term rural immersion opportunities.

DESIGN

Retrospective cohort design.

SETTING

The University of Newcastle and the University of Newcastle Department of Rural Health (UONDRH), New South Wales, Australia.

PARTICIPANTS

Data from undergraduate physiotherapy students were included.

INTERVENTION

Second-year University of Newcastle physiotherapy students undertake an introductory placement which includes one week of simulated learning followed by a two-week traditional health care placement. Supervisor training and active promotion of placements were undertaken to increase the capacity of rural sites to deliver these placements, including both simulation and immersion components.

MAIN OUTCOME MEASURE(S)

Data relating to numbers of students undertaking introductory placements and final-year rural immersion experiences in the UONDRH between 2012 and 2020 were described. A simple review of the placement strategy was also undertaken.

RESULTS

Introductory placements incorporating simulation were successfully implemented in the UONDRH settings and have continued annually. Physiotherapy staff in the UONDRH have been upskilled and have supported local clinicians to increase their supervisory capacity. The proportion of students undertaking introductory placements supported by the UONDRH has increased considerably as has the number of students completing full-year rural immersion experiences in the UONDRH.

CONCLUSIONS

Delivering introductory physiotherapy placements incorporating simulation in rural settings was feasible and this strategy leads to increased placement capacity. Early rural clinical placement opportunities can increase students' uptake of longer-term rural immersion experiences which, in turn, can positively influence rural practice intentions.

Promoting Professional Behaviours in Physical Therapy Students Using Standardized Patient Feedback

Purpose: Physical therapy (PT) students receive feedback on their professional behaviours from academic and clinical faculty. Another avenue for providing feedback to PT students is by using standardized patients (SPs). Very little research is available on the impact of SPs' specific feedback on whether, and how, PT students learn professional behaviour, and what research is available has focused on clinical competencies, communities of practice, and broad assessments of professional behaviours. The purpose of this study was to record PT students' perspectives on how combined verbal and written SP feedback affected their professional behaviours. Method: The sample of convenience consisted of seven students enrolled in a PT professional education programme in the northeastern United States before starting their first full-time clinical experience. The students agreed to participate in an SP experience focused on professional behaviours. This study used a phenomenological approach to understand the students' perspectives on receiving a combination of verbal and written SP feedback. Results: The students' perspectives on receiving SP feedback were categorized into four themes: seeing through the patient's eyes; SPs offer unique contributions to student learning; timely, verbal feedback adds a deeper understanding of professional behaviours in preparation for the clinic; and verbal feedback promotes student self-efficacy of professional behaviours. Conclusions: Using SPs' written and verbal feedback in the curriculum can be a valuable tool for enhancing the development of PT students' professional behaviour.

Understanding the impact of simulated patients on health care learners' communication skills: a systematic review

CONTEXT

Effective communication skills are at the core of good health care. Simulated patients (SPs) are increasingly engaged as an interactive means of teaching, applying and practising communication skills with immediate feedback. There is a large body of research into the use of manikin-based simulation but a gap exists in the body of research on the effectiveness of SP-based education to teach communication skills that impact patient outcomes. The aim of this systematic review was to critically analyse the existing research, investigating whether SP-based communication skills training improves learner-patient communication, how communication skill improvement is measured, and who measures these improvements.

METHODS

The databases Medline, ProQuest (Health & Medical Complete, Nursing and Allied Health Source) and CINAHL (EBSCOhost) Education Resources Information Centre (ERIC) were searched for articles that investigated the effects of SP-based education on the communication skills of medical, nursing and allied health learners.

RESULTS

There were 60 studies included in the review. Only two studies reported direct patient outcomes, one reporting some negative impact, and no studies included an economic analysis. Many studies reported statistically significant third-party ratings of improved communication effectiveness following SP-based education; however, studies were unable to be pooled for meta-analysis because of the outcome collection methods. There were a small number of studies comparing SP with no training at all and there were no differences between communication skills, contradicting the results from studies reporting benefits. Of the 60 studies included for analysis, 54 (90%) met the minimum quality score of 7/11, with four articles (7%) scoring 11/11.

CONCLUSION

SP-based education is widely accepted as a valuable and effective means of teaching communication skills but there is limited evidence of how this translates to patient outcomes and no indication of economic benefit for this type of training over another method.

Clinical simulation with dramatization: gains perceived by students and health professionals

Objective:

to identify in the literature the gains health students and professionals perceive when using clinical simulation with dramatization resources.

Method:

integrative literature review, using the method proposed by the Joanna Briggs Institute (JBI). A search was undertaken in the following databases: Latin American and Caribbean Health Sciences Literature, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Scopus, Scientific Electronic Library Online.

Results:

53 studies were analyzed, which complied with the established inclusion criteria. Among the different gains obtained, satisfaction, self-confidence, knowledge, empathy, realism, reduced level of anxiety, comfort, communication, motivation, capacity for reflection and critical thinking and teamwork stand out.

Conclusion:

the evidence demonstrates the great possibilities to use dramatization in the context of clinical simulation, with gains in the different health areas, as well as interprofessional gains.

Simulated Patients in Physical Therapy Education: Systematic Review and Meta-Analysis

BACKGROUND

Traditional models of physical therapy clinical education are experiencing unprecedented pressures. Simulation-based education with simulated (standardized) patients (SPs) is one alternative that has significant potential value, and implementation is increasing globally. However, no review evaluating the effects of SPs on professional (entry-level) physical therapy education is available.

PURPOSE

The purpose of this study was to synthesize and critically appraise the findings of empirical studies evaluating the contribution of SPs to entry-level physical therapy education, compared with no SP interaction or an alternative education strategy, on any outcome relevant to learning.

DATA SOURCES

A systematic search was conducted of Ovid MEDLINE, PubMed, AMED, ERIC, and CINAHL Plus databases and reference lists of included articles, relevant reviews, and gray literature up to May 2015.

STUDY SELECTION

Articles reporting quantitative or qualitative data evaluating the contribution of SPs to entry-level physical therapy education were included.

DATA EXTRACTION

Two reviewers independently extracted study characteristics, intervention details, and quantitative and qualitative evaluation data from the 14 articles that met the eligibility criteria.

DATA SYNTHESIS

Pooled random-effects meta-analysis indicated that replacing up to 25% of authentic patient-based physical therapist practice with SP-based education results in comparable competency (mean difference=1.55/100; 95% confidence interval=-1.08, 4.18; P=.25). Thematic analysis of qualitative data indicated that students value learning with SPs.

LIMITATIONS

Assumptions were made to enable pooling of data, and the search strategy was limited to English.

CONCLUSION

Simulated patients appear to have an effect comparable to that of alternative educational strategies on development of physical therapy clinical practice competencies and serve a valuable role in entry-level physical therapy education. However, available research lacks the rigor required for confidence in findings. Given the potential advantages for students, high-quality studies that include an economic analysis should be conducted.